The Role of 27-hydroxycholesterol in Breast Cancer: A Population-Based Multiethnic Study

27-羟基胆固醇在乳腺癌中的作用：基于人群的多种族研究

基本信息

批准号：
10166556
负责人：
Iona C Cheng
金额：
$ 22.33万
依托单位：
UNIVERSITY OF HAWAII AT MANOA
依托单位国家：
美国
项目类别：
财政年份：
2020
资助国家：
美国
起止时间：
2020-07-01 至 2021-02-28
项目状态：
已结题

来源：
https://reporter.nih.gov/project-details/10166556
关键词：
27-hydroxycholesterol Activities of Daily Living Affect African American Age Aging Attention Body Weight Body mass index Breast Cancer Prognostic Factor Breast Cancer survivor Breast Cancer survivorship Cardiovascular Diseases Characteristics Chronic Cohort Studies Complex Data Demographic Factors Diagnosis Diagnostic Dietary Practices Disabled Persons Dyslipidemias Early Diagnosis Early treatment Education Elderly Enrollment Ethnic Origin Ethnic group Failure Health Health behavior Impairment Incidence Individual Japanese American Joints Latino Life Expectancy Life Style Marital Status Matrix Metalloproteinases Measures Medicare Medicare claim Modeling Morbidity - disease rate Native Hawaiian Neighborhoods Obesity Older Population Outcome Parents Pathway interactions Patient Self-Report Patients Pattern Phenotype Physical Function Physical activity Proxy Questionnaires Race Recording of previous events Risk Role Smoking Socioeconomic Status Stage at Diagnosis Subgroup Survival Rate Survivors Time Treatment Factor Woman associated symptom base breast cancer diagnosis breast cancer survival cancer diagnosis cohort comorbidity contextual factors disability ethnic difference experience follow-up functional status improved indexing instrumental activity of daily living interest lifestyle factors malignant breast neoplasm mortality multiple chronic conditions older women physical inactivity population based prospective racial and ethnic resilience response social factors sociodemographic factors tumor

项目摘要

Abstract This application is being submitted in response to the Notice of Special Interest (NOSI) identified as NOT-CA-20-037. The median survival of breast cancer has improved steadily so that over 90% of patients will now survive at least 5 years after their initial diagnosis. As the number of older breast cancer survivors continues to increase, attention has now shifted to the occurrence of new comorbidities, symptoms, and complications after the initial breast cancer diagnosis, and the combined impact of aging and the consequences of breast cancer and its treatment in older women. Multimorbidities (MM) defined as the occurrence of two or more chronic conditions (or morbidities) in an individual may be a proxy measure of multisystem failures and progressive loss of resilience and functional reserve with increasing age. This supplement application aims to investigate the relationship between the accumulation of MM and risk of select aging phenotypes among women with incident breast cancer using the long-standing Multiethnic Cohort (MEC) study. Specifically, we will examine the relationships between MM patterns (MMP; number, type, clusters of MM, duration of MM and treatment) and three well-established metrics of physical function associated with aging: activities of daily living (ADL), instrumental activities of daily living (IADL), and mobility. This supplement proposal will build upon the parent MEC R01 study “The Role of 27-hydroxycholesterol in Breast Cancer: A Population-Based Multiethnic Study” (MPI: L. Loo/I. Cheng) by studying breast cancer survivorship in relation to MMP, as well as specific clusters of MMP such as cardiovascular disease and dyslipidemia that are directly relevant to the 27- hydroxycholesterol pathway. We propose the following aims: Aim 1: To characterize the relationship of MMP (number, type, and clusters of MM, duration of MM and treatment) among 9121 women with incident breast cancer in the MEC. We will assess MMP using baseline and follow-up questionnaires and Medicare claims data among incident breast cancer cases to examine the associations of pre- and post- cancer diagnosis MMP with demographic factors (age, race/ethnicity, marital status, education), lifestyle and health behaviors (body weight, dietary patterns, physical activity, smoking) as well as social and contextual factors (neighborhood socioeconomic status, ethnic enclaves). We will assess the association of MMP over time with breast cancer incidence among all women and by racial/ethnic groups. Aim 2. To investigate the risk of physical function disabilities associated with MMP among 3358 women with incident breast cancer in the MEC. We will use three aging metrics of physical function disabilities (ADL, IADL, and mobility) assessed in follow-up questionnaire. We will evaluate the associations of a history of MMP over time with the outcomes ADL, IADL, and mobility separately as well as a combined index among breast cancer cases. Aim 3: To assess the impact of MMP and physical function disabilities on overall mortality among 3358 women with incident breast cancer in the MEC. In a prospective analysis of breast cancer cases, we will investigate whether breast cancer survival is associated with (a) pre- and post-diagnostic MMP; (b) physical function disabilities (ADL, IADL, and mobility) separately and as a combined index; and (c) pre- and post-diagnostic MMP and physical function disabilities in a joint model

