Menopause Symptom Clusters: Refocusing Therapeutics

更年期症状群：重新调整治疗方法

• 批准号: 7952735
• 负责人: NANCY Fugate WOODS
• 金额: $ 23.4万
• 依托单位: UNIVERSITY OF WASHINGTON
• 依托单位国家: 美国
• 财政年份: 2010
• 资助国家: 美国
• 起止时间: 2010-09-15 至 2012-07-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/7952735
• 关键词: Address; Adrenal Glands; Adverse effects; Aging; Ancillary Study; Aromatase; Attention; Autonomic nervous system; BDNF gene; Behavioral; Biological Markers; Brain-Derived Neurotrophic Factor; Clinical Trials; Cohort Studies; Collaborations; Complement; Conscious; Controlled Clinical Trials; Data; Data Analyses; Depressed mood; Distress; Education; Employment; Endocrine; Epinephrine; Estrogens; Feasibility Studies; Funding; Future; Generations; Genes; Genetic; Genetic Polymorphism; Genotype; Health; Hormones; Hot flushes; Hydrocortisone; Hypothalamic structure; Individual; Intervention; Link; Low income; Menopause; Metabolism; Modeling; Moods; National Institute on Aging; Neurobehavioral Manifestations; Neurosecretory Systems; Norepinephrine; Outcome; Ovarian; Pain; Participant; Pathway interactions; Personal Satisfaction; Pituitary Gland; Postmenopause; Protocols documentation; Recording of previous events; Reporting; Research; Research Personnel; Risk Factors; Role; Serotonin; Sexual abuse; Sleep; Sleep disturbances; Social Behavior; Social support; Staging; Steroids; Stress; Symptoms; TNFRSF5 gene; Testing; Therapeutic; Time; Transcend; Vasomotor; Woman; Women' s Health; Work; base; cognitive change; design; experience; follow-up; middle age; novel; public health relevance; ranpirnase; reproductive; self esteem; social; systematic review; treatment effect

DESCRIPTION (provided by applicant): Although women experience clusters of symptoms during the menopausal transition, most research focuses on individual symptoms such as hot flashes. The proposed study shifts the paradigm from focusing on individual symptoms to symptom clusters (SCs). Re-analyzing data on symptoms and genetic polymorphisms, endocrine biomarkers, symptom vulnerability factors and sociobehavioral risk factors from over 500 participants in the Seattle Midlife Women's Health Study (P50 NR02323, R01 NR04141, P30 NR04001, P30 ES07033) with longitudinal follow-up spanning up to 19 years will allow us to achieve these aims: 1) identify prevalent symptom clusters during the late reproductive stage, early and late menopausal transition stages, and early postmenopause using latent class analysis; 2) determine the consistency of symptom clusters as women change from one menopausal transition stage to the next; 3) test models linking genetic polymorphisms, endocrine biomarkers, symptom vulnerability factors, social-behavioral risk factors and menopause-related factors to symptom clusters, and outcomes of well-being and symptom interference; 4) conduct a systematic review of controlled clinical trials to identify symptoms as secondary treatment effects and adverse effects that will inform us about therapies for symptom clusters and 5) synthesize results of the empirical analyses and systematic review to develop novel symptom cluster management protocols to be tested in future feasibility studies. An interdisciplinary scientific advisory board including National Institute on Aging-funded MS-FLASH clinical trials investigators will provide our research team an opportunity for immediate sharing of our results in order to inform design of symptom cluster management approaches as well as their ongoing studies, including the generation of ancillary studies of symptom clusters and related mechanisms. PUBLIC HEALTH RELEVANCE: The results of this study will help clinicians and women, themselves, identify symptoms that cluster together and that may have different causes. Knowing which cluster of symptoms a woman has may help her clinician recommend the treatment or treatments that are most likely to work best for her. Using some of the genetic and hormone tests, as well as information about the woman's history, such as stressful experiences she has had, may help understand what causes some of her symptoms and may help her and her clinician decide on the best treatment available for her.

描述（由申请人提供）：尽管女性在绝经期间经历了症状簇，但大多数研究都集中在单个症状上，例如潮热。拟议的研究将范式从专注于个体症状转移到症状簇（SCS）。重新分析有关症状和遗传多态性的数据，内分泌生物标志物，症状脆弱性因素和来自西雅图中年女性健康研究中500多名参与者的社会行为风险因素（P50 NR02323，P30 NR01 NR04141，R01 NR04141，P30 NR04001，P304001，P304001，P303333）为了实现这些目的：1）使用潜在的类别分析确定晚期生殖阶段，早期和晚期过渡阶段的普遍症状簇以及绝经后的早期； 2）确定症状簇的一致性，因为女性从一个更年期过渡阶段变为下一个症状； 3）将遗传多态性，内分泌生物标志物，症状脆弱性因素，社交行为风险因素和更年期相关因素与症状簇以及幸福感和症状干扰的结果联系起来的测试模型； 4）对受控临床试验进行系统的审查，以确定症状为次要治疗效果和不良影响，这将为我们提供有关症状簇的疗法的信息，5）合成经验分析的结果和系统评价的结果，以开发新的症状集群管理方案，以在未来的可行性研究中进行测试。跨学科的科学顾问委员会在内，包括国家老化资助的MS-Flash临床试验研究所，研究人员将为我们的研究团队提供一个机会，可以立即分享我们的结果，以告知症状群集管理方法的设计以及正在进行的研究，包括症状簇和相关机制的辅助研究。 公共卫生相关性：这项研究的结果将帮助临床医生和妇女自己确定聚集在一起的症状，并且可能有不同的原因。知道女性患有哪些症状可能会帮助她的临床医生推荐最有可能对她起作用的治疗或治疗方法。使用一些遗传和激素测试以及有关女性历史的信息，例如她所经历的压力很大，可能有助于了解是什么原因导致了她的某些症状，并可能帮助她和她的临床医生决定为她提供最佳治疗方法。