Dietary, Hormonal, and Lifestyle Factors and Risk of Primary Hyperparathyroidism

饮食、激素和生活方式因素以及原发性甲状旁腺功能亢进症的风险

基本信息

批准号：
7745694
负责人：
Julie Paik
金额：
$ 6.32万
依托单位：
BRIGHAM AND WOMEN'S HOSPITAL
依托单位国家：
美国
项目类别：
财政年份：
2009
资助国家：
美国
起止时间：
2009-08-15 至 2011-08-14
项目状态：
已结题

来源：
https://reporter.nih.gov/project-details/7745694
关键词：
25-hydroxyvitamin D Accounting Adipose tissue Affect Age Alcohol consumption Binding Body mass index Bone Density Calcium Calcium-Sensing Receptors Cells Chronic Cohort Studies Development Diet Dietary Calcium Dietary Factors Disease Drops Endocrine Estrogens Ethanol Fatigue Fracture Future Growth High Prevalence Hormonal Hormones Human Hyperparathyroidism Impaired cognition In Vitro Incidence Individual Infusion procedures Intake Kidney Calculi Life Style Little&apos s Disease Magnesium Medical Menopausal Status Menopause Modeling Morbidity - disease rate Mutation Neck Neoplasms Nurses&apos Health Study Outcome Parathyroid Adenoma Parathyroid Hormones Parathyroid gland Patients Phosphorous Plasma Population Postmenopause Probability Public Health Race Rattus Research Resources Risk Risk Factors Serum Somatic Mutation Symptoms Time Tissues United States Vitamin D Weight Woman calcium intake cohort depression dietary restriction feeding hazard high risk human PTH protein inorganic phosphate irradiation lifestyle factors men modifiable risk parathyroid hyperplasia prevent problem drinker prospective residence

项目摘要

DESCRIPTION (provided by applicant): Primary hyperparathyroidism affects 0.2% to 0.5% of the population, with approximately 100,000 new cases in the U.S. each year. Women are three times more commonly affected than men and the incidence increases with age, so that up to 2% of post-menopausal women are estimated to have this disease. Associated morbidity and sequelae include decreased bone mineral density, fractures, and kidney stones. Currently, little is known about risk factors for developing primary hyperparathyroidism. We propose to study prospectively the relations between dietary, hormonal, and lifestyle risk factors and the development of primary hyperparathyroidism in two large, ongoing cohort studies of women: the Nurses Health Studies I (N=85,061) and II (N=75,815). The parathyroid adenomas of sporadic primary hyperparathyroidism are monoclonal, suggesting that these neoplasms originate from single cells with a growth conferring mutation. Factors that cause parathyroid hyperplasia therefore may increase the risk for developing primary hyperparathyroidism. The specific aims are the following: Aim 1) Diet. We hypothesize that lower calcium intake, higher phosphorous intake, and lower magnesium intake are independently associated with higher risk of developing primary hyperparathyroidism. Aim 2) Menopausal Status and Post-Menopausal Hormone Use. The incidence of primary hyperparathyroidism rises sharply after menopause. We hypothesize that menopause is independently associated with a higher risk of developing primary hyperparathyroidism and that post-menopausal hormone use is associated with a lower risk of developing primary hyperparathyroidism. Aim 3) Lifestyle Factors. We hypothesize that higher body mass index, lower estimated 25- hydroxyvitamin D levels, and higher alcohol consumption are associated with the risk of developing primary hyperparathyroidism. The outcome of our prospective cohort studies will be the incidence of primary hyperparathyroidism, with all cases confirmed by medical review. Because we expect to have over 1200 cases, the statistical power will be high. For example, the power to detect a hazard ratio of 1.4 across quintiles of calcium is 0.98. This study represents the first large-scale prospective effort to identify modifiable risk factors for primary hyperparathyroidism. Findings from this study could have important public health implications by preventing disease development and its associated sequelae. Finally, the creation of this large cohort of primary hyperparathyroidism cases will serve as a valuable resource for future research.

描述（由申请人提供）：原发性甲状旁腺功能亢进症影响着 0.2% 至 0.5% 的人口，大约有 100,000 名新患者美国每年都有这样的案例。女性患病率是男性的三倍，并且发病率随着年龄的增长而增加，因此估计高达 2% 的绝经后女性患有这种疾病。相关的发病率和后遗症包括骨矿物质密度降低、骨折和肾结石。目前，人们对原发性甲状旁腺功能亢进症的危险因素知之甚少。我们建议在两项正在进行的大型女性队列研究中前瞻性地研究了饮食、激素和生活方式危险因素与原发性甲状旁腺功能亢进症的发展之间的关系：护士健康研究 I (N=85,061) 和 II (N=75,815)。散发性原发性甲状旁腺功能亢进症的甲状旁腺腺瘤是单克隆的，表明这些肿瘤起源于具有生长突变的单细胞。因此，引起甲状旁腺增生的因素可能会增加患原发性甲状旁腺功能亢进症的风险。具体目标如下：目标 1) 饮食。我们假设钙摄入量较低，磷摄入量较高，磷摄入量较低镁摄入量与患原发性甲状旁腺功能亢进症的较高风险独立相关。目标 2) 绝经状态和绝经后激素的使用。原发性发病率绝经后甲状旁腺功能亢进症急剧上升。我们假设更年期是独立的与患原发性甲状旁腺功能亢进症的较高风险相关，绝经后激素的使用与患原发性甲状旁腺功能亢进症的较低风险相关。目标 3) 生活方式因素。我们假设体重指数越高，估计值越低 25- 羟基维生素 D 水平和较高的饮酒量与发生原发性甲状旁腺功能亢进症的风险相关。我们的前瞻性队列研究的结果将是原发性甲状旁腺功能亢进症的发病率，所有病例均经医学审查确认。因为我们预计病例数会超过 1200 例，所以统计功率会很高。例如，检测五分位数钙的风险比为 1.4 的功效为 0.98。这项研究代表了第一个大规模的前瞻性努力，以确定可改变的风险因素原发性甲状旁腺功能亢进症。这项研究的结果可能通过预防疾病发展及其相关后遗症而产生重要的公共卫生影响。最后，这一大群原发性甲状旁腺功能亢进病例的创建将成为未来研究的宝贵资源。