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

描述（由申请人提供）：贫血是美国老年人群的常见健康问题;它会增加老年人残疾、体能下降、肌肉力量低下和过早死亡的风险。NHANES III最近的一项研究报告称，美国65岁以上人群的贫血患病率超过10%，并且贫血患病率因种族而异，这表明少数民族，特别是非洲裔美国人的健康状况存在显著差异。在这项研究中，来自全国妇女健康倡议（WHI）研究的大型（N > 160，000）多种族（非西班牙裔白色，西班牙裔，非洲裔美国人，美洲土著人，亚洲/太平洋岛民）队列将用于调查衰老与贫血流行病学，病理学和预后的关系。具体而言，我们将1）根据人种-种族和合并症，评估总体贫血的频率和风险因素; 2）确定WHI总体和人种-种族中10年随访期间贫血与死亡风险之间的相关性; 3）确定WHI队列总体和人种-种族中9年随访期间贫血与身体功能变化之间的相关性; 4）在那些通过双能X射线吸收测定法进行基线和前瞻性身体成分测量的人中，检查贫血与肌肉损失（肌肉减少症）的关系; 5）研究贫血与老年妇女骨质流失和骨质疏松性骨折风险的关系。此外，还将评估按形态学分类的贫血亚型频率和老年女性贫血血红蛋白浓度的最佳临界点。本研究将使用来自40家WHI临床中心的存档观察和临床试验数据。将在亚利桑那州、伯明翰和匹兹堡的WHI DXA队列中进行现有报告中的血液分析的额外数据输入和数据合并（身体成分测量）。将针对特定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是美国唯一一项具有前瞻性共病和身体成分数据以及多种族老年妇女血红蛋白值的研究。这项研究有很大的潜力提供新的和关键的证据，需要预防和管理贫血的老年妇女从不同的健康，年龄和种族背景。

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.