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Clinical Investigations: COPD |

Anemia and Inflammation in COPD*

Matthias John, MD, PhD; Soeren Hoernig, MD; Wolfram Doehner, MD; Darlington D. Okonko, MD; Christian Witt, MD, PhD; Stefan D. Anker, MD, PhD
Author and Funding Information

*From the Department of Pneumology (Campus Mitte) [Drs. John, Witt, and Hoernig] and Applied Cachexia Research, Cardiology (Campus Virchow-Klinikum) [Dr. Doehner], University Hospital Charité, Berlin, Germany; and Department of Clinical Cardiology (Drs. Okonko and Anker), National Heart & Lung Institute, Imperial College, London, UK.

Correspondence to: Matthias John, MD, PhD, Department of Pneumology, University Hospital Charité, Campus Mitte, Schumannstr. 20/21, 10098 Berlin, Germany; e-mail: matthias.john@charite.de



Chest. 2005;127(3):825-829. doi:10.1378/chest.127.3.825
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Background: Anemia in patients with COPD and its pathophysiology is an understudied issue.

Methods: In a group of 101 COPD patients (FEV1 percentage of predicted, 37 ± 2% [mean ± SEM]; mean age, 61 ± 1 years; 35% female gender), the prevalence of anemia and its relationship to body mass and weight loss, inflammatory parameters, and erythropoietin levels was determined. Data were compared to a control group (healthy persons with matched age) in order to identify potential factors that may influence the development of anemia in patients with COPD.

Results: Anemia was diagnosed in 13 patients (hemoglobin levels < 13.5 mg/dL in male patients and < 12.0 mg/dL in female patients), which represents a prevalence of 13%. Anemic COPD patients showed elevated erythropoietin levels (41.8 ± 25.4 U/L vs 16.3 ± 2.9 U/L) and an increased inflammatory response compared to nonanemic patients. A significant inverse correlation of hemoglobin vs erythropoietin (r = − 0.84, p < 0.01) was observed in anemic COPD patients, but not in the nonanemic group.

Conclusion: Anemic COPD patients show high erythropoietin levels, which may indicate presence of erythropoietin resistance. The latter may be mediated through inflammatory mechanisms, which is typical for anemia of chronic illness.

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