Adult Life Predictors of Genitourinary Disorders

描述（由申请人提供）：虽然关于影响非恶性泌尿生殖系统疾病发展的因素已经积累了相当多的知识，但仍有重大空白需要填补。这些差距之一是需要查明生命早期发生的因素，并预测生命后期的疾病或状况，以便更好地了解疾病的机制，并制定预防战略。此外，对一些假定的或已知的风险因素的亚临床方面几乎一无所知。这些非常常见的疾病在医疗保健和生活质量方面的巨大成本掩盖了人们对这些疾病缺乏重要性的认识。 为了帮助解决这些知识的不足，我们建议在年轻人冠状动脉风险发展（CARDIA）研究的参与者中进行一项研究。自1986年以来，在四个实地地点跟踪了5，115名男性和女性的这一队列，其中约有3，525人预计将参加25年级考试。从这个专门的队列中，我们收集了自青年以来非常丰富的纵向数据集。本研究的总体目标是研究在成年生活中重复测量的因素如何增加或减少良性泌尿生殖系统疾病的存在（例如，尿失禁、盆腔器官脱垂、性功能障碍、下尿路症状和勃起功能障碍）。为了实现这一目标，我们的主要目标是：1）确定可改变的因素如何与泌尿生殖系统结果相关; 2）确定选定的健康状况如何与泌尿生殖系统结果相关;以及4）创建一个资源来检查这些因素与这些泌尿生殖系统疾病的发作或进展之间的纵向关系。作为一个探索性的目标，我们还将研究炎症的生物标志物（例如，CRP、尿酸、IL-6）以及内源性激素和结合蛋白水平与泌尿生殖系统结局相关。将使用流行病学或临床研究中常用的标准化或公认的测量方法确定每个结局。我们建议间隔三年收集两次评估，以检查这些疾病的流行、新发和进展。 关注因素的重复性和评估类型（其中许多包括亚临床疾病的评估）提供了一个难得的机会。这批学生的下一个考试周期已经获得资金，这批学生的实地工作将于2010年初开始。因此，在当前评估中纳入良性泌尿生殖系统结果的机会是及时的，具有时间敏感性。拥有如此大的多种族队列的全面数据，使其成为纵向因素和泌尿外科结局研究的独特而有价值的资源。

DESCRIPTION (provided by applicant): While considerable knowledge has accumulated regarding factors that influence the development of non-malignant genitourinary disorders, there are significant gaps that need to be filled. Among these gaps is the need to identify factors that occur early in life and predict diseases or conditions later in life so that the mechanisms of disease can be better understood and for developing prevention strategies. In addition, there is almost nothing known about the subclinical aspects of some putative or known risk factors. The enormous costs in medical care and quality of life for these very common disorders belie the perceived lack of importance for these conditions. To help address these deficits in knowledge, we propose to conduct a study among the participants in the Coronary Artery Risk Development in Young Adults (CARDIA) Study. This cohort of 5,115 men and women has been followed since 1986 at four field sites with approximately 3,525 of them expect to participate in the Year 25 Exam. From this dedicated cohort comes an incredibly rich longitudinal dataset collected since young adulthood. The overall objective of this study is to examine how factors repeatedly measure over adult life may increase or decrease the presence of benign genitourinary conditions (e.g., urinary incontinence, pelvic organ prolapse, sexual dysfunction, lower urinary tract symptoms, and erectile dysfunction). To accomplish this objective, our primary aims for this proposal are to: 1) determine how modifiable factors are associated with genitourinary outcomes; 2) determine how selected health conditions are associated with genitourinary outcomes; and 4) create a resource to examine the longitudinal relationship between these factors and the onset or progression of these genitourinary conditions. As an exploratory aim we will also examine how biomarkers of inflammatory (e.g., CRP, uric acid, IL-6) and endogenous hormone and binding protein levels are associated with genitourinary outcomes Each outcome will be ascertained using a standardized or well accepted measure that is in common use in epidemiologic or clinical research. We propose to collect two assessments three years apart to examine prevalent, new onset and progression in these conditions. The repeated nature of factors of interest and the types of assessments, many that include assessments of subclinical disease, provide an uncommon opportunity. The next exam cycle for this cohort has been funded and field work with the cohort will begin early in 2010. Thus, the opportunity to include benign genitourinary outcomes in the current assessment is timely and time sensitive. Having such comprehensive data on such a large multiethnic cohort makes this a unique and valuable resource for the study of longitudinal factors and urological outcomes.