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A lifecourse approach to women's cardiometabolic and bone health: from fertility to perimenopause

女性心脏代谢和骨骼健康的生命全程方法：从生育到围绝经期

基本信息

批准号：
9975867
负责人：
Jorge Eduardo Chavarro
金额：
$ 68.91万
依托单位：
HARVARD PILGRIM HEALTH CARE, INC.
依托单位国家：
美国
项目类别：
财政年份：
2019
资助国家：
美国
起止时间：
2019-07-10 至 2024-04-30
项目状态：
已结题

来源：
https://reporter.nih.gov/project-details/9975867
关键词：
Address Adult Age American Heart Association Anthropometry Behavior Biological Markers Blood Pressure Body Composition Bone Density Cardiovascular Diseases Cessation of life Characteristics Child Child Health Clinical Complex Conceptions Data Diabetes Mellitus Diagnosis Diet Early identification Elderly Enrollment Environmental Risk Factor Family Fasting Fatty acid glycerol esters Feedback Fertility Funding Future Gestational Diabetes Glucose Goals Gold Gravidity Guidelines Hand Hand Strength Health Health behavior Height High Density Lipoprotein Cholesterol Hour Hypertension Impairment Infertility Inflammation Insulin Intervention Investigation Linear Regressions Lipids Logistic Regressions Longitudinal Studies Longitudinal cohort study Longterm Follow-up Maternal Health Measurement Measures Mediating Menopause Metabolic Metabolic syndrome Methods Modeling Modernization Morbidity - disease rate Non-Insulin-Dependent Diabetes Mellitus OGTT Obesity Osteoporosis Outcome Outcome Assessment Patient Self-Report Perimenopause Perinatal Persons Plasma Polycystic Ovary Syndrome Postpartum Period Predisposition Pregnancy Pregnancy Complications Preventive Intervention Research Research Design Research Priority Risk Risk Factors Roentgen Rays Series Statistical Data Interpretation Testing Testosterone Thinness Time Triglycerides Unsafe Sex Update Visit Weight Weight Gain Woman adipokines bone health bone mass bone turnover cardiometabolic risk cardiometabolism cardiovascular health causal model clinical care cohort data resource disability early pregnancy experience fasting glucose follow-up gestational weight gain high risk mortality mullerian-inhibiting hormone muscle form ovarian reserve parity pregnancy hypertension prospective recruit reduced muscle mass reproductive screening social sociodemographics standard measure subfertility waist circumference

项目摘要

Project Summary/Abstract This application is responsive to PA-17-091: Fertility Status as a Marker for Overall Health Across their reproductive years, many women experience substantial weight gain, declines in bone density and muscle mass, and worsening cardiometabolic health, each predicting later life morbidity and mortality. Most women have one or more pregnancies during this lifestage, and a large subset of women (up to 1/3), including many who have successfully conceived and carried a previous pregnancy, experience subfertility or infertility. Infertility, defined as the inability to conceive after 12 months of unprotected intercourse, is thus one of the most common conditions among reproductive age adults. A growing body of evidence suggests that fertility- related characteristics predict future health risks including excess weight gain, osteoporosis, cardiovascular disease (CVD), and type 2 diabetes mellitus. The overall goal of our proposed project is to test our hypothesis that women with evidence of impaired fertility will have more adverse body composition, bone health, and cardiometabolic outcomes in perimenopause. We propose a prospective longitudinal cohort study design as the optimal approach to address the proposed aims. We will leverage data from Project Viva, a highly engaged existing cohort of over 1000 socio-demographically diverse women from whom we have already collected detailed information on weight, diet, and other health behaviors beginning at enrollment in 1999-2002, and updated continually since. Exposures are assessed with validated self-reported, clinical, or research measures and will include several time-updated markers of fertility: cycles to conception; gravidity and parity; infertility diagnoses and treatments; diagnosis of polycystic ovary syndrome (PCOS) as well as measurement of testosterone, a defining characteristic of PCOS; and levels of anti-Müllerian hormone (AMH), an objective marker of ovarian reserve. Outcomes include markers of body composition (fat, lean, and bone mass), cardiovascular health, and metabolic health and will be assessed using gold-standard measures at an in-person research visit. Since study inception, we have also rigorously collected data on a wide set of behaviors, health measures, environmental factors, and social and family experiences. Results from the proposed series of investigations will inform clinical care for women from the reproductive years through perimenopause, guidelines regarding screening and long-term follow-up, and future research priorities. This proposal provides an exceptional opportunity to leverage outstanding existing data and resources and include over 20 years of high quality prospective assessments within a 5-year project period.

项目总结/文摘