Menopause Symptom Clusters: Refocusing Therapeutics

描述（由申请人提供）：尽管女性在绝经过渡期会出现一系列症状，但大多数研究都集中在个别症状上，如潮热。拟议的研究转移的范式，从集中在个别症状的症状群（SC）。重新分析西雅图中年妇女健康研究中500多名参与者的症状和遗传多态性、内分泌生物标志物、症状脆弱性因素和社会行为风险因素的数据（P50 NR 02323、R 01 NR 04141、P30 NR 04001、P30 ES 07033），纵向随访长达19年，将使我们能够实现这些目标：1）使用潜在类别分析来识别在晚期生殖阶段、早期和晚期绝经过渡阶段以及早期绝经后期间的普遍症状群; 2）确定随着妇女从一个绝经过渡阶段到下一个绝经过渡阶段的变化，症状群的一致性; 3）将遗传多态性、内分泌生物标志物、症状脆弱性因素联系起来的测试模型，社会行为危险因素和更年期相关因素对症状群的影响，以及健康和症状干预的结果; 4）对对照临床试验进行系统评价，以确定症状为次要治疗效应和不良反应，这将为我们提供有关症状群治疗的信息，以及5）综合实证分析和系统评价的结果，以制定新的症状群管理方案，在未来的可行性研究中进行测试。一个跨学科的科学咨询委员会，包括国家老龄化研究所资助的MS-FLASH临床试验研究人员将为我们的研究团队提供一个机会，立即分享我们的结果，以告知症状群管理方法的设计以及他们正在进行的研究，包括症状群和相关机制的辅助研究的产生。 公共卫生相关性：这项研究的结果将帮助临床医生和妇女自己识别聚集在一起的症状，这些症状可能有不同的原因。了解女性的哪一组症状可以帮助她的临床医生推荐最适合她的治疗方法。使用一些基因和激素测试以及有关女性历史的信息，例如她曾经有过的压力经历，可以帮助了解导致她的一些症状的原因，并可以帮助她和她的临床医生决定最适合她的治疗方法。

DESCRIPTION (provided by applicant): Although women experience clusters of symptoms during the menopausal transition, most research focuses on individual symptoms such as hot flashes. The proposed study shifts the paradigm from focusing on individual symptoms to symptom clusters (SCs). Re-analyzing data on symptoms and genetic polymorphisms, endocrine biomarkers, symptom vulnerability factors and sociobehavioral risk factors from over 500 participants in the Seattle Midlife Women's Health Study (P50 NR02323, R01 NR04141, P30 NR04001, P30 ES07033) with longitudinal follow-up spanning up to 19 years will allow us to achieve these aims: 1) identify prevalent symptom clusters during the late reproductive stage, early and late menopausal transition stages, and early postmenopause using latent class analysis; 2) determine the consistency of symptom clusters as women change from one menopausal transition stage to the next; 3) test models linking genetic polymorphisms, endocrine biomarkers, symptom vulnerability factors, social-behavioral risk factors and menopause-related factors to symptom clusters, and outcomes of well-being and symptom interference; 4) conduct a systematic review of controlled clinical trials to identify symptoms as secondary treatment effects and adverse effects that will inform us about therapies for symptom clusters and 5) synthesize results of the empirical analyses and systematic review to develop novel symptom cluster management protocols to be tested in future feasibility studies. An interdisciplinary scientific advisory board including National Institute on Aging-funded MS-FLASH clinical trials investigators will provide our research team an opportunity for immediate sharing of our results in order to inform design of symptom cluster management approaches as well as their ongoing studies, including the generation of ancillary studies of symptom clusters and related mechanisms. PUBLIC HEALTH RELEVANCE: The results of this study will help clinicians and women, themselves, identify symptoms that cluster together and that may have different causes. Knowing which cluster of symptoms a woman has may help her clinician recommend the treatment or treatments that are most likely to work best for her. Using some of the genetic and hormone tests, as well as information about the woman's history, such as stressful experiences she has had, may help understand what causes some of her symptoms and may help her and her clinician decide on the best treatment available for her.