Ovarian Function Among Samoan Women with Obesity

萨摩亚肥胖女性的卵巢功能

• 批准号: 10605790
• 负责人: Sakurako Oyama
• 金额: $ 3.26万
• 依托单位: YALE UNIVERSITY
• 依托单位国家: 美国
• 财政年份: 2023
• 资助国家: 美国
• 起止时间: 2023-07-01 至 2026-06-30
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10605790
• 关键词: Abdomen; Address; Affect; Amenorrhea; Anovulation; Biochemical; Biometry; Body fat; Body mass index; Cardiometabolic Disease; Clinical; Country; Data; Data Analyses; Data Collection; Diabetes Mellitus; Diagnosis; Evaluation; Family; Fellowship; Female; Functional disorder; Goals; Growth; Health; Hip region structure; Human; Hypertension; Income; Infertility; Irregular Menstruation; Learning; Length; Longitudinal cohort study; Luteinizing Hormone; Maternal and Child Health; Measures; Menstrual cycle; Menstruation; Mental Health; Mentors; Modeling; Morbidity - disease rate; Nutritional; Obesity; Oligomenorrhea; Outcome; Ovarian; Overweight; Ovulation; Pacific Islander; Pacific Islands; Patient Self-Report; Periodicity; Personal Satisfaction; Physicians; Polynesian; Prevalence; Procedures; Progesterone; Proxy; Public Health; Reproductive Endocrinology; Reproductive Health; Research; Research Design; Resource-limited setting; Resources; Risk; Risk Factors; Samoa; Samoan; Scientist; Specimen; Surveys; Text Messaging; Training; Ultrasonography; United States; Urine; Vagina; Variant; Woman; access disparities; aged; assisted reproduction; cardiometabolism; career; cohort; cost; emotional distress; epidemiology study; experience; high body mass index; hormonal contraception; infertility treatment; insight; low and middle-income countries; men; mortality; ovarian dysfunction; prospective; protocol development; recruit; reproductive; secondary infertility; skills; urinary

PROJECT SUMMARY/ABSTRACT Obesity is a well-established risk factor for developing cardiometabolic diseases such as diabetes and hypertension. While the impact of obesity on reproductive health is less understood, studies conducted in high- income countries have associated obesity with menstrual and ovulatory dysfunction and subsequent infertility. These findings have significant public health implications for low- and middle-income countries (LMICs) where access to assisted reproduction treatment remains practically nonexistent despite rapidly increasing obesity prevalence. Obesity-related morbidity and mortality are particularly high among Pacific LMICs. However, few studies have assessed the relationship between cardiometabolic and reproductive health in this region. Previous attempts to characterize menstrual irregularity among Pacific Islander women have relied on retrospective self-report of cycle length and variability, which is notoriously subject to recall bias and interlocuter variation. No studies to date have characterized anovulatory cycles among Pacific Islander women. This is likely because the gold-standard for determining ovulation involves daily transvaginal ultrasonography, an invasive and resource-intensive procedure that is impractical for epidemiological studies. My proposal addresses these gaps through two scientific aims and five training aims that leverage an existing cohort of approximately n=150 Samoan women aged 25-39, whose families Dr. Nicola Hawley (sponsor) and colleagues have followed since 2015. These women have participated in health and wellbeing assessments in 2015, 2017/2018, and 2019/2020. During the fourth data collection wave planned for 2022, I will measure adiposity and prospectively assess ovulatory function. In Aim 1, I will examine associations between menstrual irregularity and current adiposity and longitudinal trajectories of change in adiposity among Samoan women. In Aim 2, I will biochemically evaluate the presence or absence of ovulation among regularly menstruating women and explore the association between anovulation and BMI. Findings will provide critical insight on secondary infertility among women with obesity and inform the development of protocols for evaluating female reproductive potential in low-resource settings. Moreover, this project will shed light on the dual burden of cardiometabolic and reproductive risk among Pacific Islander women, who despite having among the highest obesity prevalence globally, are underrepresented in epidemiologic research. My training plan will enable me to develop research, clinical, and professional skills necessary to become a physician-scientist who conducts longitudinal epidemiologic studies to investigate the impact of obesity on maternal and child health outcomes in low-resource settings. My training plan outlines coursework, mentored research, and clinical experiences to enhance my skills in biostatistics, epidemiological study design and implementation, and reproductive endocrinology.

项目摘要/摘要 肥胖是患心脏代谢疾病（例如糖尿病和）的良好危险因素 高血压。虽然肥胖对生殖健康的影响知之甚少，但在高中进行的研究 收入国家的肥胖与月经和排卵功能障碍以及随后的不育相关联。 这些发现对低收入和中等收入国家（LMIC）具有重大的公共卫生影响 尽管肥胖症迅速增加 流行率。在太平洋LMIC中，与肥胖相关的发病率和死亡率尤为高。但是，很少 研究评估了该地区的心脏代谢和生殖健康之间的关系。 以前试图表征太平洋岛民妇女的月经不规则性的尝试 循环长度和可变性的回顾性自我报告，众所周知，这可能会召回偏见和 对话者的变化。迄今为止，还没有研究表征太平洋岛民妇女的无排卵周期。 这可能是因为确定排卵的金标准涉及每日经阴道超声检查， 对于流行病学研究，一种不切实际的侵入性和资源密集型程序。 我的提议通过两个科学目标解决了这些差距，五个培训目标利用了 现有的大约n = 150名萨摩亚妇女25-39岁的萨摩亚妇女的队列，其家庭尼古拉·霍利（Nicola Hawley）博士 （赞助商）和同事自2015年以来一直关注。这些妇女参加了健康和福祉 2015年，2017/2018年和2019/2020的评估。在计划于2022年的第四个数据收集浪潮中，我 将测量肥胖并前瞻性评估排卵功能。在AIM 1中，我将研究协会 在月经不规则和当前的肥胖和纵向变化的纵向轨迹之间 萨摩亚妇女。在AIM 2中，我将生化评估定期排卵的存在或不存在 月经妇女并探索主管与BMI之间的关联。调查结果将提供关键 了解肥胖妇女中的继发性不育症，并为制定规程的制定 在低资源环境中评估女性生殖潜力。此外，这个项目将阐明 太平洋岛民妇女的心脏代谢和生殖风险的双重负担，尽管有 全球肥胖症患病率最高，在流行病学研究中的代表性不足。 我的培训计划将使我能够发展研究，临床和专业技能 成为一名医师科学家，他进行纵向流行病学研究，以研究 低资源环境中母亲和儿童健康成果的肥胖症。我的培训计划概述了课程， 指导的研究和临床经验，以增强我在生物统计学方面的技能，流行病学研究 和实施和生殖内分泌学。