Environmental risk factors for uterine fibroids: a prospective ultrasound study(Supplement)

子宫肌瘤的环境危险因素：一项前瞻性超声研究（补充）

• 批准号: 9907405
• 负责人: LAUREN A WISE
• 金额: $ 21.81万
• 依托单位: HENRY FORD HEALTH SYSTEM
• 依托单位国家: 美国
• 财政年份: 2017
• 资助国家: 美国
• 起止时间: 2017-09-01 至 2020-08-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/9907405
• 关键词: Address; Administrative Supplement; Adult; Adverse event; Affect; African American; Age; Age of Onset; Automobile Driving; Blood; Caucasians; Characteristics; Chemical Exposure; Chemicals; Childhood; Cohort Studies; Communities; Data; Data Collection; Deterioration; Diagnosis; Disadvantaged; Discrimination; Disease susceptibility; Early-life trauma; Economically Deprived Population; Elderly; Endocrine Disruptors; Enrollment; Environment; Environmental Exposure; Environmental Hazards; Environmental Risk Factor; Etiology; Exposure to; Family; Fibroid Tumor; Financial Hardship; Funding; Goals; Gonadal Steroid Hormones; Growth; Gynecologic; Gynecology; Health; Health Care Costs; Health Promotion; Hemorrhage; Hormones; Human; In Vitro; Incidence; Influentials; Laboratories; Life; Life Cycle Stages; Life Style; Literature; Measurement; Measures; Medical; Menarche; Mental Depression; Morbidity - disease rate; National Institute of Environmental Health Sciences; Operative Surgical Procedures; Outcome; Pain; Pathway interactions; Persons; Phenols; Physical activity; Policy Maker; Politics; Polychlorinated Biphenyls; Prevalence; Procedures; Prospective Studies; Prospective cohort study; Proxy; Puberty; Quality of life; Questionnaires; Religion and Spirituality; Reporting; Reproductive Process; Research; Research Design; Resources; Risk; Risk Factors; Role; Sample Size; Serum; Severity of illness; Shapes; Social support; Socioeconomic Status; Spirituality; Standardization; Statistical Data Interpretation; Strategic Planning; Stress; Structure; Symptoms; Teenagers; Testing; Time; Training; Ultrasonography; United States National Institutes of Health; Urine; Uterine Fibroids; Weather; Woman; Women' s Health; Work; age effect; aged; animal data; base; biopsychosocial; bisphenol A; chemical association; cost effective; depressive symptoms; design; early experience; early onset; experience; follow-up; food insecurity; high risk population; human data; innovation; neighborhood safety; parent grant; phthalates; pollutant; pressure; prospective; psychosocial; racial disparity; reproductive; reproductive hormone; screening; symptomatology; tumor; urinary

Abstract of Funded Parent Grant (R01-ES024749) Uterine leiomyomata (UL) are diagnosed in 25-30% of reproductive-aged women, resulting in considerable gynecologic morbidity and billions in U.S. health care costs annually. African Americans have 2-3 times the UL incidence of Whites and greater disease severity. Sex steroid hormones are involved in the etiology of UL. Given that endocrine disrupting chemicals (EDCs) can alter the functioning of hormones, we propose to evaluate UL risk in relation to 3 classes of EDCs: phthalates, polychlorinated biphenyls (PCBs), and phenols, specifically bisphenol A (BPA). Our choice of chemicals is informed by their high exposure prevalence in humans and by in vitro, animal, and human data documenting their effects on reproductive hormones and processes that could influence UL risk. Existing studies of EDCs and UL are limited by small sample size, uncertain temporality due to retrospective design, and suboptimal measurement of EDCs and UL. This study will use data and biospecimens from the Study of Environment Lifestyle and Fibroids (SELF), a NIEHS prospective cohort study of 1,300 African American women aged 23-34 and free of UL at baseline (2010-2012). Questionnaire data were collected at baseline and subjects are being followed for 5 years. Every 20 months, blood and urine are collected, and ultrasounds are performed by trained sonographers to detect UL. We request support for the laboratory and statistical analysis of EDCs in relation to UL incidence. We propose a cost-effective case-cohort study design that includes 400 incident UL cases and 400 controls. We will measure urinary phthalate metabolites, serum PCBs, and urinary BPA, characterize exposures according to UL risk factors, and determine the associations of these chemicals with UL incidence and tumor characteristics. Non-persistent chemicals (phthalates, BPA) will be measured at baseline, 20 months, and 40 months. Persistent chemicals (PCBs) will be measured at baseline only. SELF provides a unique opportunity to assess the association of common EDCs with UL risk. This project has many strengths that overcome the limitations of prior studies: large sample size, prospective data collection, state-of-the-art EDC measurement, serial ultrasound screening for UL, analysis of repeated EDC measures, innovative statistical approaches for evaluating EDC mixtures, and control for multiple confounders. Pilot data show large exposure variability, providing excellent power to test the proposed hypotheses. This study of African Americans, a high-risk population for EDC exposure and UL, will provide informative data on the effects of widespread pollutants on UL, seek explanations for the racial disparity in UL incidence, and provide critical data to the public, scientific community, and policy makers.

资助的父母赠款摘要（R01-ES024749） 子宫平滑肌（UL）在25-30％的生殖妇女中被诊断出来，导致 每年有相当大的妇科发病率和数十亿美元的卫生保健费用。非洲人 美国人的白人发生率是UL发生率的2-3倍，疾病的严重程度更大。性类固醇 激素参与UL的病因。鉴于内分泌破坏化学物质（EDC） 可以改变激素的功能，我们建议评估与3类的UL风险 EDCS：邻苯二甲酸盐，多氯联苯（PCB）和苯酚，特别是双酚A（BPA）。 我们选择化学物质的选择是由于它们在人类和体外的高暴露率所带来的， 动物以及人类数据记录其对生殖激素和过程的影响 可能影响UL风险。 EDC和UL的现有研究受样本量较小的限制， 由于回顾性设计以及EDCS和UL的次优测量而引起的时间性不确定。 这项研究将使用环境生活方式和肌瘤研究中的数据和生物测量 （自我），一项NIEHS的前瞻性队列研究，对1,300名23-34岁的非裔美国妇女和 基线时没有UL（2010-2012）。问卷数据是在基线和受试者处收集的 被遵循5年。每20个月，收集血液和尿液，超声检查 由训练有素的超声检查员表演以检测到UL。我们要求对实验室的支持， EDC与UL发生率有关的统计分析。我们提出了一个具有成本效益的案例库园 研究设计，包括400个事件UL病例和400个对照。我们将测量尿 根据UL 危险因素，并确定这些化学物质与UL发生率和肿瘤的关联 特征。非持久化学物质（邻苯二甲酸盐，BPA）将在基线时测量20 月份和40个月。仅在基线时测量持久化学物质（PCB）。自己 提供了一个独特的机会来评估普通EDC与UL风险的关联。这 项目具有许多优势，可以克服先前研究的局限性：大型样本量， 预期数据收集，最先进的EDC测量，串行超声筛选 UL，分析重复的EDC措施，评估EDC的创新统计方法 混合物，并控制多个混杂因素。飞行员数据显示较大的暴露变异性， 提供出色的能力来检验拟议的假设。这项对非裔美国人的研究，一个 用于EDC暴露和UL的高风险人群将提供有关影响的信息 广泛的UL污染物，寻求解释UL发病率的种族差异，并 向公共，科学界和政策制定者提供关键数据。