Departments of Medicine, Obstetrics and Gynecology, and Epidemiology University of Michigan Ann Arbor MI.
Department of Obstetrics, Gynecology and Reproductive Sciences University of Pittsburgh Pittsburgh PA.
J Am Heart Assoc. 2023 Mar 7;12(5):e028132. doi: 10.1161/JAHA.122.028132. Epub 2023 Feb 27.
In 1985 to 1986, the CARDIA (Coronary Artery Risk Development in Young Adults) study enrolled 5115 Black or White participants, including 2788 women, aged 18 to 30 years. Over the following 35 years, the CARDIA study amassed extensive longitudinal data on women's reproductive milestones, spanning menarche to menopause. Although not initially conceived as a study of women's health, >75 CARDIA study publications address relationships between reproductive factors and events with cardiovascular and metabolic risk factors, subclinical and clinical cardiovascular disease, and social determinants of health. The CARDIA study was one of the earliest population-based reports to note Black-White differences in age at menarche and associations with cardiovascular risk factors. Adverse pregnancy outcomes, particularly gestational diabetes and preterm birth, have been assessed along with postpartum behaviors, such as lactation. Existing studies have examined risk factors for adverse pregnancy outcomes and lactation, as well as their relationship to future cardiovascular and metabolic risk factors, diagnoses, and subclinical atherosclerosis. Ancillary studies examining components of polycystic ovary syndrome and ovarian biomarkers, such as anti-Müllerian hormone, have facilitated examination of reproductive health in a population-based cohort of young adult women. As the cohort transitioned through menopause, examination of the importance of premenopausal cardiovascular risk factors along with menopause has improved our understanding of shared mechanisms. The cohort is now aged in the 50s to mid-60s, and women will begin to experience a greater number of cardiovascular events as well as other conditions, such as cognitive impairment. Thus, in the next decade, the CARDIA study will provide a unique resource for understanding how the women's reproductive life course epidemiology informs cardiovascular risk, as well as reproductive and chronological aging.
1985 年至 1986 年,CARDIA(年轻人冠状动脉风险发展)研究招募了 5115 名黑人和白人参与者,其中包括 2788 名女性,年龄在 18 至 30 岁之间。在接下来的 35 年里,CARDIA 研究积累了大量关于女性生殖里程碑的纵向数据,涵盖了初潮到绝经。尽管最初并不是作为一项女性健康研究,但>75 项 CARDIA 研究出版物探讨了生殖因素与心血管和代谢危险因素、亚临床和临床心血管疾病以及健康的社会决定因素之间的关系。CARDIA 研究是最早报告黑人和白人初潮年龄差异及其与心血管风险因素关联的人群研究之一。不良妊娠结局,特别是妊娠糖尿病和早产,以及产后行为,如哺乳,也得到了评估。现有研究已经研究了不良妊娠结局和哺乳的风险因素,以及它们与未来心血管和代谢风险因素、诊断和亚临床动脉粥样硬化的关系。辅助研究检查多囊卵巢综合征和卵巢生物标志物(如抗苗勒管激素)的组成部分,促进了在年轻成年女性的人群队列中检查生殖健康。随着队列过渡到绝经期,检查绝经前心血管风险因素的重要性以及绝经,改善了我们对共同机制的理解。该队列现在年龄在 50 多岁到 60 多岁之间,女性将开始经历更多的心血管事件以及其他疾病,如认知障碍。因此,在未来十年,CARDIA 研究将为理解女性生殖生命历程流行病学如何影响心血管风险以及生殖和时间老化提供独特的资源。