Endometriosis Diagnosis and Subtypes, Reproductive History, and Cardiovascular Disease

子宫内膜异位症的诊断和亚型、生育史和心血管疾病

• 批准号: 10660642
• 负责人: Leslie V Farland
• 金额: $ 74.54万
• 依托单位: UNIVERSITY OF UTAH
• 依托单位国家: 美国
• 财政年份: 2023
• 资助国家: 美国
• 起止时间: 2023-05-09 至 2028-04-30
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10660642
• 关键词: Accounting; Affect; Age; American Heart Association; Birth; Blood Banks; Brain Infarction; Cardiac; Cardiovascular Diseases; Cardiovascular system; Cause of Death; Cerebrovascular Disorders; Characteristics; Chronic; Chronic Disease; Chronic Kidney Failure; Clinical; Complex; Coronary heart disease; Data; Diagnosis; Disease Marker; Disease Outcome; Dyslipidemias; Early Diagnosis; Early Intervention; Electronic Health Record; Endometriomas; Event; Female; Follow-Up Studies; Glucose; Goals; Guidelines; Gynecologic; Health; Hispanic; Hyperlipidemia; Hypertension; Individual; Infertility; Infiltration; Inflammation; Inflammatory; Insulin; Knowledge; Lesion; Life; Life Cycle Stages; Life course epidemiology; Link; Lipids; Longevity; Longitudinal Studies; Measures; Mediating; Medical; Medical Electronics; Metabolic syndrome; Morbidity - disease rate; National Institute of Child Health and Human Development; Non-Insulin-Dependent Diabetes Mellitus; Outcome; Participant; Patients; Phenotype; Play; Population; Population Database; Population Heterogeneity; Predisposition; Prevention; Recontacts; Recording of previous events; Records; Reproductive History; Research; Risk; Risk Factors; Role; Sample Size; Scanning; Time; Utah; Visit; Vital Statistics; Vital Status; Woman; Women' s Health; X-Ray Computed Tomography; adverse pregnancy outcome; brain magnetic resonance imaging; cardiometabolism; cardiovascular disorder prevention; cardiovascular disorder risk; cerebral microbleeds; clinical development; clinical risk; cohort; coronary calcium scoring; design; endometriosis; follow-up; high risk; improved; middle age; mortality; reproductive; reproductive system disorder; risk stratification; screening; sociodemographics; white matter; woman health professional; young adult

PROJECT SUMMARY Endometriosis burdens ~11% of women and cardiovascular disease (CVD) is the leading cause of mortality among US women. Women who have a history of endometriosis may be at increased risk of chronic diseases, including CVD due to higher levels of inflammation, greater risk of hypertension, and greater risk for hyperlipidemia. A few studies have shown higher risk of coronary heart disease and cerebrovascular disease for those with endometriosis; however, studies have been limited by short follow-up (<10 years) or small, cross-sectional design. In addition, prior studies have not incorporated information on endometriosis subtypes or reproductive history (i.e., infertility, adverse pregnancy outcomes), all of which may alter CVD risk. Thus, there are significant gaps in our knowledge regarding the complex association between endometriosis and CVD. The proposed research will leverage data from two existing cohorts—a well-phenotyped research cohort embedded within a large representative population cohort—to investigate the relationship between endometriosis and risk of clinical and subclinical CVD. Specifically, we will analyze data from the Utah Population Database (Population Cohort) and the NICHD ENDO study (Research Cohort). The Population Cohort comprises electronic health records and vital statistics of >80,000 women with endometriosis matched 1:5 by birth year and birthplace to women with no history of endometriosis and has up to 32 years of follow-up to allow for the development of clinical CVD. The Research Cohort comprises 506 women who were assessed for endometriosis between 2007 and 2009; 184 women were diagnosed with endometriosis. Participants in the NICHD ENDO study will be re-contacted and screened for CVD risk factors and subclinical CVD markers during a new clinical visit. Leveraging both the Population Cohort and the Research Cohort, we will determine whether women with a history of endometriosis have an increased risk of a composite CVD outcome, and components of composite CVD outcome, including incident cardiovascular events, chronic hypertension, metabolic syndrome, type 2 diabetes, dyslipidemia, and chronic kidney disease compared to women without a history of endometriosis (Aim 1). We will also determine if risk of composite CVD outcome and components of composite vary by endometriosis subtype (deep infiltrating, endometriomas, superficial) (Aim 2). Via our ENDO Follow-Up Study we will determine if endometriosis increases risk of subclinical CVD, measured by CVD risk scores, cardiac CT scans, and brain MRIs compared to those without endometriosis (Aim 3). Finally, we will determine if endometriosis mediates the relationship between young adult atherogenic profile and mid-life CVD (Aim 4). The proposed project provides an unprecedented opportunity to rigorously investigate endometriosis and risk for clinical and subclinical CVD, and the role that a woman’s underlying predisposition to CVD plays in the endometriosis–CVD link. Our study findings may help inform women’s professional health guidelines in the prevention, screening, early detection, and treatment of CVD risk factors among women with endometriosis.

