Prospective Study of Diet, Physical Activity, BMI and Risk of Pulmonary Embolism

描述（由申请人提供）：饮食、体力活动、BMI和肺栓塞风险的前瞻性研究静脉血栓栓塞（VTE）代表了一系列疾病，包括深静脉血栓形成（DVT）和肺栓塞（PE）。鉴于老年人PE的高发病率和猝死率，一级预防至关重要。不幸的是，我们对可改变的风险因素-可用来指导初级预防战略的制定-的了解非常有限。拟议的研究将解决这一信息差距，并汇集了一个多学科小组的VTE临床研究人员和心血管/营养流行病学家在钱宁实验室，布里格姆妇女医院和马萨诸塞州总医院。我们将使用2项大型前瞻性观察性队列研究，使用1985年至2002年的数据，在护士健康研究（NHS）和卫生专业人员随访研究（HPFS）的老年参与者中检查饮食因素、体力活动、体重指数（BMI）和PE风险之间的关系。NHS是一项正在进行的前瞻性队列研究，研究对象是1986年年龄在50-55岁之间的121，700名女性护士。650例PE病例）。HPFS是一项正在进行的前瞻性队列研究，1986年有51，529名年龄在40-75岁之间的健康专业人士参与（约100人）。350例PE病例）。我们将讨论以下问题： 是主要的饮食模式（谨慎与西方），和特定的饮食因素（即，ω-3脂肪酸、反式脂肪、膳食纤维、抗氧化剂、含维生素K的食物）与不同的PE风险相关？PE的风险是否可以通过增加体力活动水平来改变？在正常范围内，BMI与PE呈正相关吗？通过经验证的措施收集暴露信息，包括半定量食物频率问卷、体力活动问卷和NHS和HPFS中每半年收集的广泛协变量列表。我们将使用补充问卷和医疗记录来验证报告的PE病例;这种数据收集是在20年前开始的，目前的拨款将资助完成结果验证，数据管理和上述假设的测试。所有拟议目标的统计功效均>80%。该项目将为这些大型队列研究中PE风险遗传标记的未来工作奠定基础。我们希望确定并量化PE的危险因素，从而采取公共卫生干预措施，有效降低老年人群中VTE的发病率。项目叙述：静脉血栓栓塞是一种常见且致命的疾病，尤其是在老年人中。我们建议在两项大型前瞻性队列研究（护士健康研究和健康专业人员随访研究）中研究> 150，000名成年人，以了解与饮食，体力活动和体重指数相关的可改变风险因素如何影响肺栓塞的风险。我们相信，量化这些可改变的危险因素将导致公共卫生干预，降低老年人群肺栓塞的发病率。

DESCRIPTION (provided by applicant): Prospective Study of Diet, Physical Activity, BMI and Risk of Pulmonary Embolism Venous thromboembolism (VTE) represents a spectrum of disease that includes deep venous thrombosis (DVT) and pulmonary embolism (PE). Given the high incidence and sudden mortality associated with PE in the elderly, primary prevention is of vital importance. Unfortunately, our understanding of modifiable risk factors -- that could be used to guide the development of primary prevention strategies -- is very limited. The proposed study will address this information gap and bring together a multidisciplinary group of VTE clinical researchers and cardiovascular/nutrition epidemiologists at the Channing Laboratory, Brigham and Women's Hospital and Massachusetts General Hospital. We will use 2 large prospective observational cohort studies to examine the relationship between dietary factors, physical activity, body mass index (BMI) and risk of PE among elderly participants in the Nurses' Health Study (NHS) and the Health Professionals' Follow-Up Study (HPFS), using data from 1985 to 2002. NHS is an ongoing prospective cohort study of 121,700 female nurses, age 50-55 in 1986 (approx. 650 PE cases). HPFS is an ongoing prospective cohort study of 51,529 men in health professions age 40-75 in 1986 (approx. 350 PE cases). We will address the following questions: Are major dietary patterns (Prudent vs. Western), and specific dietary factors (i.e., omega-3 fatty acids, trans fats, dietary fiber, antioxidants, Vitamin K-containing foods) associated with different risks of PE? Is the risk of PE modified by increasing levels of physical activity? Within the normal range, is BMI positively associated with PE? Exposure information was gathered by validated measures, including the Semiquantitative Food Frequency Questionnaire, the Physical Activity Questionnaire, and an extensive list of covariates collected biannually in NHS and HPFS. We will validate reported cases of PE using supplementary questionnaires and medical records; such data collection was initiated two decades ago and the current grant would fund the completion of outcome validation, data management, and testing of the hypotheses listed above. Statistical power is >80% for all of proposed aims. The project would lay the foundation for future work on genetic markers of PE risk in these large cohort studies. We hope to identify and quantify risk factors for PE that lead to public health interventions that effectively decrease the incidence of VTE in the elderly population. Project Narrative: Venous thromboembolism is a common and deadly disease, especially among the elderly. We propose to study >150,000 adults in two large prospective cohort studies (the Nurses' Health Study and Health Professionals' Follow-up Study) to learn how modifiable risk factors related to diet, physical activity, and body mass index affect the risk of pulmonary embolism. We believe that quantifying these modifiable risk factors will lead to public health interventions that decrease the incidence of pulmonary embolism in the elderly population.