Epidemiology of premenstrual syndrome and premenstrual dysphoric disorder

描述(由申请人提供)：这个职业发展奖的目标是为候选人提供一个有指导的环境，在这个环境中发展经前综合征(PMS)和经前焦虑症(PMDD)的流行病学专业知识。通过研究生课程和其他有系统的活动，候选人将：1)加强她的内分泌学知识，重点是维生素D、钙和甲状旁腺激素的代谢和生理学，以及它们与经前综合症和经前综合症的关系；2)了解激素如何影响神经功能，以及如何参与情感障碍(如经前抑郁症)的病因学；3)发展与情感障碍(如经前抑郁症)相关的心理健康和精神流行病学方面的专业知识；以及4)扩大她作为流行病学家的技能，将遗传因素和生化标记物的使用纳入流行病学。此外，候选人还将完成一项研究项目，以评估血浆和遗传因素之间的关系以及经前综合症/经前综合症的发病率。这个项目将建立在一项初步研究的有趣发现的基础上，该研究表明，摄入大量维生素D和钙的女性患经前综合症的风险显著降低30%-40%。该研究计划的具体目的是：1)评估黄体期血浆25-羟基维生素D、1，25-二羟基维生素D、钙和甲状旁腺素水平与经前综合征/经前病变风险的关系；2)评估常见的维生素D受体基因Fok1、Bsm1、APA1和Taq1是否影响经前综合征/经前病变的风险；以及3)评估年龄和基因是否会改变血浆维生素D、钙和甲状旁腺素水平与经前综合征/经前病变发病的关系。这将是迄今为止对这些关系进行的第一次前瞻性和最全面的研究。总体而言，这一职业发展奖将为候选人提供她所需的技能，以实现她的目标，即成为一名独立的流行病学家，对经前综合症/经前综合症的病因、评估、预防和治疗方面的知识做出重大贡献。与公共健康相关：这将是首次对维生素D、钙和甲状旁腺素在经前综合症和经前综合症中的作用进行前瞻性研究，经前综合症和经前综合症是导致大量绝经前妇女严重受损的疾病。确定降低经前综合症/经前综合症发病率的可修改因素将为妇女提供机会，以比目前的治疗选择更少的缺点降低她们的风险。

DESCRIPTION (provided by applicant): The objective of this career development award is to provide the candidate with a mentored environment in which to develop expertise in the epidemiology of premenstrual syndrome (PMS) and premenstrual dysphoric disorder (PMDD). Through graduate coursework and other structured activities, the candidate will: 1) strengthen her knowledge of endocrinology, focusing on the metabolism and physiology of vitamin D, calcium, and parathyroid hormone and their relationship to PMS and PMDD; 2) develop an understanding of how hormones affect neurologic function and are involved in the etiology of affective disorders such as PMDD; 3) develop expertise in mental health and psychiatric epidemiology relating to affective disorders such as PMDD; and 4) expand her skills as an epidemiologist to include the use of genetic factors and biochemical markers in epidemiology. In addition, the candidate will complete a research project to assess the relationship between plasma and genetic factors and the incidence of PMS/PMDD. This project will build upon the interesting findings of a preliminary study which suggested that women who had high intakes of vitamin D and calcium had significant 30-40 percent reductions in risk of developing PMS. Specific aims of the research plan are to: 1) evaluate the relationship between luteal phase plasma levels of 25-hydroxyvitamin D, 1, 25-dihydroxyvitamin D, calcium and PTH and risk of PMS/PMDD; 2) evaluate whether common vitamin D receptor polymorphisms including Fok1, Bsm1, Apa1, and Taq1 affect risk of PMS/PMDD; and 3) evaluate whether age and genotype may modify the relationship between plasma vitamin D, calcium and PTH levels and incidence of PMS/PMDD. This will be the first prospective and most comprehensive study of these relationships conducted to date. Overall, this career development award will provide the candidate with the skills she needs to achieve her goals of becoming an independent epidemiologist who can contribute significantly to knowledge of PMS/PMDD etiology, assessment, prevention and treatment. Relevance to public health: This will be the first prospective study of the role of vitamin D, calcium and PTH in PMS and PMDD, disorders that cause substantial levels of impairment in large numbers of premenopausal women. The identification of modifiable factors that reduce PMS/PMDD incidence will provide women opportunities for reducing their risk with fewer drawbacks than current treatment options.