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

描述(申请人提供)：贫血是美国老年人口中常见的健康问题；它增加了老年人残疾、体能下降、肌肉力量不足和过早死亡的风险。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流行率超过10%，并且贫血的流行率因种族而异，这表明少数族裔，特别是非裔美国人人口的健康差距很大。在这项研究中，来自全国妇女健康倡议(WHI)研究的一个大型(N&GT；160,000)多种族(非西班牙裔白人、西班牙裔、非裔美国人、土著美国人、亚洲/太平洋岛民)队列将被用来调查老龄化与贫血流行病学、病理学和预后的关系。具体地说，我们将1)根据种族-民族和共同发病率评估贫血的总体频率和危险因素；2)在WHI总体和种族-民族的10年随访中确定贫血和死亡风险之间的关联；3)在WHI队列的总体和种族-民族的9年随访中确定贫血和身体功能变化之间的关联；4)在那些通过双能X射线吸收测量法对身体成分进行基线和前瞻性测量的人中，检查贫血与肌肉损失(肌萎缩症)的相关性；5)研究老年女性贫血与骨质丢失和骨质疏松性骨折风险的关系。此外，还将评估按形态分类划分的贫血亚型的频率以及老年妇女贫血的最佳血红蛋白浓度临界点。这项研究将使用来自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更多用于血液分析的数据，并进行数据合并(身体成分测量)。将针对具体目标进行多变量数据分析。WHI为回答上述提出的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预期的老年女性多种族群体的共病和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来自不同健康、年龄和种族背景的老年妇女的贫血提供新的关键证据。

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.