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（申请人提供）：美国人口年龄结构的变化将急剧增加老年人骨质疏松性骨折的数量；这一增长将不成比例地影响少数族裔和男性。因此，了解这些人群骨质疏松症的流行病学非常重要。虽然骨折率存在明显的种族/民族差异，但其起源尚不清楚。拟议的研究将是一项全面的努力，通过重点关注骨折的两个主要“上游”决定因素的标志物：跌倒和骨质脆性，来进一步了解骨折率中种族/民族差异的根本原因。波士顿地区社区健康/骨骼 (BACH/Bone) 调查是一项针对随机选择的 1,219 名 29-80 岁黑人、西班牙裔和白人男性的骨骼健康研究。 BACH/Bone 员工的工作效率非常高，为同行评审期刊发表了 10 多篇论文。我们建议在基线后约 6.5 年开始对约 825 名男性进行第二波数据收集，届时该群体的年龄将在 35-86 岁之间。拟议研究的具体目标是，在种族/民族多样化、基于人群的男性样本中：1）估计骨强度和跌倒风险标记的纵向变化，无论是否对已知风险因素进行调整； 2) 确定社会因素、个人危险行为和健康状况以及生理影响对跌倒风险和骨强度标志物中种族/民族差异的相对贡献； 3) 建立第一个针对年龄和种族/民族群体的、基于人群的骨微结构估计，并确定观察到的年龄和种族/民族差异的决定因素； 4) 确定骨负荷与骨强度的比率（“风险因素”）是否存在年龄和种族/民族差异； 5) 检查遗传血统是否会导致跌倒风险和骨强度标志物的变化，超出可归因于自我认定的种族/民族的变化。 BACH/Bone 队列的代表性和种族/民族多样性是独一无二的，因此，该研究的潜在影响是巨大的。通过采用最先进的措施，重点关注跌倒风险和骨骼强度的标记，它将为我们理解骨脆性的种族/民族差异背后的难以捉摸的机制做出里程碑式的贡献。公共卫生相关性：波士顿地区社区健康/骨骼调查是一项观察性研究，旨在研究人口老龄化、社会结构、健康和生活方式、激素、遗传因素、跌倒风险标记以及骨强度之间的复杂关系。基于种族/民族多样化的老年男性样本。研究结果将继续帮助我们了解骨质脆性、骨质流失和骨质疏松症。