项目概要 子宫内膜异位症给约 11% 的女性带来负担，心血管疾病 (CVD) 是导致死亡的主要原因 在美国女性中，有子宫内膜异位症病史的女性患慢性病的风险可能会增加， 包括由于炎症水平较高而导致的 CVD、高血压风险较高以及罹患糖尿病的风险较高 一些研究表明，患冠心病和脑血管疾病的风险较高。 然而，对于子宫内膜异位症患者，研究受到随访时间短（<10 年）或规模较小的限制。 此外，先前的研究尚未纳入子宫内膜异位症亚型的信息。 或生育史（即不孕、不良妊娠结局），所有这些都可能改变 CVD 风险。 对于子宫内膜异位症和子宫内膜异位症之间的复杂关系，我们的知识存在重大差距。 CVD。拟议的研究将利用两个现有队列的数据——一个表型良好的研究队列。 嵌入一​​个具有代表性的大型人群中——以调查之间的关系 具体来说，我们将分析来自犹他州的数据。 人口数据库（人口队列）和 NICHD ENDO 研究（研究队列）。 队列包括超过 80,000 名匹配的子宫内膜异位症女性的电子健康记录和生命统计数据 对于没有子宫内膜异位症病史且随访时间长达 32 年的女性，按出生年份和出生地为 1:5 研究队列由 506 名接受评估的女性组成。 2007 年至 2009 年间，有 184 名妇女被诊断患有子宫内膜异位症。 NICHD ENDO 研究将重新接触并筛查 CVD 危险因素和亚临床 CVD 标志物 在新的临床访问期间，我们将利用人群队列和研究队列来确定。 有子宫内膜异位症病史的女性复合心血管疾病结果的风险是否增加，以及 复合CVD结果的组成部分，包括心血管事件、慢性高血压、 与没有代谢综合征、2 型糖尿病、血脂异常和慢性肾脏病的女性相比 我们还将确定复合 CVD 结果的风险及其组成部分。 复合材料因子宫内膜异位症亚型（深层浸润、子宫内膜异位症、浅表）而异（通过我们的 ENDO）。 后续研究我们将通过 CVD 风险来确定子宫内膜异位症是否会增加亚临床 CVD 的风险 与无子宫内膜异位症的患者进行评分、心脏 CT 扫描和脑 MRI 比较（目标 3）。 确定子宫内膜异位症是否介导年轻人动脉粥样硬化特征与中年CVD之间的关系 （目标 4）。拟议的项目为严格研究子宫内膜异位症提供了前所未有的机会。 临床和亚临床 CVD 的风险，以及女性潜在的 CVD 易感性在其中所起的作用 我们的研究结果可能有助于为女性的职业健康指南提供信息。 子宫内膜异位症女性心血管疾病危险因素的预防、筛查、早期发现和治疗。