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、基于社区的纵向研究，旨在描述绝经过渡期间发生的生物学、症状和心理社会变化，以及这些变化对过渡期间和之后妇女健康的影响。目前和以前的资金（SWAN I和II）支持了7年的随访，在随访结束时，60%可观察到的绝经后过渡将发生。这一竞争性续期申请（SWAN III）要求资助完成10个队列随访。这将使我们能够捕获91%的可观察到的绝经后过渡，并获得更具代表性的样本。额外的数据将集中在围绝经期晚期和绝经后早期，这一点尚未得到很好的研究。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。新科学包括测量血管硬度以评估早期心血管疾病，使用新开发的DEXA技术进行椎体形态测量，骨骼和身体成分以及循环雄激素作为雄激素生物合成的标记。后者将使用SWAN研究人员开发的分析系统。此外，我们将重点关注更年期和中年经历与年龄相关的结果和慢性疾病，包括身体和认知功能的联系。额外的后续工作将有助于扩大SWAN生物标本库（每年的血液和尿液样本以及DNA和永生化细胞），这是一个单独资助的组成部分，为解决有关健康、疾病和衰老的未来假设提供了机会。SWAN III将使我们能够实现SWAN的许多最初目标。通过在SWAN I和II期间建立的丰富基础，并最终将这些数据与年龄相关的健康结果联系起来，我们将对更年期对美国妇女健康的作用获得无与伦比的新见解。

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, symptomatic and psychosocial changes that occur during the menopausal transition and the effects of these changes on women's health during and after the transition. Current and prior funding (SWAN I and II) has supported seven years of follow-up, at the end of which 60%of observable transitions to postmenopause will have occured. This competitve renewal application (SWAN III) requests funding to complete 10 cohort follow-up visits. This will allow us to capture 91% of observable transitions to postmenopause and obtain a more representative sample. The additional data will a focus on the late perimenopausal and early postmenopausal periods that have not been well studied. 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 telphone 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 and 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). New science includes measurement of vascular stiffness to assess early cardiovascular disease, vertebral morphometry using newly developed DEXA technology bone and body composition and circulating androgens as markers androgen biosynthesis. The latter will use 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. SWAN III will allow us to bring to fruition many of the original goals of SWAN. By building upon the rich foundation developed during SWAN I and II, and ultimately linking these data to age-related health outcomes, we will achieve unparalleled new insights into the role of the menopause on the health of American women.