A Prospective Study of Diet and Fibroids in Black Women

描述(申请人提供)：子宫肌瘤(UL)，或肌瘤，是育龄妇女妇科疾病的主要来源，在美国每年造成21亿美元的医疗费用。黑人女性被诊断为UL的可能性是白人女性的2-3倍，而且在临床表现时有更严重的疾病。雌激素和孕激素与UL的发生发展密切相关。利用黑人女性健康研究(BWHS)的数据，我们建议前瞻性评估可能导致黑人女性临床相关UL高发的饮食风险因素(例如纤维和脂肪摄入量)。BWHS是一项全国性的前瞻性跟踪研究，涉及59,000名非裔美国女性。我们将关注那些看似对性激素合成、新陈代谢或生物利用度有影响的饮食因素。我们将调查这些饮食因素对超声或手术证实的自我报告UL发生率的影响。自1995年BWHS成立以来，每两年对妇女进行一次问卷调查。参与者在1995年和2001年完成了食物频率调查问卷。BWHS的验证研究表明，自我报告的UL具有很高的准确性(&gt；96%)，食品频率数据与饮食召回和日记的相关性令人满意。在1997-2007年的随访期间，将报告6000多例经超声或手术证实的肌瘤事件。大量的事件案例将提供很高的统计能力，并允许进行信息量大的分组分析，例如在35岁以下的妇女(N=2,400例)和非肥胖妇女(N=3,800例)中，应尽量减少错误分类。UL在黑人女性中的高发病率是一个重要的公共卫生问题。被认为会增加风险的饮食模式(例如，高脂肪和低纤维摄入量)在黑人女性中比白人女性更普遍。因此，拟议的研究将允许评估可能导致黑人女性UL发病率过高的可修改的危险因素。此外，这项研究可以低成本进行，因为BWHS的数据收集得到了其他赠款的支持。这项拟议的研究由一位在研究UL风险因素方面拥有丰富经验的新调查员领导，将是迄今为止关于饮食和UL的最大规模的研究，这是第一项前瞻性研究，也是第一项针对黑人女性的研究。 项目简介：子宫肌瘤(UL)，或称肌瘤，是黑人女性妇科疾病的主要来源，在美国每年造成21亿美元的医疗费用。利用黑人女性健康研究(BWHS)的数据，我们建议研究可能导致黑人女性临床相关UL高发的饮食风险因素。BWHS是一项针对非裔美国女性的大型前瞻性后续研究。被认为会增加风险的饮食模式(例如，高脂肪和低纤维摄入量)在黑人女性中比白人女性更普遍。因此，拟议的研究将允许评估临床上相关的UL的风险因素，这些因素可能导致黑人女性的过度发病率。

DESCRIPTION (provided by applicant): Uterine leiomyomata (UL), or fibroids, are a major source of gynecologic morbidity among reproductive-aged women and account for 2.1 billion dollars in health care costs each year in the United States. Black women are 2-3 times more likely than white women to be diagnosed with UL and have more severe disease at the time of clinical presentation. Estrogen and progesterone have been implicated in the development and growth of UL. Using data from the Black Women's Health Study (BWHS), a nationwide prospective follow-up study of 59,000 African-American women, we propose to prospectively assess dietary risk factors (e.g., fiber and fat intake) that might contribute to the high incidence of clinically relevant UL in black women. We will focus on dietary factors that plausibly have an effect on sex hormone synthesis, metabolism, or bioavailability. We will investigate the influence of these dietary factors on the incidence of self-reported UL confirmed by ultrasound or surgery. Since the inception of the BWHS in 1995, women have been followed biennially by questionnaire. Food frequency questionnaires were completed by participants in 1995 and 2001. Validation studies in the BWHS have demonstrated high accuracy of self-reported UL (>96%) and satisfactory correlation of the food frequency data with dietary recalls and diaries. During follow-up from 1997-2007, over 6,000 incident cases of fibroids confirmed by ultrasound or surgery will have been reported. The large number of incident cases will provide high statistical power and allow for informative subgroup analyses, e.g. among women under age 35 (N=2,400 cases) and non-obese women (N=3,800) among whom misclassification should be minimized. The high incidence of UL in black women is a problem of public health importance. Dietary patterns hypothesized to increase risk (e.g., high fat and low fiber intake) are more prevalent in black women than white women. Thus, the proposed study will permit evaluation of modifiable risk factors that may contribute to the excess UL incidence among black women. Moreover, the study can be carried out at low cost because BWHS data collection is supported by other grants. The proposed study, led by a new investigator with extensive experience in studying risk factors for UL, would be the largest by far of diet and UL, the first prospective study, and the first study in black women. Project Narrative: Uterine leiomyomata (UL), or fibroids, are a major source of gynecologic morbidity among black women and account for 2.1 billion dollars in health care costs each year in the United States. Using data from the Black Women's Health Study (BWHS), a large prospective follow-up study of African-American women, we propose to study dietary risk factors that might contribute to the high incidence of clinically relevant UL in black women. Dietary patterns hypothesized to increase risk (e.g., high fat and low fiber intake) are more prevalent in black women than white women. Thus, the proposed study will permit the evaluation of risk factors for clinically relevant UL that may contribute to the excess incidence among black women.