Anemia of chronic disease in chronic obstructive pulmonary disease: a case-control study of cardiopulmonary exercise responses.
Title | Anemia of chronic disease in chronic obstructive pulmonary disease: a case-control study of cardiopulmonary exercise responses. |
Publication Type | Journal Article |
Year of Publication | 2011 |
Authors | Boutou, A. K., Stanopoulos I., Pitsiou G. G., Kontakiotis T., Kyriazis G., Sichletidis L., & Argyropoulou P. |
Journal | Respiration |
Volume | 82 |
Issue | 3 |
Pagination | 237-45 |
Date Published | 2011 |
ISSN | 1423-0356 |
Keywords | Anemia, Case-Control Studies, Cross-Sectional Studies, Erythropoietin, Exercise Test, Female, Ferritins, Forced Expiratory Volume, Hemoglobins, Humans, Male, Middle Aged, Pulmonary Disease, Chronic Obstructive |
Abstract | BACKGROUND: Anemia may be present in patients with chronic obstructive pulmonary disease (COPD) and further impair their functional capacity.OBJECTIVES: This study investigated the prevalence of anemia of chronic disease (ACD) in COPD patients and its impact on dyspnea and exercise capacity, utilizing cardiopulmonary exercise testing (CPET).METHODS: ACD prevalence was assessed in 283 consecutive patients with stable COPD (263 males, 60 females; age 60.31 ± 5.34 years; percent forced expiratory volume in 1 s 46.94 ± 6.12). ACD diagnosis was based on a combination of clinical and laboratory parameters [hemoglobin (Hb) <13 g/dl for males, <12 g/dl for females; ferritin >30 ng/ml; total iron-binding capacity <250 μg/dl, and transferrin saturation rate between 15 and 50%]. Twenty-seven patients who were identified with ACD (cases) and 27 matched nonanemic patients (controls) completed maximal CPET, and data were compared between the groups.RESULTS: ACD was diagnosed in 29 patients, which represents a prevalence of 10.24%; the severity of anemia was generally mild (mean Hb: 12.19 ± 0.66 g/dl). Patients with ACD had a higher Medical Research Council dyspnea score compared to controls (2.78 ± 0.44 vs. 2.07 ± 0.55; p <0.001) and lower peak O(2) uptake (VO(2)) (59.54 ± 17.17 vs. 71.26 ± 11.85% predicted; p <0.05), peak work rate (54.94 ± 21.42 vs. 68.72 ± 20.81% predicted; p <0.05) and peak VO(2)/heart rate (69.07 ± 17.26 vs. 82.04 ± 18.22% predicted; p <0.05). There was also a trend for a lower anaerobic threshold (48.48 ± 15.16 vs. 55.42 ± 9.99% predicted; p = 0.062). No exercise parameter indicative of respiratory limitation differed between the groups.CONCLUSIONS: ACD occurs in approximately 10% of stable COPD patients and has a negative impact on dyspnea and circulatory efficiency during exercise. |
DOI | 10.1159/000326899 |
Alternate Journal | Respiration |
PubMed ID | 21576921 |