Ethnic/Racial Variation in Intracerebral Hemorrhage (ERICH)

脑出血的民族/种族变异 (ERICH)

• 批准号: 8308549
• 负责人: Daniel Woo
• 金额: $ 346.27万
• 依托单位: UNIVERSITY OF CINCINNATI
• 依托单位国家: 美国
• 财政年份: 2010
• 资助国家: 美国
• 起止时间: 2010-08-01 至 2015-07-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/8308549
• 关键词: 5 year old; Accounting; Acquired Immunodeficiency Syndrome; Admission activity; Admixture; Adult; Affect; African American; Age; Alleles; Alzheimer' s Disease; American; Apolipoprotein E; Blood Vessels; Brain; Brain hemorrhage; Brain imaging; Candidate Disease Gene; Case-Control Studies; Cause of Death; Censuses; Cerebral hemisphere hemorrhage; Cessation of life; Characteristics; Classification; Clinical; Collection; DNA; Data; Data Collection; Digit structure; Disabled Persons; Epidemiology; Ethnic Origin; Ethnic group; Film; Future; Gender; General Hospitals; Genes; Genetic; Genetic Polymorphism; Genome Scan; Genomics; Genotype; Geographic Locations; Goals; Health Care Costs; Healthcare; Heart Diseases; Hemorrhage; Hispanic Americans; Hispanics; Hospitals; Human; Image; Individual; Injury; Institutes; Interview; Ischemic Stroke; Lead; Leukoaraiosis; Life; Literature; Lobar; Location; Magnetic Resonance Imaging; Malignant Neoplasms; Massachusetts; Measures; Mediating; Methodology; Methods; Mexican; Minority; Minority Groups; Morbidity - disease rate; National origin; Neurologic; Not Hispanic or Latino; Outcome; Patients; Persons; Phenotype; Population; Prevention; Process; Proteomics; Puerto Rican; Quality Control; Race; Reading; Recruitment Activity; Relative (related person); Research; Research Personnel; Risk; Risk Factors; Rupture; Sample Size; Sampling; Scanning; Severities; Socioeconomic Factors; Stroke; Survivors; Testing; United States; Universities; Variant; White Matter Disease; apolipoprotein E-2; apolipoprotein E-4; base; biobank; care burden; case control; clinical practice; comparison group; design; disability; effective therapy; experience; forest; genetic risk factor; genome wide association study; high risk; improved; interest; mortality; neuroimaging; public health relevance; racial and ethnic; racial difference; regional difference; repository; sample collection; statistical center

DESCRIPTION (provided by applicant): Intracerebral hemorrhage (ICH) occurs when a blood vessel ruptures within the brain parenchyma leading to neurologic injury and frequently death. Approximately 40-50% of patients who suffer from an ICH will die from the hemorrhage. Of the survivors, the majority are disabled. Thus, ICH is the subtype of stroke with the highest morbidity and mortality rates. Minority populations of African-Americans and Hispanics have been found to have roughly double the rate of ICH as whites and on average, have ICH at a younger age. Yet despite this disproportionate health care burden, fewer than 200 ICH cases among African-Americans and less than a hundred ICH cases among Hispanics have been collected with DNA available for testing. Our proposal is to collect 1000 cases of ICH among whites, 1000 cases of ICH among blacks, 1000 cases of ICH among Hispanics, and 3000 controls matched to the cases by race/ethnicity, age (5 years), gender and geographic location. Our long-term goal is to perform a genome-wide association study of intracerebral hemorrhage which includes a significant proportion of minorities with ICH. A genome-wide association study evaluates DNA with hundreds of thousands of markers to identify regions or genes which are associated with either a greater or lesser risk of ICH. However, the current proposal will not complete this type of analysis as insufficient numbers are currently available. Thus, the goals of the current proposal are to: 1) understand the risk factors of greatest importance for ICH among blacks and Hispanics; 2) determine differences in brain-imaging by race/ethnicity; 3) determine factors that mediate differences in outcomes rates by race/ethnicity; and 4) determine if Hispanics and African-Americans from different regions or national origin (such as Mexican, Cuban, etc.) are genetically different. To accomplish these goals, we have 11 recruitment centers representing 30 recruitment hospitals throughout the United States with large populations of African-Americans and Hispanics. White ICH cases from the same regions will also be recruited to account for regional differences in risk factors as well as a comparison group for risk factors, outcomes and imaging differences. A centralized neuroimaging center will be developed for uniform reading and analysis of films at Massachusetts General Hospital in conjunction with Georgetown University. A biorepository will be developed for centralized DNA processing and sample handling at the Miami Institute for Human Genomics. And a data and statistical center will be developed at Wake Forest University. The major advantages of this study are the experience of the investigators, particularly with recruitment of minority populations and particular interest in ICH and epidemiology; uniform definitions of cases, risk factors, and centralized analyses; and the ability to identify and recruit the large number of subjects (6000 total) required for the study. PUBLIC HEALTH RELEVANCE: Stroke is the third leading cause of death and the leading cause of disability among adults. More people are disabled by stroke than Alzheimer's disease, heart disease, cancer or AIDS. Intracerebral hemorrhage is the type of stroke with the highest death and disability rates. ICH occurs in 70,000 Americans every year and a single year of ICH cases in the United States leads to approximately $3.7 billion dollars of health care costs. African-Americans and Hispanics have twice the rate of this type of stroke than whites do and have this type of stroke at an earlier age in life. Yet we know little about the biologic differences that lead to this ethnic disparity. Our proposal will compare minorities with ICH to controls from the same population as well as explore genetic, radiographic and outcomes differences.

