Ovarian Function Among Samoan Women with Obesity

萨摩亚肥胖女性的卵巢功能

• 批准号: 10605790
• 负责人: Sakurako Oyama
• 金额: $ 3.26万
• 依托单位: YALE UNIVERSITY
• 依托单位国家: 美国
• 财政年份: 2023
• 资助国家: 美国
• 起止时间: 2023-07-01 至 2026-06-30
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10605790
• 关键词: Abdomen; Address; Affect; Amenorrhea; Anovulation; Biochemical; Biometry; Body fat; Body mass index; Cardiometabolic Disease; Clinical; Country; Data; Data Analyses; Data Collection; Diabetes Mellitus; Diagnosis; Evaluation; Family; Fellowship; Female; Functional disorder; Goals; Growth; Health; Hip region structure; Human; Hypertension; Income; Infertility; Irregular Menstruation; Learning; Length; Longitudinal cohort study; Luteinizing Hormone; Maternal and Child Health; Measures; Menstrual cycle; Menstruation; Mental Health; Mentors; Modeling; Morbidity - disease rate; Nutritional; Obesity; Oligomenorrhea; Outcome; Ovarian; Overweight; Ovulation; Pacific Islander; Pacific Islands; Patient Self-Report; Periodicity; Personal Satisfaction; Physicians; Polynesian; Prevalence; Procedures; Progesterone; Proxy; Public Health; Reproductive Endocrinology; Reproductive Health; Research; Research Design; Resource-limited setting; Resources; Risk; Risk Factors; Samoa; Samoan; Scientist; Specimen; Surveys; Text Messaging; Training; Ultrasonography; United States; Urine; Vagina; Variant; Woman; access disparities; aged; assisted reproduction; cardiometabolism; career; cohort; cost; emotional distress; epidemiology study; experience; high body mass index; hormonal contraception; infertility treatment; insight; low and middle-income countries; men; mortality; ovarian dysfunction; prospective; protocol development; recruit; reproductive; secondary infertility; skills; urinary

PROJECT SUMMARY/ABSTRACT Obesity is a well-established risk factor for developing cardiometabolic diseases such as diabetes and hypertension. While the impact of obesity on reproductive health is less understood, studies conducted in high- income countries have associated obesity with menstrual and ovulatory dysfunction and subsequent infertility. These findings have significant public health implications for low- and middle-income countries (LMICs) where access to assisted reproduction treatment remains practically nonexistent despite rapidly increasing obesity prevalence. Obesity-related morbidity and mortality are particularly high among Pacific LMICs. However, few studies have assessed the relationship between cardiometabolic and reproductive health in this region. Previous attempts to characterize menstrual irregularity among Pacific Islander women have relied on retrospective self-report of cycle length and variability, which is notoriously subject to recall bias and interlocuter variation. No studies to date have characterized anovulatory cycles among Pacific Islander women. This is likely because the gold-standard for determining ovulation involves daily transvaginal ultrasonography, an invasive and resource-intensive procedure that is impractical for epidemiological studies. My proposal addresses these gaps through two scientific aims and five training aims that leverage an existing cohort of approximately n=150 Samoan women aged 25-39, whose families Dr. Nicola Hawley (sponsor) and colleagues have followed since 2015. These women have participated in health and wellbeing assessments in 2015, 2017/2018, and 2019/2020. During the fourth data collection wave planned for 2022, I will measure adiposity and prospectively assess ovulatory function. In Aim 1, I will examine associations between menstrual irregularity and current adiposity and longitudinal trajectories of change in adiposity among Samoan women. In Aim 2, I will biochemically evaluate the presence or absence of ovulation among regularly menstruating women and explore the association between anovulation and BMI. Findings will provide critical insight on secondary infertility among women with obesity and inform the development of protocols for evaluating female reproductive potential in low-resource settings. Moreover, this project will shed light on the dual burden of cardiometabolic and reproductive risk among Pacific Islander women, who despite having among the highest obesity prevalence globally, are underrepresented in epidemiologic research. My training plan will enable me to develop research, clinical, and professional skills necessary to become a physician-scientist who conducts longitudinal epidemiologic studies to investigate the impact of obesity on maternal and child health outcomes in low-resource settings. My training plan outlines coursework, mentored research, and clinical experiences to enhance my skills in biostatistics, epidemiological study design and implementation, and reproductive endocrinology.

项目总结/摘要 肥胖是发展心脏代谢疾病如糖尿病和糖尿病的公认危险因素。 高血压虽然人们对肥胖对生殖健康的影响了解较少，但在高水平地区进行的研究表明， 收入国家将肥胖与月经和排卵功能障碍以及随后的不孕症联系在一起。 这些发现对低收入和中等收入国家（LMIC）具有重要的公共卫生意义， 尽管肥胖症迅速增加，但实际上仍然无法获得辅助生殖治疗 普遍性。太平洋低收入国家与肥胖有关的发病率和死亡率特别高。但很少 研究评估了该地区心脏代谢与生殖健康之间的关系。 以前试图描述太平洋岛民妇女月经不规则的特征， 回顾性自我报告的周期长度和变异性，这是众所周知的回忆偏见， 对话者变异迄今为止，没有研究表明太平洋岛民妇女的无排卵周期。 这可能是因为确定排卵的金标准包括每天的经阴道超声检查， 这是一种侵入性和资源密集型的程序，对于流行病学研究来说是不切实际的。 我的建议通过两个科学目标和五个培训目标来解决这些差距， 现有队列约有n=150名年龄在25-39岁的萨摩亚妇女，其家庭由Nicola Hawley博士 （发起人）和同事自2015年以来一直在跟踪。这些妇女参与了健康和福利 2015年、2017/2018年和2019/2020年的评估。在计划于2022年进行的第四次数据收集浪潮中， 将测量肥胖并前瞻性评估排卵功能。在目标1中，我将研究关联 月经不规律和当前肥胖之间的关系以及肥胖的纵向变化轨迹， 萨摩亚女人。在目标2中，我将通过生物化学评估定期排卵的存在或不存在。 研究对象为女性，探讨无排卵与BMI之间的关系。调查结果将提供关键的 对肥胖妇女继发性不孕症的认识，并为制定治疗方案提供信息。 评估女性在低资源环境中的生殖潜力。此外，该项目将阐明 太平洋岛民妇女的心脏代谢和生殖风险的双重负担， 在全球肥胖率最高的人群中，在流行病学研究中的代表性不足。 我的培训计划将使我能够发展必要的研究，临床和专业技能， 成为一名进行纵向流行病学研究以调查 肥胖对低资源环境中孕产妇和儿童健康结果的影响。我的培训计划概述了课程， 指导研究和临床经验，以提高我在生物统计学，流行病学研究设计方面的技能 以及生殖内分泌学。