Study of Women's Health Across the Nation-Endocrine Lab

描述（由申请人提供）：全国妇女健康研究（SWAN）是一项多中心、多种族、以社区为基础的纵向研究，旨在描述更年期过渡期间发生的生物学和社会心理变化，并评估其对妇女健康的影响。目前和过去的资助（SWAN I和II）支持六年的随访，在随访结束时，60%可观察到的绝经后过渡将发生。这项竞争性更新申请（SWAN III）和一项单独的竞争性补充申请共同要求资助，以完成总共10次队列随访，使我们能够捕获91%可观察到的绝经后过渡，并提供更具代表性的样本。这些额外的数据将使我们能够关注文献中尚未得到很好研究的围绝经期晚期和绝经后早期。随着女性绝经期结束（最后一次月经后两年），我们将从每年一次的随访计划改为每两年一次的随访计划，并在交替的年份进行邮件和电话联系。这将为在SWAN III之后开展具有成本效益和不那么密集的后续行动奠定基础。我们将继续目前的观察，并在四个科学项目领域（卵巢老化；症状、风险因素、功能和衰老；心血管风险因素；骨量的决定因素和结果）中开展新的科学研究。新科学包括

DESCRIPTION (provided by applicant): The Study of Women's Health Across the Nation (SWAN) is a multicenter, multiethnic, community based, longitudinal study designed to characterize the biological and psychosocial changes that occur during the menopausal transition and to assess their effect on women's health. Current and past funding (SWAN I and II) support six years of follow-up, at the end of which 60% of observable transitions to postmenopause will have occurred. Together, this competitive renewal application (SWAN III) and a separate competitive supplement application request funding to complete a total of 10 cohort follow-up visits, allowing us to capture 91% of observable transitions to postmenopause and providing a more representative sample. The additional data will permit a focus on the late perimenopausal and early postmenopausal periods that have not been well studied in the literature. As women reach the end of early postmenopause (two years following the final menstrual period), we will shift from an annual to a bi-annual follow-up schedule with mail and telephone contact in the alternating years. This will set the stage for cost-effective and less intensive follow-up beyond SWAN III. We will continue our current observations as well as undertake new science in each of the four scientific project areas (ovarian aging; symptoms, risk factors, functioning and aging; cardiovascular risk factors; and determinants and outcomes of bone mass). The new science includes measurement of vascular stiffness to assess early cardiovascular disease, salivary cortisol levels, vertebral morphometry using newly developed DEXA technology, and circulating androgens and total bioactive estrogens using an assay system developed by SWAN investigators. In addition, we will focus on linking the menopause and midlife experiences to age-related outcomes and chronic diseases, including physical and cognitive function. The additional follow-up will contribute to and expand the SWAN biological specimen repository (annual blood and urine samples as well as DNA and immortalized cells), a separately funded component that provides opportunities to address future hypotheses about health, disease and aging. With SWAN III, many of the original goals of SWAN will be brought to fruition. We will build upon the rich foundation developed during SWAN I and II, and ultimately link these data to subsequent age-related health outcomes.