PREVALENCE & PROGRESSION OF SUBCLINICAL ATHEROSCLEROSIS

描述：（改编自研究者摘要）亚临床 动脉粥样硬化将在728名妇女中进行评估（305名非洲裔美国人，423名 高加索人）参加了匹兹堡和芝加哥的妇女的研究网站， 全国健康（SWAN），一项多中心研究， 生物学和心理社会学的前因和绝经的后果。程度 卵巢功能减退会影响血管功能， 冠状动脉、主动脉和颈动脉粥样硬化的发展 将对动脉进行评估。冠状动脉和主动脉的连续测量 钙化（EBCT）、颈动脉粥样硬化、内皮功能和 主动脉硬化将间隔两年进行。患病率和 亚临床动脉粥样硬化的进展将根据以下因素进行评价： 卵巢功能、心理社会和行为因素的系列测量， 凝血和炎症的标志物以及传统的心血管风险 所有这些因素都在SWAN中收集。卵巢功能下降和绝经前 肥胖可能是早期冠状动脉粥样硬化的主要决定因素 通过EBCT上的钙化测量。主动脉钙化早于 冠状动脉钙化，可以预测冠状动脉钙化，并预计 是与这些年轻人中的传统因素相关的风险的最佳标志。 妇女初步数据显示冠状动脉和主动脉的变化 在这些妇女中可以在短时间内观察到钙化。一 雌激素水平下降的时期是观察雌激素水平变化的最佳时间。 内皮功能可能先于可测量的动脉粥样硬化， 可能是潜在疾病的最早标志。血管僵硬，一个标志 对于血管系统的生物老化， 胰岛素敏感性的测量在中年妇女中改变， 与中心性肥胖症的增加相关联。疾病的种族差异 某些风险因素的流行程度和相对重要性是可能的。的 研究人员指出，总的来说，这一应用程序将允许详细的 阐明卵巢功能减退如何影响心血管疾病， 这只能在仔细的前瞻性研究的背景下进行， 更年期，如天鹅。

DESCRIPTION: (Adapted from the Investigator's Abstract) Subclinical atherosclerosis will be evaluated in 728 women (305 African American, 423 Caucasian) enrolled in the Pittsburgh and Chicago sites of the Study of Women's Health Across the Nation (SWAN), a multicenter study characterizing the biological and psychosocial antecedents and sequellae of menopause. The extent to which diminishing ovarian function affects vascular function and accelerates the development of atherosclerosis in the coronary arteries, aorta and carotid arteries will be evaluated. Serial measures of coronary and aortic calcification (by EBCT), carotid atherosclerosis, endothelial function and aortic stiffening will be performed two years apart. The prevalence and progression of subclinical atherosclerosis will be evaluated in relation to serial measures of ovarian function, psychosocial and behavioral factors, markers of clotting and inflammation as well as traditional cardiovascular risk factors, all collected in SWAN. Decreased ovarian function and premenopausal obesity are likely the primary determinants of early coronary atherosclerosis as measured by calcification on EBCT. Aortic calcification occurs earlier than coronary calcification, may predict coronary calcification, and is expected to be the best marker of risk associated with traditional factors in these younger women. Preliminary data indicate that changes in coronary and aortic calcification can be observed over short periods of time in these women. A period of diminishing estrogen levels is the optimum time to observe changes in endothelial function which likely precede measurable atherosclerosis and thus may be the earliest markers for disease potential. Vascular stiffness, a marker for the biologic aging of the vascular system, is highly correlated with measures of insulin sensitivity which is altered in women at mid-life in conjunction with increases in central adiposity. Racial differences in disease prevalence and the relative importance of certain risk factors are likely. The investigators state that in summary, this application will allow a detailed elucidation of how diminishing ovarian function affects cardiovascular disease, which can only be done within the context of a careful prospective study of the menopausal transition such as SWAN.