Epidemiology of premenstrual syndrome and premenstrual dysphoric disorder

描述（由申请人提供）：该职业发展奖的目的是为候选人提供一个受指导的环境，使其在经前综合症（PMS）和经前焦虑症（PMDD）的流行病学方面发展专业知识。通过研究生课程和其他有组织的活动，候选人将：1)加强内分泌学的知识，重点研究维生素D、钙、甲状旁腺激素的代谢和生理及其与经前症候群和经前不悦症的关系；2)了解激素如何影响神经功能，并参与情感性障碍（如经前不悦症）的病因；3)发展与经前不悦症等情感性障碍有关的精神卫生和精神流行病学专业知识；4)扩展她作为流行病学家的技能，包括在流行病学中使用遗传因素和生化标记。此外，候选人将完成一项研究项目，评估血浆和遗传因素与经前症候群/经前不悦症发病率之间的关系。该项目将建立在一项有趣的初步研究结果的基础上，该研究表明，摄入大量维生素D和钙的女性患经前综合症的风险显著降低30- 40%。本研究计划的具体目的是：1)评价黄体期血浆25-羟基维生素D、1,25 -二羟基维生素D、钙、甲状旁腺素水平与经前综合征/经前抑郁风险的关系；2)评估常见的维生素D受体多态性包括Fok1、Bsm1、Apa1和Taq1是否影响经前症候群/经前不悦症的风险；3)评估年龄和基因型是否可能改变血浆维生素D、钙和甲状旁腺素水平与经前综合征/经前不悦症发病率之间的关系。这将是迄今为止对这些关系进行的第一次前瞻性和最全面的研究。总的来说，这个职业发展奖项将为候选人提供她所需的技能，以实现她成为一名独立的流行病学家的目标，她可以为PMS/PMDD的病因、评估、预防和治疗方面的知识做出重大贡献。与公共卫生的相关性：这将是第一个关于维生素D、钙和甲状旁腺激素在经前综合症和经前抑郁症中的作用的前瞻性研究，这些疾病会导致大量绝经前妇女的严重损害。确定减少经前综合症/经前不悦症发病率的可改变因素将为妇女提供减少其风险的机会，比目前的治疗方案的缺点更少。

DESCRIPTION (provided by applicant): The objective of this career development award is to provide the candidate with a mentored environment in which to develop expertise in the epidemiology of premenstrual syndrome (PMS) and premenstrual dysphoric disorder (PMDD). Through graduate coursework and other structured activities, the candidate will: 1) strengthen her knowledge of endocrinology, focusing on the metabolism and physiology of vitamin D, calcium, and parathyroid hormone and their relationship to PMS and PMDD; 2) develop an understanding of how hormones affect neurologic function and are involved in the etiology of affective disorders such as PMDD; 3) develop expertise in mental health and psychiatric epidemiology relating to affective disorders such as PMDD; and 4) expand her skills as an epidemiologist to include the use of genetic factors and biochemical markers in epidemiology. In addition, the candidate will complete a research project to assess the relationship between plasma and genetic factors and the incidence of PMS/PMDD. This project will build upon the interesting findings of a preliminary study which suggested that women who had high intakes of vitamin D and calcium had significant 30-40 percent reductions in risk of developing PMS. Specific aims of the research plan are to: 1) evaluate the relationship between luteal phase plasma levels of 25-hydroxyvitamin D, 1, 25-dihydroxyvitamin D, calcium and PTH and risk of PMS/PMDD; 2) evaluate whether common vitamin D receptor polymorphisms including Fok1, Bsm1, Apa1, and Taq1 affect risk of PMS/PMDD; and 3) evaluate whether age and genotype may modify the relationship between plasma vitamin D, calcium and PTH levels and incidence of PMS/PMDD. This will be the first prospective and most comprehensive study of these relationships conducted to date. Overall, this career development award will provide the candidate with the skills she needs to achieve her goals of becoming an independent epidemiologist who can contribute significantly to knowledge of PMS/PMDD etiology, assessment, prevention and treatment. Relevance to public health: This will be the first prospective study of the role of vitamin D, calcium and PTH in PMS and PMDD, disorders that cause substantial levels of impairment in large numbers of premenopausal women. The identification of modifiable factors that reduce PMS/PMDD incidence will provide women opportunities for reducing their risk with fewer drawbacks than current treatment options.