Impact of Life Course Socioeconomic Status on the Ovarian Reserve

生命历程社会经济地位对卵巢储备的影响

• 批准号: 8747818
• 负责人: Maria E. Bleil
• 金额: $ 7.73万
• 依托单位: UNIVERSITY OF WASHINGTON
• 依托单位国家: 美国
• 财政年份: 2014
• 资助国家: 美国
• 起止时间: 2014-09-20 至 2016-08-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/8747818
• 关键词: Accounting; Address; Adult; Age; Age at Menarche; Aging; Antral; Atherosclerosis; Biological Markers; Biological Process; Body mass index; California; Cardiac; Censuses; Childhood; Cigarette; Communities; Data Set; Development; Disadvantaged; Endocrine Disruptors; Environment; Environmental Exposure; Ethnic Origin; Exposure to; Funding; Goals; Health; Intervention; Investigation; Life Cycle Stages; Link; Literature; Measures; Menopause; Morbidity - disease rate; Myocardial Ischemia; Neighborhoods; Online Systems; Outcome; Ovarian; Participant; Patient Self-Report; Postmenopause; Premenopause; Puberty; Public Health; Race; Recording of previous events; Research; Residencies; Review Literature; Risk; Risk Factors; Services; Socioeconomic Status; Stroke; Testing; Time; Toxic Environmental Substances; Toxicant exposure; United States National Institutes of Health; Woman; base; cardiovascular risk factor; cigarette smoking; cohort; early onset; hormonal contraception; indexing; insight; low socioeconomic status; mortality; mullerian-inhibiting hormone; parity; public health relevance; reproductive; screening; socioeconomics; tool; toxicant

DESCRIPTION (provided by applicant): The number of post-menopausal US women will rise by 30% between years 2007 and 2020, an increase of more than 1 million women per year over a period of just 13 years. The timing of menopause is a key determinant of post-menopausal health and mortality. In particular, earlier age at menopause is associated with an increase in cardiovascular risk for outcomes including ischemic heart disease, stroke, atherosclerosis, and cardiac-specific mortality which together account for a significant proportion of morbidity and mortality among women in the post-menopausal period. In this regard, elucidating factors that explain variability in the timing of menopause is of critical importance as it raises the possibiliy that such factors may be modified through intervention efforts specifically targeting the delay of menopause and/or the amelioration of its sequelae. Review of the literature examining predictors of menopausal onset shows a growing number of studies have found lower socioeconomic status (SES) is prospectively related to earlier menopausal onset, even independently of other well-established risk factors for accelerated reproductive aging such as cigarette smoking. The examination of menopausal timing as an outcome is significantly limited; however, as menopause by definition is determined retrospectively after which time intervention is not possible. To address this limitation and extend the current literature, the proposed study will instead examine variability in "ovarian aging", the biological process underlying the loss of ovarian function leading to the permanent cessation of menses (i.e., menopause). Specifically, the goals of the proposed study are to examine aspects of women's environments, including 1) neighborhood-level SES, measured over the life course and in particular developmental periods (childhood, puberty, and adulthood) as well as 2) selected environmental toxicants (that commonly cluster in low SES environments) in relation to ovarian aging. These associations will be examined in an existing, community-based cohort of 978 pre-menopausal women ages 25-45 who were participants in the OVA Study (2006-2011), a cross-sectional investigation that assessed ovarian aging as indexed by well- established biomarkers of total ovarian reserve, including antral follicle count (AFC) and anti-Mullerian hormone (AMH). NIH funding will support the extraction of SES-related and environmental exposure variables from publically available datasets to be merged with the existing OVA Study dataset in order to evaluate whether histories of greater neighborhood-level socioeconomic disadvantage and increased exposure to selected toxicants may accelerate the depletion of the ovarian reserve as indexed by lower AFC and AMH levels. Results from the current study will provide new insights into the identification of predictors of accelerated ovarian aging and its sequelae and in pointing to new avenues for screening and intervention among at-risk women.

描述（由申请人提供）：在2007年至2020年期间，美国绝经后妇女的数量将增加30％，在短短13年内，每年增加了100万妇女。更年期的时机是绝经后健康和死亡率的关键决定因素。特别是，更年期的较早年龄与结局的心血管风险增加有关，包括缺血性心脏病，中风，动脉粥样硬化和心脏特异性死亡率，这在绝经后期的女性中占女性的发病率和死亡率很大。在这方面，阐明更年期时间变化的因素至关重要，因为它可以通过专门针对更年期延迟和/或缓解后遗症来修改这些因素的可能性。对更年期发作预测因素的文献的回顾表明，越来越多的研究发现，社会经济地位（SES）的较低的研究与早期的更年期发作有关，甚至与其他公认的危险因素相关，甚至独立于加速繁殖老化的危险因素，例如吸烟。 将绝经时机作为结果的检查显着有限。但是，由于更年期是追溯确定的，之后不可能进行干预。为了解决这一限制并扩展当前文献，拟议的研究将研究“卵巢衰老”的变异性，这是卵巢功能丧失的生物学过程，导致永久性停止月经（即更年期）。具体而言，拟议的研究的目标是检查女性环境的各个方面，包括1）邻里水平的SES，在生命过程中，尤其是在发展期（儿童期，青春期和成年期）以及2）所选的环境毒物（通常在低SES环境中聚集在低SES环境中），在相对于卵巢衰变中。这些关联将在现有的，基于社区的队列中进行，由978名年龄段25-45岁的绝经前妇女参加，他们是OVA研究的参与者（2006-2011），这是一项横断面研究，评估了卵巢老化，该研究评估了卵巢衰老，是由卵巢储备总数（包括Antral Follicle Count）（包括Antral follicle count）（Antral follice Count）（Aftii and and ant ant ant ant ant ant the）（Antral follice Count）（Aftii and ant ant ant ant ant and and and and）。 NIH资金将支持从公开可用的数据集中提取与现有的OVA研究数据集合并的公共可用数据集中的变量，以评估是否会评估更大的社区社会经济劣势的历史和增加所选有毒物质的较高的毒性含量是否会加速卵巢储备的消耗，因为该储备会被降低量化水平和较低的水平。当前研究的结果将为鉴定加速卵巢衰老及其后遗症的预测指标提供新的见解，并指向 在高危妇女中筛查和干预的新途径。