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.

项目摘要 子宫内膜异位症伯良约11％的女性和心血管疾病（CVD）是死亡率的主要原因 我们中的妇女。有子宫内膜异位症病史的妇女可能会增加患慢性疾病的风险， 包括由于炎症水平较高，高血压风险更高以及更大的风险，包括CVD 高脂血症。一些研究表明，冠心病和脑血管疾病的风险更高 对于子宫内膜异位症的人；但是，研究受到短期随访（<10年）或小的限制， 横截面设计。此外，先前的研究未纳入有关子宫内膜异位症亚型的信息 或生殖历史（即不孕症，不良妊娠结局），所有这些都可能改变CVD风险。那， 关于子宫内膜异位症和 CVD。拟议的研究将利用来自两个现有队列的数据，这是一项精心设计的研究队列 嵌入在大型代表人群中，以研究 子宫内膜异位症以及临床和亚临床CVD的风险。具体来说，我们将分析犹他州的数据 人口数据库（人群队列）和NICHD ENDO研究（研究队列）。人口 队列包括电子健康记录和> 80,000名子宫内膜异位症女性的重要统计数据 1：5到出生年度和生日，没有子宫内膜异位症史，最多有32年的随访 允许开发临床CVD。研究队列建立了506名经过评估的女性 在2007年至2009年之间的子宫内膜异位症； 184名妇女被诊断出患有子宫内膜异位症。参与者 NICHD ENDO研究将重新接触并筛选CVD风险因素和亚临床CVD标记 在新的临床访问中。利用人口队列和研究队列，我们​​将确定 有子宫内膜异位症史的妇女是否有复合CVD结局的风险增加，并且 复合CVD结果的组成部分，包括入射心血管事件，慢性高血压， 与没有A的女性相比 子宫内膜异位症的史（AIM 1）。我们还将确定复合CVD结果的风险和组成部分是否 复合材料因子宫内膜异位症亚型而异（深浸润，子宫内膜瘤，表面）（AIM 2）。通过我们的恩托 后续研究我们将确定子宫内膜异位症是否增加了通过CVD风险衡量的亚临床CVD的风险 与没有子宫内膜异位症的分数，心脏CT扫描和大脑MRI相比（AIM 3）。最后，我们会的 确定子宫内膜异位症是否介导了年轻的成人动脉粥样硬化特征与中期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 以及临床和亚临床CVD的风险，以及女性对CVD发挥的倾向的作用 子宫内膜异位症链接。我们的研究结果可能有助于告知妇女专业健康指南 在子宫内膜异位症女性中，预防，筛查，早期检测和治疗CVD危险因素。