描述（由申请人提供）：当脑实质内的血管破裂时，就会发生脑出血（ICH），导致神经损伤并经常导致死亡。大约 40-50% 的 ICH 患者会死于出血。在幸存者中，大多数都是残疾人。因此，ICH是发病率和死亡率最高的卒中亚型。研究发现，非裔美国人和西班牙裔等少数群体的脑出血发生率大约是白人的两倍，而且平均而言，脑出血的发病年龄较年轻。然而，尽管医疗保健负担不成比例，但收集到的可用于检测的 DNA 病例还不到 200 例非裔美国人中的 ICH 病例和不到 100 例西班牙裔中的 ICH 病例。我们的建议是收集 1000 个白人 ICH 病例、1000 个黑人 ICH 病例、1000 个西班牙裔 ICH 病例以及 3000 个按种族/族裔、年龄（5 岁）、性别和地理位置与病例相匹配的对照。我们的长期目标是开展脑出血的全基因组关联研究，其中包括很大一部分患有脑出血的少数群体。全基因组关联研究使用数十万个标记来评估 DNA，以确定与 ICH 风险较高或较低相关的区域或基因。然而，当前的提案将无法完成此类分析，因为目前可用的数量不足。因此，当前提案的目标是： 1）了解黑人和西班牙裔中对 ICH 最重要的风险因素； 2）确定种族/民族的大脑成像差异； 3）确定影响种族/民族结果率差异的因素； 4) 确定来自不同地区或民族（例如墨西哥、古巴等）的西班牙裔和非裔美国人是否存在基因差异。为了实现这些目标，我们在拥有大量非洲裔美国人和西班牙裔人口的美国设有 11 个招募中心，代表 30 家招募医院。来自同一地区的白种人脑出血病例也将被招募，以解释危险因素的地区差异，以及危险因素、结果和影像学差异的对照组。马萨诸塞州总医院将与乔治敦大学联合开发一个集中的神经影像中心，用于统一读取和分析胶片。迈阿密人类基因组研究所将开发一个生物样本库，用于集中 DNA 处理和样本处理。维克森林大学将建立一个数据和统计中心。这项研究的主要优点是研究人员的经验，特别是招募少数群体以及对 ICH 和流行病学特别感兴趣；病例、风险因素和集中分析的统一定义；以及识别和招募研究所需的大量受试者（总共 6000 名）的能力。 公共卫生相关性：中风是成年人死亡的第三大原因，也是导致残疾的主要原因。因中风致残的人数比阿尔茨海默病、心脏病、癌症或艾滋病还要多。脑出血是死亡率和致残率最高的中风类型。每年有 70,000 名美国人发生 ICH，美国一年的 ICH 病例会导致约 37 亿美元的医疗费用。非裔美国人和西班牙裔的此类中风发病率是白人的两倍，并且患此类中风的年龄较早。然而我们对导致这种种族差异的生物学差异知之甚少。我们的提案将比较具有 ICH 的少数群体与来自同一人群的对照，并探索遗传、 放射学和结果差异。