Adult Life Predictors of Genitourinary Disorders

描述(由申请人提供)：虽然关于影响非恶性泌尿生殖系统疾病发展的因素已经积累了大量的知识，但仍有显著的空白需要填补。在这些差距中，需要确定生命早期发生的因素，并预测生命后期的疾病或状况，以便更好地了解疾病的机制，并制定预防战略。此外，对一些假定的或已知的危险因素的亚临床方面几乎一无所知。这些非常常见的疾病在医疗保健和生活质量方面的巨大成本掩盖了人们对这些疾病缺乏重要性的看法。为了帮助解决这些知识上的不足，我们建议在青年冠状动脉风险发展(CARDIA)研究的参与者中进行一项研究。自1986年以来，在四个实地考点对5115名男女进行了跟踪调查，其中约有3525人预期参加25年考试。从这个专心致志的队列中，我们收集到了一个极其丰富的纵向数据集，这些数据集是从年轻的成年人开始收集的。这项研究的总体目标是研究在成人生活中反复测量的因素如何增加或减少良性生殖系统疾病(例如，尿失禁、盆腔器官脱垂、性功能障碍、下尿路症状和勃起功能障碍)的出现。为了实现这一目标，我们这项建议的主要目的是：1)确定可改变的因素如何与泌尿生殖系统的结果相关联；2)确定选定的健康状况如何与泌尿生殖系统的结果相关联；以及4)创建一个资源来检查这些因素与这些泌尿生殖系统疾病的发生或发展之间的纵向关系。作为一个探索性目标，我们还将研究炎症生物标记物(例如，CRP、尿酸、IL-6)以及内源性激素和结合蛋白水平与泌尿生殖系统结果的关系。每个结果都将使用流行病学或临床研究中常用的标准化或公认的测量方法来确定。我们建议收集两次相隔三年的评估，以检查这些疾病的流行、新发和进展情况。感兴趣的因素和评估类型的重复性质，其中许多包括对亚临床疾病的评估，提供了一个罕见的机会。这一群体的下一个考试周期已经得到资助，与该群体的实地工作将于2010年初开始。因此，将良性泌尿生殖系统结果纳入当前评估的机会是及时的，也是对时间敏感的。拥有关于如此大的多种族队列的如此全面的数据，使其成为研究纵向因素和泌尿学结果的独特而有价值的资源。 公共卫生相关性：这项研究的总体目标是研究在成人生活中反复测量的因素如何增加或减少非恶性生殖系统疾病(例如，尿失禁、盆腔器官脱垂、性功能障碍、下尿路症状、前列腺肥大和勃起功能障碍)的出现。这项研究将在青年冠状动脉风险发展研究(CARDIA)的男性和女性中进行，他们自1986年以来一直受到跟踪。我们希望，通过确定影响泌尿生殖系统状况的因素，我们可以帮助制定初级和二级预防措施。

DESCRIPTION (provided by applicant): While considerable knowledge has accumulated regarding factors that influence the development of non-malignant genitourinary disorders, there are significant gaps that need to be filled. Among these gaps is the need to identify factors that occur early in life and predict diseases or conditions later in life so that the mechanisms of disease can be better understood and for developing prevention strategies. In addition, there is almost nothing known about the subclinical aspects of some putative or known risk factors. The enormous costs in medical care and quality of life for these very common disorders belie the perceived lack of importance for these conditions. To help address these deficits in knowledge, we propose to conduct a study among the participants in the Coronary Artery Risk Development in Young Adults (CARDIA) Study. This cohort of 5,115 men and women has been followed since 1986 at four field sites with approximately 3,525 of them expect to participate in the Year 25 Exam. From this dedicated cohort comes an incredibly rich longitudinal dataset collected since young adulthood. The overall objective of this study is to examine how factors repeatedly measure over adult life may increase or decrease the presence of benign genitourinary conditions (e.g., urinary incontinence, pelvic organ prolapse, sexual dysfunction, lower urinary tract symptoms, and erectile dysfunction). To accomplish this objective, our primary aims for this proposal are to: 1) determine how modifiable factors are associated with genitourinary outcomes; 2) determine how selected health conditions are associated with genitourinary outcomes; and 4) create a resource to examine the longitudinal relationship between these factors and the onset or progression of these genitourinary conditions. As an exploratory aim we will also examine how biomarkers of inflammatory (e.g., CRP, uric acid, IL-6) and endogenous hormone and binding protein levels are associated with genitourinary outcomes Each outcome will be ascertained using a standardized or well accepted measure that is in common use in epidemiologic or clinical research. We propose to collect two assessments three years apart to examine prevalent, new onset and progression in these conditions. The repeated nature of factors of interest and the types of assessments, many that include assessments of subclinical disease, provide an uncommon opportunity. The next exam cycle for this cohort has been funded and field work with the cohort will begin early in 2010. Thus, the opportunity to include benign genitourinary outcomes in the current assessment is timely and time sensitive. Having such comprehensive data on such a large multiethnic cohort makes this a unique and valuable resource for the study of longitudinal factors and urological outcomes. PUBLIC HEALTH RELEVANCE: The overall objective of this study is to examine how factors repeatedly measure over adult life may increase or decrease the presence of non-malignant genitourinary conditions (e.g., urinary incontinence, pelvic organ prolapse, sexual dysfunction, lower urinary tract symptoms, enlarged prostate and erectile dysfunction). The study will be done among the men and women in the Coronary Artery Risk Development in Young Adults (CARDIA) Study who have been followed since 1986. We hope that by identifying factors affecting genitourinary conditions we can help in the development of primary and secondary prevention interventions.