Investigator Names and Contact Information

Zhao Chen (zchen@u.arizona.edu)

Introduction/Intent

AS191 summary and aims

Older women have a higher risk for physical function impairment and disability in comparison to older men. Low relative skeletal muscle mass (SMM) or sarcopenia contributes to the decline in physical functions among the elderly. The primary objective of this study is to investigate biological mechanisms for sarcopenia and to identify biomarkers that predict SMM loss. There are two specific aims: to assess the association of cytokines and hormonal factors with sarcopenia and the rate of SMM loss, and to investigate the sensitivity and specificity of these biomarkers in predicting SMM loss. A case-cohort study design will be used to include 400 cases and 1000 randomly selected women from the entire WHI OS DXA (Dual-energy X-ray Absorptiometry) cohort. The cases are defined as women with the highest (top 10%) rate of SMM loss during the follow-up. SMM is assessed in an ongoing WHI ancillary study (AS#153, PI: Zhao Chen). The biomarkers that will be measured in this study are IL-1a, IL-1b, IL-6, IL-10, TNF-a, TNF-b, Growth Hormone, Insulin, Leptin, C-reactive protein, IL-1ra, IL-6sR, TNF RII, IGF-1, IGFBP-1 and IGFBP-3. The modified multivariate analysis for case-cohort studies and the ROC analysis will be used. This study is unique and innovative in the study design, selection of bioassays and the study population and will have significant impacts on women’s health.

Aims

Loss of skeletal muscle mass (SMM) often occurs in older populations even in the absence of overt disease. Many diseases and conditions, such as chronic rheumatic diseases, may further accelerate muscle loss, and increase a person’s risk for sarcopenia (very low SMM), a condition that leads to declined physical functions and poor quality of life in older age. Increased levels of inflammatory factors and lower levels of IGF are associated with low skeletal muscle mass, suggesting that changes in levels of cytokines and hormonal factors with aging may be potential mechanisms for loss of SMM. The specificity and sensitivity of these biomarkers in assessing acute changes in skeletal muscle, and in screening and predicting skeletal muscle loss in longitudinal follow-up have not been fully investigated.

Our primary objective is to investigate the biological mechanisms for sarcopenia and to identify biomarkers that predict changes in skeletal muscle mass. The specific aims of this study include:

  1. To assess the association of cytokines and hormonal factors with sarcopenia and rate of SMM loss derived from DXA scans.
  2. To assess the sensitivity and specificity of these biomarkers in predicting loss of SMM.

AS 199 - Summary and Aims

Low relative skeletal muscle mass (SMM) or sarcopenia contributes to the decline in physical functions among the elderly. Both genetic factors and environmental factors may contribute to the development of sarcopenia. However, very little is known about genetic risk factors and their interactions with environment factors in aging-related loss of SMM. The primary objective of this study is to investigate genetic variations in selected catabolic (IL-1, IL-6, TNF-alpha) and anabolic (IGF-1 and GH) factors in relationship to SMM loss among older women. Gene to gene interactions as well as interaction between gene and environmental factors will also be examined. A case-cohort study design will be used to include 800 cases and 2000 sub-cohort of women who are matched on age and ethnicity with the cases and are selected from the entire WHI OS DXA (dual-energy x-ray absorptiometry) cohort. The cases are defined as women with the highest (top 10%) rate of SMM loss during the follow-up. SMM can be estimated from DXA-derived body composition measurements based on previously published studies. The precision of the estimates on SMM will be further improved in an ongoing WHI ancillary study (AS#153, PI: Zhao Chen). Results of this study may help us to identify high-risk populations for sarcopenia and to develop targeted therapies and preventions to reduce SMM loss among the growing population of older people in the United States.

Aims

Our primary objective of this study is to investigate genetic variations and interactions of genetic and environmental factors in determining rate of skeletal muscle loss. Using the resources of the Women’s Health Initiative and the invaluable biospecimen collection and body composition measures (from dual-energy x-ray absorptiometry –DXA) over time, we propose the following primary specific aims:

  1. To evaluate the role of genetic variation in catabolic inflammatory cytokines (IL-6, IL-1, TNF-alpha) on SMM loss (DXA-derived measurements) in age- and ethnicity-matched postmenopausal women controlling for levels of physical activity.

