Study of Women's Health Across the Nation-Endocrine Lab

描述(申请人提供)：全国妇女健康研究(SWAN)是一项多中心、多种族、以社区为基础的纵向研究，旨在描述更年期过渡期间发生的生物和心理社会变化，并评估其对妇女健康的影响。目前和过去的资金(SWAN I和SWAN II)支持六年的后续行动，在这六年结束时，60%的可观察到的绝经后过渡将发生。这项竞争性续签申请(SWAN III)和一项单独的竞争性补充申请共同申请资金，以完成总共10次队列随访，使我们能够捕捉到91%的可观察到的绝经后过渡，并提供了更具代表性的样本。额外的数据将允许重点关注绝经后期、围绝经期和绝经早期，这些时期在文献中还没有得到很好的研究。随着女性绝经早期(最后一次月经后两年)的结束，我们将从每年一次的随访计划转变为每两年一次的随访计划，每隔一年通过邮件和电话联系。这将为在Swan III之后进行更具成本效益和更低强度的后续研究奠定基础。我们将继续目前的观察，并在四个科学项目领域(卵巢衰老；症状、风险因素、功能和衰老；心血管风险因素；以及骨量的决定因素和结果)中的每一个领域开展新的科学研究。这项新的科学包括 测量血管硬度以评估早期心血管疾病、唾液皮质醇水平、使用新开发的DEXA技术进行脊椎形态测量，以及使用SWAN研究人员开发的测试系统测量循环雄激素和总生物活性雌激素。此外，我们将专注于将更年期和中年经历与年龄相关的结果和慢性病联系起来，包括身体和认知功能。额外的后续行动将有助于并扩大天鹅生物标本库(年度血液和尿液样本以及DNA和永生化细胞)，这是一个单独资助的组成部分，为解决未来关于健康、疾病和老龄化的假设提供了机会。有了天鹅三号，天鹅最初的许多目标都将实现。我们将建立在第一次和第二次天鹅行动期间开发的丰富基础上，并最终将这些数据与随后的与年龄相关的健康结果联系起来。

DESCRIPTION (provided by applicant): The Study of Women's Health Across the Nation (SWAN) is a multicenter, multiethnic, community based, longitudinal study designed to characterize the biological and psychosocial changes that occur during the menopausal transition and to assess their effect on women's health. Current and past funding (SWAN I and II) support six years of follow-up, at the end of which 60% of observable transitions to postmenopause will have occurred. Together, this competitive renewal application (SWAN III) and a separate competitive supplement application request funding to complete a total of 10 cohort follow-up visits, allowing us to capture 91% of observable transitions to postmenopause and providing a more representative sample. The additional data will permit a focus on the late perimenopausal and early postmenopausal periods that have not been well studied in the literature. As women reach the end of early postmenopause (two years following the final menstrual period), we will shift from an annual to a bi-annual follow-up schedule with mail and telephone contact in the alternating years. This will set the stage for cost-effective and less intensive follow-up beyond SWAN III. We will continue our current observations as well as undertake new science in each of the four scientific project areas (ovarian aging; symptoms, risk factors, functioning and aging; cardiovascular risk factors; and determinants and outcomes of bone mass). The new science includes measurement of vascular stiffness to assess early cardiovascular disease, salivary cortisol levels, vertebral morphometry using newly developed DEXA technology, and circulating androgens and total bioactive estrogens using an assay system developed by SWAN investigators. In addition, we will focus on linking the menopause and midlife experiences to age-related outcomes and chronic diseases, including physical and cognitive function. The additional follow-up will contribute to and expand the SWAN biological specimen repository (annual blood and urine samples as well as DNA and immortalized cells), a separately funded component that provides opportunities to address future hypotheses about health, disease and aging. With SWAN III, many of the original goals of SWAN will be brought to fruition. We will build upon the rich foundation developed during SWAN I and II, and ultimately link these data to subsequent age-related health outcomes.