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Monday, April 21
Grant Miller: Managerial Incentives in Public Service Delivery

Knee OA - intersections of obesity, inflammation and metabolic dysfunction (Continuation YR 02)

a PSC Research Project

Investigators:   Carrie Anne Karvonen-Gutierrez, Sioban D. Harlow

This project is a continuation of DRDA No. 11-PAF01615, for Yr 02 funding --
This application proposes a study that will serve as the dissertation for the doctoral degree of Carrie Karvonen-Gutierrez at the University of Michigan School of Public Health.
The goal of the study is to characterize obesity-related cardiovascular and metabolic health trajectories in relation to the onset and increased severity of knee osteoarthritis (OA) in a bi-racial population of mid-aged women with repeated (over time) knee radiographs and magnetic resonance imaging (MRI).
Osteoarthritis is the leading cause of pain, disability and functional limitations and is associated with loss of productivity and significant health care expenditures. Obesity has been the primary risk factor for knee osteoarthritis. Emerging knowledge about the importance of adipose tissue as an active endocrine organ has prompted the exploration of novel mechanisms by which obesity can influence osteoarthritis onset and progression. Consideration of obesity-related biomarkers that may have shared pathophysiology between osteoarthritis and cardiovascular and metabolic diseases may elucidate disease mechanisms and develop better treatment paradigms and therapeutic modalities.
The data source for this investigation is the Michigan site of the Study of Women?s Health Across the Nation (SWAN), which includes a site-specific study of osteoarthritis and physical functioning. Radiographs will be used to identify osteoarthritis status and its change; however, MRI data and its changes will be used to provide the information about soft tissue changes which are potentially relevant to the observed changes in metabolic characteristics. The knee radiograph data, magnetic resonance imaging assessments and body composition data acquired at the Michigan site can be combined with 14 years of cardiovascular and metabolic biomarker data from the Core Study. The Michigan SWAN Study provides the opportunity to examine both level and 14-year trajectories in cardiovascular and metabolic measures. Specifically, this study will examine the relation of (1) inflammatory markers and lipids; (2) insulin resistance; and (3) the adipocytokine, leptin, to repeated measures of radiographically-defined knee OA and selected MRI features (cartilage defects, bone marrow lesions, meniscal abnormalities, synovitis and effusion).

Funding Period: 09/01/2012 to 08/31/2013

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