A Secular Change in Menstrual Characteristicis of Adult and Midlife Women?

成年和中年女性月经特征的长期变化？

• 批准号: 7561079
• 负责人: Sioban D Harlow
• 金额: $ 30.25万
• 依托单位: UNIVERSITY OF MICHIGAN AT ANN ARBOR
• 依托单位国家: 美国
• 财政年份: 2008
• 资助国家: 美国
• 起止时间: 2008-02-01 至 2011-01-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/7561079
• 关键词: Accounting; Address; Adult; Affect; Age; Age at Menarche; Aging; Amenorrhea; Body Size; Body mass index; Breast; Calendar; Cardiovascular Diseases; Characteristics; Chronic Disease; Cohort Effect; Conceptions; Conflict (Psychology); Cox Models; Data; Data Analyses; Data Set; Enrollment; Equation; Europe; Evaluation; Exogenous Hormone Therapy; Fertility; Fracture; Generations; Goals; Health; Hormones; Impact evaluation; Individual; Knowledge; Length; Life; Life Cycle Stages; Life Style; Link; Longevity; Longitudinal Studies; Malignant Neoplasms; Malignant neoplasm of ovary; Masks; Menopause; Menstrual cycle; Menstruation; Methods; Minnesota; Modeling; Morbidity - disease rate; Natural History; Nature; North America; Ovarian; Pattern; Physical activity; Population; Premenopause; Probability; Puberty; Reproductive History; Risk; Risk Factors; Sampling; Seminal; Signal Transduction; Smoke; Smoking; Students; Techniques; Time; Trust; Universities; Woman; age related; clinically relevant; cohort; disorder risk; experience; hazard; health record; interest; middle age; mortality; parity; programs; reproductive; young adult

DESCRIPTION (provided by applicant): Secular declines in age at menarche have been well documented and a secular increase in age at menopause has been suggested by some studies. Change in age at menarche or menopause are of scientific interest because their timing is related to women's fertility, risk of chronic diseases, and mortality. An equally important, but rarely addressed question is whether secular change has occurred in menstrual function during the prime reproductive years or the menopausal transition. Menstrual characteristics of adult women are important markers of ovarian function and have been associated with fertility, age at menopause, and women's long term risk of chronic disease. Given the secular change in risk factors that influence menstrual function, including body size, smoking, parity and hormone use, evaluation of their impact on menstrual function is warranted. The historic TREMIN dataset presents a unique opportunity to address the question of secular change in menstrual characteristics of US women. It is the only dataset in existence worldwide with prospectively recorded menstrual cycle information across two distinct generations of women sampled from a comparable referent population and linked to information on reproductive, anthropometric and lifestyle characteristics. Students attending the University of Minnesota were enrolled in 1936-39 (Cohort 1) and in 1961-64 (Cohort II). We propose to analyze the prospectively recorded menstrual calendar and health record data from the 1151 Cohort I women and 905 Cohort II women who participated for 5 to 35 years. Our goal is to evaluate whether secular change has occurred in menstrual patterns of adult women or in the timing of the menopausal transition and, if so, whether these differences are explained by secular differences in parity, body mass index, smoking, or hormone use. We will estimate menstrual characteristics across the lifespan using linear mixed models and marginal models fit with generalized estimating equations to separately model mean, variance and correlation of menstrual cycle length by age. We will estimate the effect of cohort on age at onset of the menopausal transition and on duration of the transition using Cox proportional hazards and the varying coefficient Cox model along with a change-point model for mean and variance. We propose multiple imputation techniques to account for intermittent missing data and new methods for addressing the problem of hormone use masking the timing of reproductive aging. Analyses of these truly unique data will make a substantial contribution to our understanding of the nature of secular change in menstrual characteristics throughout reproductive life. Understanding of the extent to which menstrual function during the prime of reproductive life is influenced by secular change in population risk factors would allow us to predict the potential impact of such changes on fertility, menstrual morbidity and reproductive aging. Ultimately, surveillance of menstrual characteristics young women might facilitate prediction of changes in age-related fertility dynamics, timing of the menopausal transition and chronic disease risk associated with reproductive aging. This project takes advantage of the historic TREMIN dataset -- the only dataset in existence worldwide with prospectively recorded menstrual cycle information across two distinct generations of women sampled from a comparable referent population -- to assess whether secular change has occurred in the menstrual experience of young adult and midlife women. Menstrual characteristics are important markers of ovarian function and are associated with fertility, age at menopause, and women's long term risk of chronic disease. Understanding of the extent to women's menstrual experience is influenced by secular change in population risk factors such as body size, smoking, parity and hormone use will facilitate prediction of the potential impact of these population changes on fertility, menstrual morbidity and reproductive aging.

描述（由申请人提供）：初潮时年龄的长期下降已得到充分记录，一些研究表明绝经时年龄会长期增加。初潮或绝经年龄的变化具有科学意义，因为其时间与女性的生育能力、慢性病风险和死亡率有关。一个同样重要但很少被提及的问题是，在最佳生育年龄或更年期过渡期间，月经功能是否发生了长期变化。成年女性的月经特征是卵巢功能的重要标志，与生育能力、绝经年龄以及女性患慢性病的长期风险有关。鉴于影响月经功能的危险因素（包括体型、吸烟、产次和激素使用）的长期变化，有必要评估它们对月经功能的影响。历史性的 TREMIN 数据集为解决美国女性月经特征的长期变化问题提供了独特的机会。它是全球现有的唯一一个数据集，前瞻性记录了两代不同女性的月经周期信息，这些信息是从可比较的参考人群中抽取的，并与生殖、人体测量和生活方式特征信息相关联。明尼苏达大学的学生于 1936-39 年（第一组）和 1961-64 年（第二组）入学。我们建议对参与 5 至 35 年的 1151 名队列 I 女性和 905 名队列 II 女性的前瞻性记录的月经日历和健康记录数据进行分析。我们的目标是评估成年女性的月经模式或绝经过渡时间是否发生了长期变化，如果是的话，这些差异是否可以通过胎次、体重指数、吸烟或激素使用的长期差异来解释。我们将使用线性混合模型和边际模型与广义估计方程拟合来估计整个生命周期的月经特征，以分别对月经周期长度与年龄的平均值、方差和相关性进行建模。我们将使用 Cox 比例风险、变系数 Cox 模型以及均值和方差的变化点模型来估计队列对绝经过渡开始年龄和过渡持续时间的影响。我们提出了多种插补技术来解释间歇性缺失数据，并提出了解决激素使用掩盖生殖衰老时间问题的新方法。对这些真正独特的数据的分析将为我们理解整个生殖生涯中月经特征的长期变化的本质做出重大贡献。了解生育高峰期月经功能受人口危险因素长期变化的影响程度，将使我们能够预测这些变化对生育力、月经发病率和生殖衰老的潜在影响。最终，对年轻女性月经特征的监测可能有助于预测与年龄相关的生育动态、绝经过渡时间以及与生殖衰老相关的慢性疾病风险的变化。该项目利用历史性的 TREMIN 数据集（全球现有的唯一数据集，前瞻性记录了从可比较的参考人群中抽取的两代不同女性的月经周期信息）来评估年轻人的月经经历是否发生了长期变化。成年和中年妇女。月经特征是卵巢功能的重要标志，与生育能力、绝经年龄以及女性患慢性病的长期风险有关。了解女性月经经历在多大程度上受到人口风险因素（例如体型、吸烟、产次和激素使用）长期变化的影响，将有助于预测这些人口变化对生育力、月经发病率和生殖衰老的潜在影响。