Ethnic/Racial Variation in Intracerebral Hemorrhage (ERICH)

脑出血的民族/种族变异 (ERICH)

• 批准号: 8117572
• 负责人: Daniel Woo
• 金额: $ 464.18万
• 依托单位: UNIVERSITY OF CINCINNATI
• 依托单位国家: 美国
• 财政年份: 2010
• 资助国家: 美国
• 起止时间: 2010-08-01 至 2015-07-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/8117572
• 关键词: 5 year old; Accounting; Acquired Immunodeficiency Syndrome; Admission activity; Admixture; Adult; Affect; African American; Age; Alleles; Alzheimer' s Disease; American; Apolipoprotein E; Blood Vessels; Brain; Brain hemorrhage; Brain imaging; Candidate Disease Gene; Case-Control Studies; Cause of Death; Censuses; Cerebral hemisphere hemorrhage; Cessation of life; Characteristics; Classification; Clinical; Collection; DNA; Data; Data Collection; Digit structure; Disabled Persons; Epidemiology; Ethnic Origin; Ethnic group; Film; Future; Gender; General Hospitals; Genes; Genetic; Genetic Polymorphism; Genome Scan; Genomics; Genotype; Geographic Locations; Goals; Health Care Costs; Healthcare; Heart Diseases; Hemorrhage; Hispanic Americans; Hispanics; Hospitals; Human; Image; Individual; Injury; Institutes; Interview; Ischemic Stroke; Lead; Leukoaraiosis; Life; Literature; Lobar; Location; Magnetic Resonance Imaging; Malignant Neoplasms; Massachusetts; Measures; Mediating; Methodology; Methods; Mexican; Minority; Minority Groups; Morbidity - disease rate; National origin; Neurologic; Not Hispanic or Latino; Outcome; Patients; Persons; Phenotype; Population; Prevention; Process; Proteomics; Puerto Rican; Quality Control; Race; Reading; Recruitment Activity; Relative (related person); Research; Research Personnel; Risk; Risk Factors; Rupture; Sample Size; Sampling; Scanning; Severities; Socioeconomic Factors; Stroke; Survivors; Testing; United States; Universities; Variant; White Matter Disease; apolipoprotein E-2; apolipoprotein E-4; base; biobank; care burden; case control; clinical practice; comparison group; design; disability; effective therapy; experience; forest; genetic risk factor; genome wide association study; high risk; improved; interest; mortality; neuroimaging; public health relevance; racial and ethnic; racial difference; regional difference; repository; sample collection; statistical center

