De La Cruz-Góngora Vanessa, Salinas-Rodriguez Aaron, Manrique-Espinoza Betty
Center for Evaluation and Surveys Research, National Institute of Public Health, Cuernavaca, Mexico.
Front Nutr. 2024 Mar 13;11:1323450. doi: 10.3389/fnut.2024.1323450. eCollection 2024.
Low hemoglobin levels are a significant biomarker in the prognosis of sarcopenia. Anemia and sarcopenia are frequent and disabling conditions in the older adult population, but little is known about the role of anemia in the onset and progression of sarcopenia. This study aimed to determine whether prospective changes in anemia are associated with the incidence and persistence of sarcopenia.
Data come from the second and third waves (2014, 2017) of the World Health Organization (WHO) Study on global AGEing and adult health (SAGE) in Mexico. SAGE-Mexico is a dynamic cohort with national representativeness, including a follow-up sample and new enrollments. For this study, 1,500 older adults (aged 50 or above) with measurements in both waves were included. Sarcopenia was defined as having low muscle quantity and either/both slow gait speed and weak handgrip strength. Anemia was defined according to hemoglobin concentrations, adjusted for altitude, as recommended by the WHO, <120 g/L for women and <130 g/L for men. Multinomial logistic regression was used to estimate the association between anemia and prospective changes in sarcopenia.
The baseline prevalence of anemia was 17.4%, and that of sarcopenia was 12.1%. The incidence and persistence of anemia were 10.6% (95% CI: 7.3-15.0%) and 6.9% (95% CI: 4.7-9.8%), respectively, and for sarcopenia, they were 5.3% (95% CI: 3.7-7.7%) and 9.2% (95% CI: 6.4-13.0%), respectively. Incident anemia was associated with incident (RRR = 3.64, 95% CI: 1.18-11.19) but not with persistent (RRR = 0.75, 95% CI: 0.18-3.20) sarcopenia. Persistent anemia was significantly associated with persistent (RRR = 3.59, 95% CI: 1.14-11.27) but not incident (RRR = 1.17, 95% CI: 0.30-4.54) sarcopenia.
Changes in anemia are significantly associated with incident and persistent sarcopenia. Primary actions to promote a healthy diet rich in antioxidants, high-quality proteins, and micronutrients, as well as moderate physical activity and maintaining a healthy weight, are crucial for the aging population to delay the deleterious effects of anemia and sarcopenia.
低血红蛋白水平是肌肉减少症预后的一项重要生物标志物。贫血和肌肉减少症在老年人群中很常见且会导致功能障碍，但关于贫血在肌肉减少症的发生和发展中的作用，人们了解甚少。本研究旨在确定贫血的前瞻性变化是否与肌肉减少症的发病率和持续存在有关。
数据来自世界卫生组织（WHO）在墨西哥开展的全球老龄化与成人健康研究（SAGE）的第二波和第三波调查（2014年、2017年）。墨西哥SAGE研究是一个具有全国代表性的动态队列，包括随访样本和新加入者。本研究纳入了1500名在两波调查中均有测量数据的老年人（年龄50岁及以上）。肌肉减少症的定义为肌肉量低且步态速度慢和握力弱二者之一或二者兼具。贫血按照世界卫生组织的建议，根据调整海拔后的血红蛋白浓度进行定义，女性<120 g/L，男性<130 g/L。采用多项逻辑回归来估计贫血与肌肉减少症前瞻性变化之间的关联。
贫血的基线患病率为17.4%，肌肉减少症的基线患病率为12.1%。贫血的发病率和持续存在率分别为10.6%（95%置信区间：7.3 - 15.0%）和6.9%（95%置信区间：4.7 - 9.8%），肌肉减少症的发病率和持续存在率分别为5.3%（95%置信区间：3.7 - 7.7%）和9.2%（95%置信区间：6.4 - 13.0%）。新发贫血与新发肌肉减少症相关（相对风险比RRR = 3.64，95%置信区间：1.18 - 11.19），但与持续性肌肉减少症无关（RRR = 0.75，95%置信区间：0.18 - 3.20）。持续性贫血与持续性肌肉减少症显著相关（RRR = 3.59，95%置信区间：1.14 - 11.27），但与新发肌肉减少症无关（RRR = 1.17，95%置信区间：0.30 - 4.54）。
贫血的变化与新发和持续性肌肉减少症显著相关。采取主要行动促进富含抗氧化剂、优质蛋白质和微量营养素的健康饮食，以及适度的体育活动和保持健康体重，对于老年人群延缓贫血和肌肉减少症的有害影响至关重要。