抽象的本申请是为了响应标识为 NOT-CA-20-037 的特殊利益通知 (NOSI) 而提交的。乳腺癌的中位生存期稳步提高，目前超过 90% 的患者可生存至少 5 年在初次诊断数年后，随着老年乳腺癌幸存者数量的持续增加，人们的关注度越来越高。现在转移到初始乳腺癌后出现新的合并症、症状和并发症诊断、衰老的综合影响以及乳腺癌的后果及其对老年女性的治疗。多重疾病 (MM) 定义为个体可能出现两种或多种慢性病（或发病）是多系统故障以及弹性和功能储备逐渐丧失的替代衡量标准该补充应用程序旨在调查 MM 积累与风险之间的关系。使用长期存在的多种族队列 (MEC) 选择乳腺癌女性中的事件衰老表型具体来说，我们将检查 MM 模式之间的关系（MMP；MM 的数量、类型、簇、 MM 持续时间和治疗）以及与衰老相关的三个公认的身体功能指标：活动该补充提案将以日常生活能力（ADL）、工具性日常生活活动（IADL）和流动性为基础。母体 MEC R01 研究“27-羟基胆固醇在乳腺癌中的作用：基于人群的研究” 多种族研究”（MPI：L. Loo/I. Cheng）通过研究乳腺癌存活率与 MMP 的关系，以及特定的 MMP 簇，例如与 27- 直接相关的心血管疾病和血脂异常羟基胆固醇途径。我们提出以下目标：目标 1：表征 MMP 的关系（数量、类型和 MEC 地区 9121 名乳腺癌女性患者的 MM 簇、MM 持续时间和治疗）。我们将使用基线和后续调查问卷以及事件乳房中的医疗保险索赔数据来评估 MMP 癌症病例，检查癌症诊断前和癌症诊断后 MMP 与人口因素（年龄、种族/民族、婚姻状况、教育程度）、生活方式和健康行为（体重、饮食模式、体力活动、吸烟）以及社会和背景因素（社区社会经济地位、种族聚居地）。评估所有女性和种族/族裔群体中 MMP 随着时间的推移与乳腺癌发病率的关联。目标 2. 调查 3358 名患有 MMP 的女性发生与 MMP 相关的身体功能残疾的风险 MEC 中的乳腺癌事件我们将使用身体功能残疾的三个衰老指标（ADL、IADL 和）。我们将评估 MMP 病史与随时间推移的关联性。结果 ADL、IADL 和活动能力分别以及乳腺癌病例中的综合指数目标 3：评估 MMP 和身体功能残疾对 3358 名患有此病的女性总体死亡率的影响在对乳腺癌病例的前瞻性分析中，我们将调查是否发生乳腺癌。乳腺癌存活率与 (a) 诊断前和诊断后的 MMP 相关；(b) 身体功能障碍（ADL、 IADL 和活动能力）单独或作为综合指标；以及 (c) 诊断前和诊断后 MMP 和身体功能联合模型中的残疾