DESCRIPTION (provided by applicant): Intracerebral hemorrhage (ICH) occurs when a blood vessel ruptures within the brain parenchyma leading to neurologic injury and frequently death. Approximately 40-50% of patients who suffer from an ICH will die from the hemorrhage. Of the survivors, the majority are disabled. Thus, ICH is the subtype of stroke with the highest morbidity and mortality rates. Minority populations of African-Americans and Hispanics have been found to have roughly double the rate of ICH as whites and on average, have ICH at a younger age. Yet despite this disproportionate health care burden, fewer than 200 ICH cases among African-Americans and less than a hundred ICH cases among Hispanics have been collected with DNA available for testing. Our proposal is to collect 1000 cases of ICH among whites, 1000 cases of ICH among blacks, 1000 cases of ICH among Hispanics, and 3000 controls matched to the cases by race/ethnicity, age (5 years), gender and geographic location. Our long-term goal is to perform a genome-wide association study of intracerebral hemorrhage which includes a significant proportion of minorities with ICH. A genome-wide association study evaluates DNA with hundreds of thousands of markers to identify regions or genes which are associated with either a greater or lesser risk of ICH. However, the current proposal will not complete this type of analysis as insufficient numbers are currently available. Thus, the goals of the current proposal are to: 1) understand the risk factors of greatest importance for ICH among blacks and Hispanics; 2) determine differences in brain-imaging by race/ethnicity; 3) determine factors that mediate differences in outcomes rates by race/ethnicity; and 4) determine if Hispanics and African-Americans from different regions or national origin (such as Mexican, Cuban, etc.) are genetically different. To accomplish these goals, we have 11 recruitment centers representing 30 recruitment hospitals throughout the United States with large populations of African-Americans and Hispanics. White ICH cases from the same regions will also be recruited to account for regional differences in risk factors as well as a comparison group for risk factors, outcomes and imaging differences. A centralized neuroimaging center will be developed for uniform reading and analysis of films at Massachusetts General Hospital in conjunction with Georgetown University. A biorepository will be developed for centralized DNA processing and sample handling at the Miami Institute for Human Genomics. And a data and statistical center will be developed at Wake Forest University. The major advantages of this study are the experience of the investigators, particularly with recruitment of minority populations and particular interest in ICH and epidemiology; uniform definitions of cases, risk factors, and centralized analyses; and the ability to identify and recruit the large number of subjects (6000 total) required for the study. PUBLIC HEALTH RELEVANCE: Stroke is the third leading cause of death and the leading cause of disability among adults. More people are disabled by stroke than Alzheimer's disease, heart disease, cancer or AIDS. Intracerebral hemorrhage is the type of stroke with the highest death and disability rates. ICH occurs in 70,000 Americans every year and a single year of ICH cases in the United States leads to approximately $3.7 billion dollars of health care costs. African-Americans and Hispanics have twice the rate of this type of stroke than whites do and have this type of stroke at an earlier age in life. Yet we know little about the biologic differences that lead to this ethnic disparity. Our proposal will compare minorities with ICH to controls from the same population as well as explore genetic, radiographic and outcomes differences.

描述（由申请人提供）：脑出血（ICH）发生在脑实质内血管破裂导致神经损伤和经常死亡的时候。大约40-50%的脑出血患者会死于出血。在幸存者中，大多数是残疾人。因此，脑出血是卒中中发病率和死亡率最高的亚型。研究发现，非裔美国人和西班牙裔少数民族患脑出血的比例大约是白人的两倍，而且平均而言，患脑出血的年龄更小。然而，尽管有这种不成比例的医疗负担，在非洲裔美国人中不到200例脑出血病例，在西班牙裔美国人中不到100例脑出血病例已收集到可用于检测的DNA。我们的建议是在白人中收集1000例脑出血病例，在黑人中收集1000例脑出血病例，在西班牙裔中收集1000例脑出血病例，并根据种族/民族、年龄（5岁）、性别和地理位置收集3000例对照。我们的长期目标是开展脑出血的全基因组关联研究，其中包括相当比例的少数民族脑出血患者。一项全基因组关联研究用数十万个标记对DNA进行评估，以确定与脑出血风险较高或较低相关的区域或基因。但是，目前的建议将无法完成这类分析，因为目前可用的数字不足。因此，当前提案的目标是：1)了解黑人和西班牙裔人群中最重要的ICH风险因素；2)确定不同种族/民族的脑成像差异；3)确定调解不同种族/民族的转归率差异的因素；4)确定来自不同地区或国籍（如墨西哥人、古巴人等）的西班牙裔和非裔美国人在基因上是否存在差异。为了实现这些目标，我们在全美拥有11个招聘中心，代表30家招聘医院，这些医院有大量非洲裔美国人和西班牙裔美国人。还将招募来自同一地区的白色脑出血病例，以解释风险因素的地区差异，以及风险因素、结果和影像学差异的比较组。马萨诸塞州总医院将与乔治敦大学联合建立一个集中的神经成像中心，用于统一阅读和分析电影。将在迈阿密人类基因组学研究所开发一个生物储存库，用于集中DNA处理和样品处理。维克森林大学将建立一个数据和统计中心。这项研究的主要优势在于研究者的经验，特别是在招募少数民族人群和对脑出血和流行病学特别感兴趣方面；病例、危险因素的统一定义和集中分析；以及识别和招募研究所需的大量受试者（总共6000人）的能力。