Menopause Symptom Clusters: Refocusing Therapeutics

描述(由申请人提供)：尽管女性在更年期过渡期间会经历一系列症状，但大多数研究都集中在个别症状上，如潮热。这项拟议的研究将研究范式从关注个别症状转变为关注症状群(SCS)。对西雅图中年妇女健康研究(P50 NR02323，R01 NR04141，P30 NR04001，P30 ES07033)500多名参与者的症状和遗传多态、内分泌生物标记物、症状易感性因素和社会行为危险因素的数据进行重新分析，并进行长达19年的纵向跟踪，将使我们能够实现这些目标：1)使用潜在类别分析确定生殖后期、绝经早期和绝经后期以及绝经早期的流行症状群；2)确定妇女从一个更年期过渡到下一个更年期时症状群的一致性；3)测试模型，将遗传多态、内分泌生物标记物、症状易感因素、社会行为风险因素和更年期相关因素与症状群、幸福感和症状干预的结果联系起来；4)对受控临床试验进行系统综述，以确定症状为二次治疗效果和不良反应，从而为我们提供有关症状群治疗的信息；5)综合经验分析和系统综述的结果，开发新的症状群管理方案，在未来的可行性研究中进行测试。一个包括国家老龄研究所资助的MS-Flash临床试验研究人员在内的跨学科科学顾问委员会将为我们的研究团队提供一个机会，立即分享我们的结果，以便为症状群管理方法的设计及其正在进行的研究提供信息，包括生成症状群和相关机制的辅助研究。 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，以及可能有不同原因的症状。了解女性有哪一组症状可能会帮助她的临床医生推荐对她最有效的一种或多种治疗方法。使用一些基因和激素测试，以及关于女性病史的信息，如她曾经历过的压力经历，可能有助于了解导致她一些症状的原因，并可能帮助她和她的临床医生决定对她可用的最佳治疗方法。

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.