Anemia and Its Relationship with Sarcopenia, Physical Function, and Mortality

描述（由申请人提供）：贫血是美国老年人常见的健康问题；它还增加了老年人残疾、体能下降、肌肉力量下降和过早死亡的风险。NHANES III最近的一项研究报告称，65岁以上的美国人口中贫血的患病率超过10%，并且贫血的患病率因种族而异，这表明少数民族，特别是非洲裔美国人的健康差异很大。在这项研究中，来自全国妇女健康倡议（WHI）研究的一个大型（约160,000人）多种族（非西班牙裔白人、西班牙裔、非洲裔美国人、美洲原住民、亚洲/太平洋岛民）队列将被用来调查衰老与贫血流行病学、病理和预后的关系。具体来说，我们将1)评估贫血的频率和危险因素，根据整体和种族和合并症；2)确定在WHI总体上和按种族划分的10年随访中贫血与死亡风险之间的关系；3)在整个WHI队列中确定贫血与身体功能变化之间的关系，随访时间为9年，并按种族进行随访；4)在使用双能x线吸收仪进行基线和前瞻性身体成分测量的人群中，检查贫血与肌肉减少（肌肉减少症）的关系；5)研究老年妇女贫血与骨质流失及骨质疏松性骨折风险的关系。此外，还将评估老年妇女贫血的形态学分类和血红蛋白浓度的最佳截断点的贫血亚型的频率。本研究将使用来自40个WHI临床中心的存档观察和临床试验数据。来自亚利桑那州、伯明翰和匹兹堡的WHI DXA队列将从现有报告中输入用于血液分析的其他数据，并合并数据（身体成分测量）。将针对具体目标进行多变量数据分析。WHI为回答上述研究问题提供了独特而宝贵的资源，因为WHI是国内唯一一项在多种族老年妇女群体中具有前瞻性合并症、身体成分数据以及血红蛋白值的研究。这项研究有很大的潜力为预防和管理不同健康、年龄和种族背景的老年妇女贫血提供新的和关键的证据。

DESCRIPTION (provided by applicant): Anemia is a common health problem in US older populations; and it increases the risk for disability, decline in physical performance, low muscle strength, and premature death in the elderly. A recent study from NHANES III reported the prevalence of anemia being larger than 10% in the US population over age 65, and the prevalence of anemia varied by ethnicity, suggesting significant health disparities in minorities, especially in the African American population. In this study, a large (N >160,000) multiethnic (non-Hispanic white, Hispanic, African American, Native American, Asian/Pacific Islander) cohort from the nationwide Women's Health Initiative (WHI) study will be used to investigate the relationships of aging with anemia epidemiology, pathology and prognosis. Specifically, we will 1) evaluate the frequency of and risk factors for anemia overall and according to race-ethnicity and co-morbidity; 2) determine the association between anemia and risk of death over 10 years of follow-up in the WHI overall and by race-ethnicity; 3) determine associations between anemia and changes in physical function over 9 years of follow-up in the WHI cohort overall and by race- ethnicity; 4) examine associations of anemia with muscle loss (sarcopenia) among those with baseline and prospective measurements of body composition from dual-energy x-ray absorptiometry; and 5) study the association of anemia with bone loss and risk for osteoporotic fractures in older women. In addition, the frequency of anemia subtypes by morphologic categories and optimal cutoff points of hemoglobin concentrations for anemia in older women will be evaluated. This study will use archived observational and clinical trial data from 40 WHI clinical centers. Additional data entering for blood analysis from existing reports, and data merging (body composition measurements) will be conducted in the WHI DXA cohort from Arizona, Birmingham and Pittsburgh. Multivariate data analyses will be conducted for the specific aims. The WHI provides a unique and invaluable resource for answering the research questions proposed above, as the WHI is the only study in the nation that has prospective co-morbidities and body composition data as well as hemoglobin values in multiethnic groups of older women. This study has a great potential to provide new and critical evidence that is needed for preventing and managing anemia in older women from different health, age and ethnic backgrounds.