Menopause Symptom Clusters: Refocusing Therapeutics

更年期症状群：重新调整治疗方法

基本信息

批准号：
8142917
负责人：
NANCY Fugate WOODS
金额：
$ 19.31万
依托单位：
UNIVERSITY OF WASHINGTON
依托单位国家：
美国
项目类别：
财政年份：
2010
资助国家：
美国
起止时间：
2010-09-15 至 2013-07-31
项目状态：
已结题

来源：
https://reporter.nih.gov/project-details/8142917
关键词：
Address Adrenal Glands Adverse effects Aging Ancillary Study Aromatase Attention Autonomic nervous system BDNF gene Behavioral Biological Markers Brain-Derived Neurotrophic Factor Clinical Trials Cohort Studies Collaborations Complement Conscious Controlled Clinical Trials Data Data Analyses Depressed mood Distress Education Employment Endocrine Epinephrine Estrogens Feasibility Studies Funding Future Generations Genes Genetic Genetic Polymorphism Genotype Health Hormones Hot flushes Hydrocortisone Hypothalamic structure Individual Intervention Link Low income Menopause Metabolism Modeling Moods NPY gene National Institute on Aging Neurobehavioral Manifestations Neurosecretory Systems Norepinephrine Outcome Ovarian Pain Participant Pathway interactions Personal Satisfaction Pituitary Gland Postmenopause Protocols documentation Recording of previous events Reporting Research Research Personnel Risk Factors Role Serotonin Sexual abuse Sleep Sleep disturbances Social Behavior Social support Staging Steroids Stress Symptoms TNFRSF5 gene Testing Therapeutic Time Transcend Vasomotor Woman Women&apos s Health Work base cognitive change design experience follow-up middle age novel public health relevance ranpirnase reproductive self esteem social systematic review treatment effect

项目摘要

DESCRIPTION (provided by applicant): Although women experience clusters of symptoms during the menopausal transition, most research focuses on individual symptoms such as hot flashes. The proposed study shifts the paradigm from focusing on individual symptoms to symptom clusters (SCs). Re-analyzing data on symptoms and genetic polymorphisms, endocrine biomarkers, symptom vulnerability factors and sociobehavioral risk factors from over 500 participants in the Seattle Midlife Women's Health Study (P50 NR02323, R01 NR04141, P30 NR04001, P30 ES07033) with longitudinal follow-up spanning up to 19 years will allow us to achieve these aims: 1) identify prevalent symptom clusters during the late reproductive stage, early and late menopausal transition stages, and early postmenopause using latent class analysis; 2) determine the consistency of symptom clusters as women change from one menopausal transition stage to the next; 3) test models linking genetic polymorphisms, endocrine biomarkers, symptom vulnerability factors, social-behavioral risk factors and menopause-related factors to symptom clusters, and outcomes of well-being and symptom interference; 4) conduct a systematic review of controlled clinical trials to identify symptoms as secondary treatment effects and adverse effects that will inform us about therapies for symptom clusters and 5) synthesize results of the empirical analyses and systematic review to develop novel symptom cluster management protocols to be tested in future feasibility studies. An interdisciplinary scientific advisory board including National Institute on Aging-funded MS-FLASH clinical trials investigators will provide our research team an opportunity for immediate sharing of our results in order to inform design of symptom cluster management approaches as well as their ongoing studies, including the generation of ancillary studies of symptom clusters and related mechanisms. PUBLIC HEALTH RELEVANCE: The results of this study will help clinicians and women, themselves, identify symptoms that cluster together and that may have different causes. Knowing which cluster of symptoms a woman has may help her clinician recommend the treatment or treatments that are most likely to work best for her. Using some of the genetic and hormone tests, as well as information about the woman's history, such as stressful experiences she has had, may help understand what causes some of her symptoms and may help her and her clinician decide on the best treatment available for her.

描述（由申请人提供）：尽管女性在更年期过渡期间会经历一系列症状，但大多数研究都集中在潮热等个体症状上。拟议的研究将范式从关注个体症状转变为关注症状群（SC）。重新分析西雅图中年妇女健康研究（P50 NR02323、R01 NR04141、P30 NR04001、P30 ES07033）中 500 多名参与者的症状和遗传多态性、内分泌生物标志物、症状脆弱性因素和社会行为危险因素的数据，并进行纵向随访长达 19 年的时间将使我们能够实现以下目标： 1) 使用潜在类别分析确定生殖后期、绝经早期和晚期过渡阶段以及绝经后早期的普遍症状群； 2) 确定女性从一个更年期过渡阶段到下一个更年期过渡阶段时症状群的一致性； 3）将遗传多态性、内分泌生物标志物、症状脆弱因素、社会行为危险因素和更年期相关因素与症状群以及健康和症状干扰结果联系起来的测试模型； 4) 对对照临床试验进行系统回顾，以确定症状作为次要治疗效果和不良反应，这将为我们提供有关症状群治疗的信息；5) 综合实证分析和系统回顾的结果，以制定新的症状群管理方案在未来的可行性研究中进行测试。包括国家老龄化研究所资助的 MS-FLASH 临床试验研究人员在内的跨学科科学咨询委员会将为我们的研究团队提供立即分享结果的机会，以便为症状群管理方法的设计及其正在进行的研究提供信息，包括症状群和相关机制的辅助研究的产生。公共卫生相关性：这项研究的结果将帮助临床医生和女性本身识别聚集在一起且可能有不同原因的症状。了解女性有哪一组症状可能有助于她的临床医生推荐最有可能最适合她的治疗方法。使用一些基因和激素测试以及有关该女性病史的信息（例如她所经历的压力经历）可能有助于了解导致她某些症状的原因，并可能帮助她和她的临床医生决定适合她的最佳治疗方法。