Evaluating the Association between Cardiometabolic Health Over the Lifespan and Vertebral Strength

评估终生心脏代谢健康与椎骨强度之间的关联

• 批准号: 10586010
• 负责人: Nicole C Wright
• 金额: $ 68.01万
• 依托单位: UNIVERSITY OF ALABAMA AT BIRMINGHAM
• 依托单位国家: 美国
• 财政年份: 2023
• 资助国家: 美国
• 起止时间: 2023-03-01 至 2028-02-28
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10586010
• 关键词: Adult; Attenuated; Biological; Biological Markers; Biomechanics; Black race; Bone Density; Bone Resorption; Cardiometabolic Disease; Central obesity; Classification; Clinical; Clinical Data; Coronary Artery Risk Development in Young Adults Study; Data; Dependence; Dual-Energy X-Ray Absorptiometry; Elderly; Eligibility Determination; Equation; Evaluation; Female; Fracture; Goals; Health; Hyperlipidemia; Hypertension; Image; Individual; Inflammation; Intervention; Investigation; Life Cycle Stages; Lipids; Longevity; Measurement; Measures; Mediating; Medicaid; Modeling; Molecular; Non-Insulin-Dependent Diabetes Mellitus; Osteoclasts; Osteogenesis; Participant; Pattern; Predictive Factor; Public Health; Questionnaires; Race; Renal function; Research Design; Research Personnel; Role; Scanning; Spinal Fractures; Technology; Time; United States; Vertebral Bone; X-Ray Computed Tomography; abdominal CT; aged; biomarker identification; blood glucose regulation; bone health; bone mass; bone strength; burden of illness; cardiometabolism; cardiovascular health; cohort; epidemiology study; fracture risk; fragility fracture; glucose metabolism; health assessment; health data; high risk population; male; men; mortality risk; novel; nursing home length of stay; sex; spine bone structure; women of color; Adult; Attenuated; Biological; Biological Markers; Biomechanics; Black race; Bone Density; Bone Resorption; Cardiometabolic Disease; Central obesity; Classification; Clinical; Clinical Data; Coronary Artery Risk Development in Young Adults Study; Data; Dependence; Dual-Energy X-Ray Absorptiometry; Elderly; Eligibility Determination; Equation; Evaluation; Female; Fracture; Goals; Health; Hyperlipidemia; Hypertension; Image; Individual; Inflammation; Intervention; Investigation; Life Cycle Stages; Lipids; Longevity; Measurement; Measures; Mediating; Medicaid; Modeling; Molecular; Non-Insulin-Dependent Diabetes Mellitus; Osteoclasts; Osteogenesis; Participant; Pattern; Predictive Factor; Public Health; Questionnaires; Race; Renal function; Research Design; Research Personnel; Role; Scanning; Spinal Fractures; Technology; Time; United States; Vertebral Bone; X-Ray Computed Tomography; abdominal CT; aged; biomarker identification; blood glucose regulation; bone health; bone mass; bone strength; burden of illness; cardiometabolism; cardiovascular health; cohort; epidemiology study; fracture risk; fragility fracture; glucose metabolism; health assessment; health data; high risk population; male; men; mortality risk; novel; nursing home length of stay; sex; spine bone structure; women of color

