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: 10532245
• 负责人: Elaine Mott Urbina
• 金额: $ 70.52万
• 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/10532245
• 关键词: African American; Age; Angiotensins; Apolipoproteins; Atherosclerosis; Birth; Blood Vessels; Blood Volume; Body Weight; Cardiac; Cardiac Output; Cardiovascular Diseases; Cardiovascular alteration; Cardiovascular system; Cause of Death; Cessation of life; Data; Development; 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; 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; Vascular Diseases; Vascular resistance; Ventricular; Visceral; Visit; Woman; Women' s Health; 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/resistance; middle age; older women; parity; particle; post pregnancy; 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.

摘要 怀孕通常被描述为生理“压力测试”，可能会发现潜在的风险， 高血压、糖尿病和心血管疾病。即使在简单的怀孕中，女性也会经历快速的 心脏代谢的变化，以支持胎儿发育。虽然许多这些适应 分娩后不久恢复正常，但一些变化持续存在，包括超声心动图变化， 心脏结构和降低高密度脂蛋白胆固醇（HDL-C）。是否这些 妊娠相关的变化，或HDL颗粒结构或功能的改变，有助于 长期心血管风险未知。出生后婴儿的产次或活产总数， 更年期女性患心血管疾病的风险也更大， HDL-C水平、HDL结构和功能以及心脏和血管功能的改变。 然而，在将观察到的心血管变化与 妊娠与观察到的产次与绝经后心血管健康之间的关系。 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350名中位年龄46岁的参与者中进行新的面对面访问， 当妇女处于绝经前或围绝经期时。NGHS招收了871名女孩（50%是非洲人- 美国人和50%的白色）在1987年9岁或10岁时，对他们进行了17次检查，直到27岁， 包括7个年龄在20-27岁之间的超声心动图，多个保存的样本和生殖 历史问卷这项研究将进行详细的脂蛋白大小和功能 从储存的和新的样本中进行评估，并进行心血管成像， 中位年龄46岁时的超声心动图：1）确定特定脂蛋白颗粒大小 从以前到短期和长期职位的分布和功能变化 妊娠; 2）确定妊娠相关的心脏适应是否会导致长期 心脏结构和功能的改变，从而增加女性的CVD风险， 测试产次是否会增加CV风险，而与社会经济地位无关 (SES)非裔美国人和白色妇女的死亡率。随着我们目标的完成，我们将拥有 确定了妊娠相关脂蛋白和心血管疾病之间的潜在途径， 变化和绝经前心血管健康的妇女在他们的四十多岁。源自我们的 拟议中的研究将填补我们对这些风险如何积累的理解中的一个关键空白 以及社会经济地位如何促进平等- 长期相关风险。这项研究中的女性也暴露在肥胖流行病中， 从而加深对当代生殖发育的理解。