Trajectories of ovarian reserve and cardiovascular risk in Black and White women

摘要 女性的生殖生命周期会影响她的长期健康，包括 心血管疾病。绝经过渡会影响卵巢癌的发病和发生时间。 可能导致长期健康后果的心血管变化。其中有一个联系 较早发病的绝经年龄与心血管死亡率和心力衰竭之间的关系 更年期与较高的心血管疾病发病率有关。卵巢的大小 卵泡池和卵巢激素分泌停止是影响卵巢功能的关键因素。 更年期的时间。血清抗苗勒氏激素(AMH)已成为一种重要的 卵泡池的标记物。AMH已被证明反映了 生殖能力随着年龄的增加而增加。AMH的早期下降和更快的轨迹 下降与心血管疾病风险的增加有关。本研究 补充剂将在生殖寿命内的多个时间点测试AMH值，方法是使用 来自NHLBI生长与健康研究(NGHS)的存储样本和预期样本。 1987年，NGHS招募了871名9岁或10岁的女孩(50%是黑人，50%是白人)，并进行了检查 最多17次，至27岁，包括20-27岁之间的7次超声心动图，多次 保存样本和生育史调查问卷。本增刊的家长研究 将在生殖后期招募350名NGHS参与者(平均年龄46岁)和 收集心血管实验室和成像以及更新生命周期信息 社会经济地位和健康的社会决定因素。本附录将增加评估 卵巢储备的时间轨迹：1)确定卵巢储备的差异和其 黑人和白人女性之间的轨迹以及健康的社会决定因素(SDOH) 影响这一差异；2)确定卵巢储备的轨迹是否在 生殖生命过程会影响心血管疾病的风险或疾病。此外，这一点 补充旨在创建一个研究参与者咨询小组，以帮助优化研究招募 以及留存，特别是在黑人女性中。随着我们目标的完成，我们将理解 SDOH和RACE对卵巢储备的影响以及确定卵巢储备比率 下降可能是未来心血管疾病的一个标志。本补充资料旨在 通过增加有关生殖系统的更多信息来增加父母补助金 影响心血管疾病以及提供改善受试者招募的机制， 留存，以及对研究的满意度。

Abstract The reproductive lifecycle of a women can affect her long-term health including onset of cardiovascular disease. The menopausal transition affects the onset and timing of cardiovascular changes that can lead to long term health consequences. There is a link between the age at menopause and cardiovascular mortality and heart failure, as earlier onset of menopause is associated with higher rates of cardiovascular disease. The size of the ovarian follicle pool and cessation of ovarian hormone production is a key factor that influences the timing of menopause. Serum anti-mullerian hormone (AMH) has emerged as an important marker of the ovarian follicle pool. AMH has been shown to reflect the gradual decline in reproductive capacity with increasing age. Early decline in AMH and a more rapid trajectory of decline have been associated with increased risk for cardiovascular disease. This study supplement will test AMH values at multiple timepoints over the reproductive lifespan by utilizing stored samples and prospective samples from the NHLBI Growth and Health Study (NGHS). NGHS enrolled 871 girls (50% Black and 50% White) in 1987 at age 9 or 10 and examined them up to 17 times, to age 27, including 7 echocardiograms between ages 20-27, multiple saved samples and reproductive history questionnaires. The parent study for this supplement will be enrolling 350 NGHS participants in the late reproductive stage (average age 46) and collecting cardiovascular labs and imaging as well as update lifetime information on socioeconomic status and social determinants of health. This supplement will add assessment of ovarian reserve trajectory of time to: 1) Determine differences in the ovarian reserve and its trajectories between Black and White women and how the social determinants of health (SDOH) impact this difference; 2) Determine if the trajectory of ovarian reserve decline across the reproductive life-course affects cardiovascular disease risk or disease. In addition, this supplement aims to create a study participant advisory group to help optimize study recruitment and retention particularly in Black women. With completion of our aims, we will understand the effect of SDOH and race on ovarian reserve as well as determine if the rate of ovarian reserve decline can be a marker for future cardiovascular disease. This supplement is designed to enhance the parent grant by adding additional information about the reproductive system affecting cardiovascular disease as well as provide mechanisms to improve subject recruitment, retention, and satisfaction with the study.