Predictors and Consequences of Subchondral Bone Attrition in Osteoarthritis

骨关节炎软骨下骨磨损的预测因子和后果

基本信息

批准号：
7686372
负责人：
TUHINA NEOGI
金额：
$ 13.07万
依托单位：
BOSTON UNIVERSITY MEDICAL CAMPUS
依托单位国家：
美国
项目类别：
财政年份：
2007
资助国家：
美国
起止时间：
2007-09-14 至 2012-08-31
项目状态：
已结题

来源：
https://reporter.nih.gov/project-details/7686372
关键词：
Affect Age Aging Arthritis Blood Blood specimen Bone Density Bone remodeling Boston Braces-Orthopedic appliances Cartilage Clinical Research Coagulation Process Cohort Studies Collaborations Complex Data Defect Degenerative polyarthritis Development Disease Elderly Environment Epidemiologic Studies Epidemiology Epiphysial cartilage Evaluation Failure Focal Adhesions Fracture Goals Growth Investigation Joints Knee Knee Osteoarthritis Lateral Lead Limb structure Magnetic Resonance Imaging Measures Mechanics Medial Mentorship Morbidity - disease rate Multicenter Studies Nutritional Pain Participant Pathology Persons Play Population Positioning Attribute Prevalence Property Public Health Regulation Research Research Personnel Research Training Rheumatism Risk Role Scientist Severities Shapes Stress Surface Symptoms Therapeutic Intervention Thinking Tissues Universities Vitamin D Vitamin K aging population bone bone health bone quality bone turnover career cohort depression disability high risk interest medical schools mineralization prevent programs prospective response rheumatologist therapeutic target

项目摘要

DESCRIPTION (provided by applicant): I am a rheumatologist who is undertaking research training under the mentorship of Dr. David T. Felson at Boston University School of Medicine. I am also pursuing a doctoral degree in Epidemiology. My immediate career goals are to pursue further clinical research training to establish myself as an independent investigator. My long-term goals are to continue in an academic position as a clinician scientist, with a research career focused on epidemiologic study of rheumatic diseases. At present, my interests lie in studying pathophysiologic contributors to osteoarthritis (OA), and in particular, factors related to bone health in OA. Dr. Felson and his research team have a proven track-record in OA research and have made numerous important contributions to the field. In this research environment, I've already begun to explore the association of vitamin K, a nutritional factor with bone effects, with OA in collaboration with Dr. Sarah Booth, a collaborator on this proposed study. This proposed study will extend this collaboration to study additional aspects of OA by focusing on factors that are associated with subchondral bone attrition in OA, which is a depression of the subchondral bony surface unrelated to gross fracture. Subchondral bone is thought to play an important role in both the pain and progression of OA. The altered properties of subchondral bone likely reflect both mechanical and systemic factors. We propose examining the relation of subchondral bone attrition on knee MRI with limb alignment/bone mineral density, and nutritional factors related to bone health measured in blood (vitamins D and K), and the interaction of these factors, using data from 1600 participants of the Multicenter OA Study (MOST), a large 30-month prospective cohort. We also propose examining the relation of subchondral bone attrition with cartilage defects on MRI, and with knee pain. Thus, this study proposes to examine potential contributors to the development and progression of OA, and identify potential targets for therapeutic strategies. Relevance: OA is the most common form of arthritis with no proven therapies for its management. Given our aging population, this constitutes a major public health concern. If we determine that mechanical and systemic factors interact to produce bony abnormalities in OA, this would suggest that both systemic and mechanical aspects must be targeted to successfully treat OA, including possibly antiresorptive therapy and vitamins D and K supplements in combination with knee braces.

描述（由申请人提供）：我是一名风湿病学家，正在波士顿大学医学院 David T. Felson 博士的指导下接受研究培训。我还在攻读流行病学博士学位。我的近期职业目标是接受进一步的临床研究培训，使自己成为一名独立研究者。我的长期目标是继续担任临床科学家的学术职务，其研究生涯专注于风湿性疾病的流行病学研究。目前，我的兴趣在于研究骨关节炎 (OA) 的病理生理学影响因素，特别是与 OA 中骨骼健康相关的因素。 Felson 博士和他的研究团队在 OA 研究方面拥有良好的记录，并为该领域做出了许多重要贡献。在这个研究环境中，我已经开始与这项拟议研究的合作者 Sarah Booth 博士合作，探索维生素 K（一种对骨骼影响的营养因子）与 OA 之间的关系。这项拟议的研究将扩大这种合作，通过关注与骨关节炎软骨下骨磨损相关的因素来研究骨关节炎的其他方面，骨磨损是与严重骨折无关的软骨下骨表面的凹陷。软骨下骨被认为在 OA 的疼痛和进展中发挥着重要作用。软骨下骨特性的改变可能反映了机械和系统因素。我们建议使用来自 1600 名参与者的数据来检查膝盖 MRI 上的软骨下骨磨损与肢体排列/骨矿物质密度、血液中测量的与骨骼健康相关的营养因素（维生素 D 和 K）以及这些因素的相互作用，以及这些因素的相互作用。多中心 OA 研究 (MOST)，一项为期 30 个月的大型前瞻性队列。我们还建议检查软骨下骨磨损与 MRI 软骨缺损以及膝盖疼痛的关系。因此，本研究建议检查 OA 发生和进展的潜在因素，并确定治疗策略的潜在目标。相关性： OA 是最常见的关节炎形式，目前还没有经过验证的治疗方法。鉴于我们的人口老龄化，这构成了一个重大的公共卫生问题。如果我们确定机械和全身因素相互作用导致 OA 骨异常，这表明必须同时针对全身和机械方面才能成功治疗 OA，包括可能的抗骨吸收治疗以及维生素 D 和 K 补充剂与护膝的结合。