ABSTRACT Fragility fractures are a substantial public health problem in older adults in the United States (US), with vertebral fractures being the most prevalent fracture type. Cardiometabolic disorders (e.g., hypertension, type 2 diabetes mellitus, abdominal obesity, and hyperlipidemia) have been associated with lower bone strength, bone mineral density (BMD), and higher fracture risk. Although several epidemiologic studies have evaluated the role of cardiometabolic health on vertebral fractures, by not accounting for the clustering of cardiometabolic conditions, many of the study findings are limited. Large studies with the ability to adjust for multiple cardiometabolic conditions are needed to provide information on the full effect of cardiometabolic conditions on vertebral health, including BMD and strength. Studies evaluating molecular mechanisms of cardiometabolic conditions on vertebral health also have study design limitations, including the lack of adjustment for clustering of other cardiometabolic conditions and/or biomarkers, and cross-sectional evaluations where either the cardiometabolic exposures and/or bone health data are assessed at a single time point. The lack of longitudinal data limits our ability to understand how cardiometabolic health is related to vertebral health. Lastly, advances in computed tomography (CT) technology has allowed for bone mass and strength measurements. Biomechanical CT (BCT) analysis has allowed researchers to obtain validated bone mass and strength on CT images obtained for other clinical indications, opening the investigation of the role of cardiometabolic disorders on vertebral health in individuals who do not routinely receive DXA imaging (i.e. women of color and men). The Coronary Artery Risk Development in Young Adults (CARDIA) study has followed 5,115 Black and White male and female adults aged 18-30 years at baseline for 35 years. The proposed study will build on CARDIA’s previously collected cardiometabolic disease and biomarker data. It will also add vertebral strength data through BCT analysis of Year 25 and 35 abdominal CT scans. Our aims are to: 1) Evaluate the association between cardiometabolic disease patterns and vertebral health, 2) Determine the role of cardiometabolic biomarkers on vertebral health, and 3) Identify cardiometabolic health factors that predict 10-year changes in vertebral health. Our overall goal is to provide unbiased and longitudinal estimates of the association between cardiometabolic health and vertebral health, and to explore the potential biologic mechanisms of these associations. Determining how cardiometabolic disease patterns and biomarkers, at clinical or subclinical levels, impact vertebral bone health is highly desirable and can lead to changes in fracture screening protocols in this high risk population.

抽象的 在美国（美国）的老年人中，脆弱性骨折是一个实质性的公共卫生问题 骨折是最普遍的断裂类型。心脏代谢疾病（例如高血压，类型2 糖尿病，腹部肥胖和高脂血症）与骨强度较低有关 矿物质密度（BMD）和更高的断裂风险。尽管一些流行病学研究评估了该作用 椎骨骨折的心脏代谢健康，不考虑心脏代谢的聚类 条件，许多研究结果受到限制。大型研究能够调整多个 需要心脏代谢条件以提供有关心脏代谢条件的全部影响的信息 椎骨健康，包括BMD和力量。评估心脏代谢分子机制的研究 椎骨健康条件还具有研究设计局限性，包括缺乏聚类的调整 其他心脏代谢条件和/或生物标志物以及横截面评估 心脏代谢暴露和/或骨骼健康数据在一个时间点评估。缺乏纵向 数据限制了我们了解心脏代谢健康与椎骨健康如何相关的能力。最后，进步 在计算机断层扫描（CT）中，技术允许进行骨骼质量和强度测量。 生物力学CT（BCT）分析使研究人员能够在CT上获得经过验证的骨骼质量和强度 获得其他临床适应症的图像，开启了心脏代谢性疾病作用的研究 关于不常规接收DXA成像的个人（即有色人种和男性的女性）的椎体健康。这 年轻人的冠状动脉风险发展（CARDIA）遵循5,115个黑白男性 和18-30岁的女性成年人在基线35岁。拟议的研究将基于Cardia的 先前收集的心脏代谢疾病和生物标志物数据。它还将通过 BCT分析25年和35次腹部CT扫描。我们的目的是：1）评估 心脏代谢疾病模式和椎骨健康，2）确定心脏代谢的作用 关于椎骨健康的生物标志物，3）确定预测10年的心脏代谢健康因素 椎骨健康的变化。我们的总体目标是提供公正的纵向估计 心脏代谢健康与椎骨健康之间的关联，并探索潜在的生物学 这些关联的机制。确定心脏代谢疾病模式和生物标志物如何 临床或亚临床水平，撞击椎骨健康是高度可取的，可能导致断裂变化 筛选该高风险人群中的方案。