Data Dictionaries and Study Documentation

This section displays all study-related data dictionaries and study-related files. The investigators for this study will upload the datasets, data dictionaries, and other study-related files. Study-related files will be made available to the public one year after the completion of the ancillary study, with the exception of the datasets, which will only be available to those with a Data Distribution Agreement. Those will be available to those with permission to download and will appear as a download link next to the data dictionary

Data Dictionaries

Name
Description
No results found

Study Documents

Name
Description
NameAS191-199 case control selection.pdfDescription

Related Papers

The associations between magnetic resonance images-measured skeletal muscle mass, adipose depots and obesity-associated inflammation biomarkers in postmenopausal women: an ancillary study of the Women’s Health Initiative

Approved Proposal, Gong, Juanfen et al., 2015/5 MSID: 2749
Keywords: Aging; Sarcopenia; Adiposity; Inflammatory Markers; Postmenopausal
Related Studies: 191, 199

Longitudinal changes skeletal muscle mass, fat mass, and serum biomarkers of adiposity in postmenopausal women: an ancillary study of the Women’s Health Initiative

Approved Proposal, Ochs-Balcom, Heather et al., 2012/6 MSID: 1841
Keywords: Aging; Adiposity; Sarcopenia; Obesity; Inflammatory Markers; Adipokines; Lean Mass
Related Studies: 191, 199

Blood circulated catabolic and anabolic biomarkers associated with absolute and relative skeletal muscle mass in Hispanic and Non-Hispanic postmenopausal women---an ancillary study of the Women’s Health Initiative

Approved Proposal, Chen, Zhao et al., 2011/8 MSID: 1531
Keywords: Biomarkers; Sarcopenia; Lean Mass; Postmenopausal; Aging
Related Studies: 191, 199

Biomarkers of inflammation, pregnancy loss, and cardiovascular disease risk

Approved Proposal, Wright, Catherine et al., 2021/1 MSID: 4354
Keywords: Inflammation; Biomarkers; Reproductive History; Miscarriage; Cardiovascular Disease

The relationship between sleep and markers of inflammation in postmenopausal women: an ancillary study of the Women’s Health Initiative

Approved Proposal, Crane, Tracy et al., 2012/7 MSID: 1877
Keywords: Sleep Duration; Sleep Quality; Insomnia; Inflammation; Cytokines; Immune Response
Related Studies: 191, 199

Evaluation of the association between circulating IL-1β and related cytokines and incident atrial fibrillation in a cohort of postmenopausal women

Marco Perez et al., 2023/1 PubMed #36646198 MSID: 2432
Background: Inflammatory cytokines play a role in atrial fibrillation (AF). Interleukin (IL)-1β, which is targeted in the treatment of ischemic heart disease, has not been well-studied in relation to AF. Methods: Postmenopausal women from the Women's Health Initiative were included. Cox proportional hazards regression models were used to evaluate the association between log-transformed baseline cytokine levels and future AF incidence. Models were adjusted for body mass index, age, race, educatio...
Keywords: Atrial Fibrillation; Myocytokines; Il-6; Crp; Biomarkers; Inflammation

Social stress, abdominal adiposity, breast cancer incidence and mortality in postmenopausal women

Approved Proposal, Valencia, Celina L. et al., 2022/6 MSID: 4397
Keywords: Breast Cancer; Social Stress; Cancer Incidence; Adiposity; Obesity
Related Studies: 191, 554, 573

Short sleep duration is associated with decreased serum leptin, increased energy intake, and decreased diet quality in postmenopausal women

Jennifer Stern et al., 2014/1 PubMed #24347344 MSID: 1878
Short sleep duration induces hormonal perturbations contributing to hyperphagia, insulin resistance, and obesity. The majority of these studies are conducted in young adults. This analysis in a large (n = 769) sample of postmenopausal women (median age 63 years) sought to (a) confirm that sleep duration and sleep quality are negatively correlated with circulating leptin concentrations and (b) to examine the relationship between self-reported sleep, dietary energy intake, and diet quality, as wel...
Keywords: Obesity; Sleep Loss; Weight Gain; Leptin; Energy Intake; Diet Quality
Related Studies: 191, 199

Determining the relationship between serum ferritin levels and risk of cardiovascular disease (CVD) in postmenopausal women

Approved Proposal, Dasgupta, Shabitri et al., 2023/1 MSID: 4851
Keywords: Cardiovascular Disease Serum Ferritin Risk Score Inflammation Biomarker
Related Studies: 191

The associations of leptin, adiponectin and resistin with incident atrial fibrillation in women

Simon Ermakov et al., 2016/5 PubMed #27146694 MSID: 2360
OBJECTIVES: Higher body mass index (BMI) is an important risk factor for atrial fibrillation (AF). The adipokines leptin, adiponectin and resistin are correlates of BMI, but their association with incident AF is not well known. We explored this relationship in a large cohort of postmenopausal women. METHODS: We studied an ethnically diverse cohort of community-dwelling postmenopausal women aged 50-79 who were nationally recruited at 40 clinical centres as part of the Women's Health Initiative in...
Keywords: Atrial Fibrillation; Cardiac Arrhythmia
Related Studies: 189, 191, 238, 266, BA10, BA11, W35