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指导环境，以培养经前综合症（PMS）和经前焦虑症（PMDD）流行病学方面的专业知识。通过研究生课程和其他结构化活动，候选人将：1）加强内分泌学知识，重点关注维生素 D、钙和甲状旁腺激素的代谢和生理学及其与经前综合症和经前抑郁症的关系； 2) 了解激素如何影响神经功能以及如何参与情感障碍（如经前抑郁症）的病因学； 3) 发展与经前抑郁症等情感障碍相关的心理健康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，候选人还将完成一个研究项目，以评估血浆和遗传因素与经前综合症/经前抑郁症（PMS/PMDD）发病率之间的关系。该项目将建立在一项初步研究的有趣发现之上，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着降低 30-40%。该研究计划的具体目标是：1）评估黄体期血浆25-羟基维生素D、1,25-二羟基维生素D、钙和PTH水平与PMS/PMDD风险之间的关系； 2）评估常见维生素D受体多态性（包括Fok1、Bsm1、Apa1和Taq1）是否影响经前综合症/经前抑郁症（PMDD）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 PTH 水平与 PMS/PMDD 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个前瞻性和最全面的研究。总体而言，该职业发展奖将为候选人提供实现成为独立流行病学家的目标所需的技能，该流行病学家可以为 PMS/PMDD 病因学、评估、预防和治疗方面的知识做出重大贡献。与公共健康的相关性：这将是第一个关于维生素 D、钙和 PTH 在经前综合症 (PMS) 和经前抑郁症 (PMDD) 中的作用的前瞻性研究，这些疾病对大量绝经前妇女造成严重损害。确定减少经前综合症/经前抑郁障碍发生率的可改变因素将为女性提供降低风险的机会，而且比目前的治疗方案缺点更少。

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.