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，以发展经前综合征（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的活动，候选人将：1）加强她的内分泌学知识，重点是维生素D，钙和甲状旁腺激素的代谢和生理学及其与PMS和PMDD的关系; 2）了解激素如何影响神经功能，并参与情感障碍如PMDD的病因; 3）发展与情感障碍（如PMDD）相关的心理健康和精神病学方面的专业知识;以及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志物。此外，候选人将完成一项研究项目，以评估血浆和遗传因素与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的基础上，该研究表明，摄入大量维生素D和钙的妇女患PMS的风险显著降低30- 40%。本研究计划的具体目的是：1）评估黄体期血浆25-羟维生素D、1，25-二羟维生素D、钙和PTH水平与PMS/PMDD风险的关系; 2）评估常见维生素D受体Fok 1、Bsm 1、Apa 1和Taq 1多态性是否影响PMS/PMDD风险;评估年龄和基因型是否可以改变血浆维生素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次前瞻性和最全面的研究。总的来说，这个职业发展奖将为候选人提供她需要的技能，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病因学，评估，预防和治疗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PTH在PMS和PMDD中作用的前瞻性研究，这些疾病会导致大量绝经前妇女的严重损害。确定可改变的因素，降低PMS/PMDD的发病率将提供妇女的机会，降低其风险，比目前的治疗方案更少的缺点。

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.