Sex-specific Risk for Vascular Dysfunction and Cognitive Decline

血管功能障碍和认知能力下降的特定性别风险

• 批准号: 8343815
• 负责人: VIRGINIA M MILLER
• 金额: $ 115.89万
• 依托单位: MAYO CLINIC ROCHESTER
• 依托单位国家: 美国
• 财政年份: 2012
• 资助国家: 美国
• 起止时间: 2012-09-01 至 2017-08-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/8343815
• 关键词: Address; Affect; Attention; Basic Science; Blood; Blood Platelets; Blood Vessels; Brain; Cardiovascular Diseases; Cardiovascular system; Caring; Cerebrum; Characteristics; Clinic; Clinical; Clinical Research; Cognition; Cognitive; Complement; Diagnostic Procedure; Dilator; Disease; Early treatment; Epidemiology; Estrogens; Event; Female; Functional disorder; Future; Health; Hormonal; Image; Imaging Techniques; Impaired cognition; Individual; International; Life; Longevity; Medical Research; Medicine; Menopause; Morbidity - disease rate; Patients; Performance; Persons; Placebos; Pre-Eclampsia; Pregnancy; Prevention; Process; Quality Control; Recording of previous events; Research; Research Infrastructure; Research Personnel; Resources; Risk; Risk Factors; Sex Characteristics; Specialized Center; Strategic Planning; Structure; Testing; Vascular blood supply; Vasodilator Agents; Woman; base; cerebrovascular; cognitive function; cohort; data management; experience; hormone therapy; innovation; lens; men; mortality; novel; operation; population based; pregnancy disorder; programs; response; sex; tool

DESCRIPTION (provided by the applicant): Establishing a Specialized Center of Research on Sex Differences (SCOR) at Mayo Clinic is consistent with Mayo's strategic plan for research to best serve every patient, every day, through personalized medicine. Sex differences research is integral to personalized medicine. Cardiovascular disease and cognitive decline are two related conditions disproportionately affecting men and women across their lifespan with distinct differences in manifestations, responses to treatments, morbidity, and mortality. The overarching theme of this interdisciplinary SCOR is to understand how female-specific conditions associated with major hormonal shifts, hypertensive pregnancy disorders, and menopausal estrogen deficiency or menopausal hormone therapy affect cerebrovascular function and cognition in women. Three individual but interrelated projects will investigate the overarching theme. Project I will test the hypothesis that a history of hypertensive pregnancy disorders is a risk factor for all-cause and cardiovascular mortality, future cardiovascular disease, and cognitive impairment by using a population-based approach. Cohorts selected from the Rochester Epidemiology Project (REP) will be evaluated prospectively for cerebrovascular responses and cognitive function. Project II will investigate the neuroprotective effects of estrogen treatment on imaging markers of cognitive health and cognitive performance in women who were treated with estrogens compared with placebo during early menopause. Early menopause is considered the "window of opportunity" for estrogen treatment. This project leverages the cohort of the ongoing Kronos Early Estrogen Prevention Study (KEEPS). Project III, using cohorts defined in Projects I and II, will define cerebral microvascular dilator capacit, characterize the thrombotic potential of blood-borne microvesicles and platelets, and define relationships among those characteristics with cerebral microvascular vasodilator capacity and changes in brain structure and cognition. An administrative core will support operations and quality control, and a clinical analytical core will provide standardized subject recruitment, data management, and analysis for all three projects. The SCOR is highly responsive to the RFA because it addresses specific sex differences underpinning diseases affecting persons through life transitions, it integrates clinical and basic research, and it uses unique resources at Mayo Clinic. This project involves novel technical approaches of imaging and blood-soluble markers to mechanistically approach disease processes. Furthermore, the defined infrastructure and cohorts will provide the basis for future research on sex differences. Viewing research and medical delivery through a "sex-based lens," with attention to an individual's sex chromosomal complement and hormonal status, is fundamental to personalized care. The SCOR on Sex Differences at Mayo Clinic will facilitate incorporation of sex determinants of health, disease, and treatments across the research and clinical enterprise. In addition, the SCOR investigators will disseminate sex-differences research for specific and general national and international audiences. DESCRIPTION (provided by applicant): Cardiovascular disease and cognitive decline are two related conditions disproportionately affecting men and women across their lifespan. This interdisciplinary program will utilize innovative tools imaging and diagnostic techniques to understand how changes in blood supply to the brain affect cognition in women who have experienced a hypertensive pregnancy event, preeclampsia, and menopause. These studies will identify which women might benefit from early treatments to sustain cognitive health across their life transitions.

描述（由申请方提供）：在马约诊所建立性别差异研究专门中心（SCOR）符合马约的研究战略计划，即通过个性化医疗每天为每位患者提供最佳服务。性别差异研究是个性化医疗的组成部分。心血管疾病和认知能力下降是两种相关的疾病，不成比例地影响男性和女性的整个生命周期，在表现、治疗反应、发病率和死亡率方面存在明显差异。这个跨学科SCOR的首要主题是了解与主要激素变化，高血压妊娠障碍，绝经期雌激素缺乏或绝经期激素治疗相关的女性特定条件如何影响女性的脑血管功能和认知。三个独立但相互关联的项目将研究这一总体主题。项目I将通过使用基于人群的方法来检验这一假设，即妊娠期高血压疾病史是全因和心血管死亡率、未来心血管疾病和认知障碍的危险因素。将前瞻性评价从罗切斯特流行病学项目（REP）中选择的队列的脑血管反应和认知功能。项目II将研究雌激素治疗对认知健康和认知表现的成像标志物的神经保护作用，这些标志物是在绝经早期接受雌激素治疗的女性与安慰剂相比的。早期绝经被认为是雌激素治疗的“机会之窗”。该项目利用了正在进行的Kronos早期雌激素预防研究（KEEPS）的队列。项目III，使用项目I和II中定义的队列，将定义脑微血管扩张剂容量，表征血液传播的微泡和血小板的血栓形成潜力，并定义这些特征与脑微血管扩张剂容量和脑结构和认知变化之间的关系。管理核心将支持运营和质量控制，临床分析核心将提供标准化的受试者招募、数据 管理和分析所有三个项目。SCOR对RFA高度响应，因为它解决了通过生命转变影响人们的疾病的特定性别差异，它整合了临床和基础研究，并使用了马约诊所的独特资源。该项目涉及成像和血液可溶性标记物的新技术方法，以机械地接近疾病过程。此外，确定的基础设施和队列将为今后的性别差异研究提供基础。 通过“基于性别的透镜”观察研究和医疗服务，关注个人的性染色体补充和激素状况，是个性化护理的基础。马约诊所的性别差异SCOR将促进在整个研究和临床企业中纳入健康、疾病和治疗的性别决定因素。此外，SCOR调查员将向特定和一般的国家和国际受众传播性别差异研究。 描述（由申请人提供）：心血管疾病和认知能力下降是两个相关的条件不成比例地影响男性和女性在他们的生命周期。这个跨学科的计划将利用创新的工具成像和诊断技术，以了解大脑血液供应的变化如何影响经历过高血压妊娠事件，先兆子痫和更年期的女性的认知。这些研究将确定哪些女性可能受益于早期治疗，以在其生命过渡期间维持认知健康。