Effect of reproductive history on longitudinal change in cardiac, vascular and lipid parameters

生育史对心脏、血管和血脂参数纵向变化的影响

• 批准号: 10390148
• 负责人: Elaine Mott Urbina
• 金额: $ 72.81万
• 依托单位: CINCINNATI CHILDRENS HOSP MED CTR
• 依托单位国家: 美国
• 财政年份: 2021
• 资助国家: 美国
• 起止时间: 2021-12-01 至 2026-11-30
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10390148
• 关键词: Address; African American; Age; Angiotensins; Atherosclerosis; Birth; Blood Vessels; Blood Volume; Body Weight; Body Weight decreased; Cardiac; Cardiac Output; Cardiac development; Cardiovascular Diseases; Cardiovascular alteration; Cardiovascular system; Cause of Death; Cessation of life; Data; Diabetes Mellitus; Echocardiography; Endocrine Physiology; Endothelium; Enrollment; Evaluation; Event; Exposure to; Fetal Development; Generations; Growth; Health; High Density Lipoprotein Cholesterol; High Density Lipoproteins; Hormonal; Hypertension; Intervention; Left Ventricular Mass; Life; Link; Lipids; Lipoproteins; Live Birth; Longevity; Longitudinal cohort; Low Density Lipoprotein oxidation; Menopause; Modeling; Myocardial dysfunction; National Heart, Lung, and Blood Institute; Nulliparity; Obesity; Obesity Epidemic; Onset of illness; Participant; Particle Size; Pathway interactions; Perimenopause; Peripheral; Persons; Physiological; Postmenopause; Postpartum Period; Pregnancy; Premenopause; Prevalence; Proteins; Questionnaires; Relaxation; Reporting; Reproductive History; Research; Risk; Risk Factors; Sampling; Socioeconomic Status; Stress Tests; Structure; Testing; Time; Vascular Diseases; Vascular resistance; Ventricular; Visceral; Visit; Woman; Women' s Health; apolipoprotein C-III; arterial stiffness; blood lipid; cardiometabolism; cardiovascular disorder prevention; cardiovascular disorder risk; cardiovascular health; cardiovascular imaging; cardiovascular risk factor; cohort; experience; follow-up; girls; heart function; indexing; insulin sensitivity; middle age; older women; parity; particle; pre-clinical; prospective; racial disparity; reproductive; reproductive development

Abstract Pregnancy is often described as a physiologic “stress test” that may uncover latent risk for hypertension, diabetes and CVD. Even in uncomplicated pregnancies, women experience rapid cardiometabolic changes to support fetal development. While many of these adaptations normalize soon after delivery, some changes persist, including echocardiographic changes in cardiac structure and lower high-density lipoprotein cholesterol (HDL-C). Whether these pregnancy-related changes, or alterations in HDL particle structure or function, contribute to long-term cardiovascular risk is unknown. Parity, or the total number of live births, among post- menopausal women is also associated with greater risk of cardiovascular disease and alterations in HDL-C levels, HDL structure and function, and cardiac and vascular function. However, a significant research gap exists in linking observed cardiovascular changes across pregnancy to the observed associations of parity with cardiovascular health post-menopause. We will address this gap by leveraging existing data and samples from the NHLBI Growth and Health Study (NGHS) and conduct a new in-person visit in 350 participants at median age 46, when the women will be pre- or peri-menopausal. NGHS enrolled 871 girls (50% African- American and 50% white) in 1987 at age 9 or 10 and examined them up to 17 times, to age 27, including 7 echocardiograms between ages 20-27, multiple saved samples and reproductive history questionnaires. This study will conduct detailed lipoprotein sizing and functionality assessments from stored and new samples and conduct cardiovascular imaging and repeat echocardiograms at median age 46 to: 1) Determine the specific lipoprotein particle size distribution and function changes which occur from before to short- and long-term post pregnancy; 2) Determine whether pregnancy-related cardiac adaptations result in long-term alterations in cardiac structure and function, thereby increasing CVD risk for women in their forties; and 3) Test whether parity increases CV risk independently of socioeconomic status (SES) in African-American and white women. With the completion of our aims, we will have determined the prospective pathways between pregnancy-related lipoprotein and cardiovascular changes and pre-menopausal cardiovascular health for women in their forties. Results from our proposed studies will fill a critical gap in our understanding of how such risks may accumulate during a woman's reproductive life, as well as how socioeconomic status contributes to parity- related risk long-term. Women in this study have also been exposed to the obesity epidemic, lending greater understanding to contemporary reproductive development.

抽象的 怀孕通常被描述为一种生理“压力测试”，可能会发现潜在风险 高血压，糖尿病和CVD。即使在简单的怀孕中，妇女也会经历迅速 心脏代谢变化以支持胎儿发育。虽然许多改编 交付后不久归一化，一些变化持续存在，包括超声心动图的变化 心脏结构和较低的高密度脂蛋白胆固醇（HDL-C）。是否这些 与怀孕有关的变化或HDL颗粒结构或功能的改变，有助于 长期心血管风险尚不清楚。均等，或活产的总数 更年期妇女还与心血管疾病的风险更大有关 HDL-C水平，HDL结构和功能以及心脏和血管功能的改变。 但是，在将观察到的心血管变化联系在一起的研究差距很大 怀孕与观察到的奇偶校验后的偶然性关联。 我们将通过利用NHLBI增长的现有数据和样本来解决这一差距 健康研究（NGHS），并在46岁的中位参与者中进行新的面对面访问， 妇女将是预选前或期周期的何时。 NGHS招募了871名女孩（非洲50％ 1987年，美国和50％的白色）在9岁或10岁时检查它们，最多可达17次，直到27岁 包括20-27岁之间的7个超声心动图，多个保存样品和生殖 历史问卷。这项研究将进行详细的脂蛋白尺寸和功能 评估存储和新样品的评估，并进行心血管成像并重复 超声心动图的中位年龄46至：1）确定特异性脂蛋白粒径 从前到短期和长期邮政的分布和功能变化 怀孕; 2）确定与怀孕相关的心脏适应是否长期导致 心脏结构和功能的改变，从而增加了女性的CVD风险 四十年代； 3）测试平等是否独立于社会经济地位增加CV风险 （SES）在非裔美国人和白人妇女中。随着我们目标的完成，我们将拥有 确定与妊娠有关的脂蛋白和心血管之间的前瞻性途径 四十多岁的妇女的变化和绝经前心血管健康。我们的结果 拟议的研究将填补我们对这种风险如何累积的理解的关键空白 在妇女的生殖生活中，以及社会经济地位如何促进平等 - 长期相关的风险。这项研究中的妇女也暴露于肥胖症流行病， 对当代复制发展有更大的了解。