Racial/Ethnic Disparities in Fall Risk and Bone Strength Among Men

男性跌倒风险和骨强度的种族/民族差异

• 批准号: 8064354
• 负责人: Andre B. Araujo
• 金额: $ 91.23万
• 依托单位: NEW ENGLAND RESEARCH INSTITUTES, INC.
• 依托单位国家: 美国
• 财政年份: 2002
• 资助国家: 美国
• 起止时间: 2002-05-15 至 2014-04-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/8064354
• 关键词: Accounting; Affect; Age; Aging; Area; Back; Biological; Body Composition; Bone Density; Bone Tissue; Boston; Clinic; Clinical; Community Health; Complex; Coupled; Data; Data Collection; Development; Disease; Elderly; Enrollment; Epidemiology; Ethnic Origin; Ethnic group; Event; Fracture; Genetic; Health; Health Status; Hip Fractures; Hip region structure; Hispanics; Hormones; Individual; Journals; Life; Life Style; Light; Measures; Minority; Osteoporosis; Paper; Peer Review; Persons; Physical Function; Physiological; Population; Population Heterogeneity; Prevention; Prevention strategy; Primary Prevention; Race; Relative (related person); Reporting; Research; Residual state; Resource Allocation; Risk; Risk Behaviors; Risk Factors; Sampling; Secondary Prevention; Services; Shapes; Structure; Surgeon; Surveys; United States National Institutes of Health; Variant; Woman; bone; bone health; bone loss; bone strength; cohort; cost; density; fall risk; falls; follow-up; insight; men; osteoporosis with pathological fracture; population based; racial and ethnic; racial and ethnic disparities; racial/ethnic difference; research study; skeletal; social; trend

DESCRIPTION (provided by applicant): The changing shape of the U.S. population age structure will dramatically increase the number of osteoporotic fractures in the elderly; the increase will disproportionately affect minorities and men. It is therefore important to understand the epidemiology of osteoporosis in these populations. While there are clear racial/ethnic differences in fracture rates, their origins are not understood. The proposed study will be a comprehensive effort to further our understanding of the fundamental causes of racial/ethnic disparities in fracture rates by focusing on markers of two primary `upstream' determinants of fracture: falls and bone fragility. The Boston Area Community Health/Bone (BACH/Bone) Survey is a study of skeletal health in a randomly selected group of 1,219 black, Hispanic, and white men between 29-80 y. BACH/Bone staff have been very productive, producing over 10 papers for peer-reviewed journals. We propose a second wave of data collection on ~825 men to begin ~6.5 y after baseline, when the cohort will be between 35-86 y. The Specific Aims of the proposed study are to, in a racially/ethnically diverse, population-based sample of men: 1) Estimate longitudinal changes in markers of bone strength and fall risk, with and without adjustment for known risk factors; 2) Determine the relative contributions of social factors, individual risk behaviors and health status, and physiological influences to racial/ethnic differences in markers of fall risk and bone strength; 3) Establish the first age- and racial/ethnic group-specific, population-based estimates of bone microarchitecture, and identify determinants of observed age and racial/ethnic differences; 4) Determine whether there are age and racial/ethnic differences in the ratio of bone loads to bone strength (the `factor of risk'); 5) Examine whether genetic ancestry contributes to variations in markers of fall risk and bone strength beyond that attributable to self-identified race/ethnicity. The representativeness and racial/ethnic diversity of the BACH/Bone cohort are unique, and, as such, the potential impact of the study is enormous. By focusing upstream on markers of fall risk and bone strength with state-of-the-art measures, it will make landmark contributions to our understanding of the elusive mechanisms underlying racial/ethnic differences in bone fragility. PUBLIC HEALTH RELEVANCE: The Boston Area Community Health/Bone Survey is an observational research study examining the complex relationships between aging, social structure, health and lifestyle, hormones, genetic factors, and markers of fall risk as well as bone strength in a population-based sample of racially/ethnically diverse aging men. Findings will continue to inform our understanding of bone fragility, bone loss, and osteoporosis.

描述（由申请人提供）：美国人口年龄结构的变化将大大增加老年人骨质疏松骨折的数量；增加将对少数民族和男人产生不成比例的影响。因此，重要的是要了解这些人群中骨质疏松症的流行病学。尽管破裂率存在明显的种族/种族差异，但尚不清楚它们的起源。拟议的研究将是一项全面的努力，以进一步理解裂缝率的种族/种族差异的基本原因，通过关注裂缝的两个主要“上游”决定因素的标记：跌倒和骨骼脆弱性。波士顿地区社区健康/骨（BACH/骨骼）调查是一项随机选择的1,219组黑色，西班牙裔和白人男子的骨骼健康研究的研究。 Bach/Bone员工非常有生产力，为同行评审期刊生产了10多篇论文。我们建议在基线后〜6.5 y上进行〜825名男性的第二波数据收集，当时该队列将在35-86 y之间。拟议的研究的具体目的是在种族/种族多样的基于人群的男性样本中：1）估计骨骼强度和跌落风险标志物的纵向变化，并对已知的风险因素进行调整，并没有调整； 2）确定社会因素，个人风险行为和健康状况的相对贡献，以及生理影响对种族/种族差异的影响跌落风险和骨骼力量的标志； 3）建立第一个年龄和种族/种族特异性的，基于人群的骨微体系结构的估计，并确定观察到的年龄和种族/种族差异的决定因素； 4）确定骨负荷与骨骼强度之比的年龄和种族/种族差异（风险因素'）； 5）检查遗传血统是否有助于降至自我识别种族/种族的跌落风险和骨骼强度标记的变化。 Bach/骨头队列的代表性和种族/种族多样性是独一无二的，因此，研究的潜在影响是巨大的。通过通过最先进的措施将上游专注于跌落风险和骨骼强度的标记，它将为我们理解骨骼脆弱性种族/种族差异的难以捉摸的机制做出里程碑意义。公共卫生相关性：波士顿地区社区健康/骨调查是一项观察性研究，研究了衰老，社会结构，健康和生活方式，荷尔蒙，遗传因素，遗传因素和跌落风险的标志以及骨骼强度的复杂关系，种族/种族多样化的衰老男人。调查结果将继续为我们对骨骼脆弱，骨质流失和骨质疏松症的理解提供信息。