Systematic review of anaemia and inflammatory markers in chronic obstructive pulmonary disease

Hoepers, Andréa Thives de Carvalho; Menezes, Marcia Margarete; Fröde, Tânia Sílvia

doi:10.1111/1440-1681.12357

Cited by 30 publications

(37 citation statements)

References 56 publications

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“…(16). It has been suggested that oxygen supply to tissues was probably adversely affected when COPD was accompanied by increased systemic inflammation (17), and that erythropoietin resistance had also increased (18). This is supported by the significant relationship between the RDW/Hb ratio and mortality in our study.…”

Section: Discussionsupporting

confidence: 82%

Are Red Blood Cell Distribution Width and RDW / Hemoglobin Ratio Predictable in Mortality Among Patients with Chronic Obstructive Pulmonary Disease?

organ¹

2019

Erciyes Med J

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Objective: Chronic obstructive pulmonary disease (COPD), the third most common cause of death in the world, is a multicomponent disease with pulmonary and extrapulmonary manifestations. The red blood cell distribution width (RDW) conveys important information for short-and long-term prognosis through a variety of medical conditions. Anemia can be seen in patients with COPD due to systemic inflammation and malnutrition. The aim of this study was to evaluate the role of RDW and RDW/Hgb in the prediction of mortality in patients with exacerbated COPD. Materials and Methods: Between December 2015 and December 2017, 97 patients admitted to the Department of Chest Diseases at the Ufuk University Medical Faculty, with a diagnosis of COPD exacerbation were evaluated retrospectively. The demographic, clinical, laboratory characteristics, pulmonary functional tests, and arterial blood gases were noted. The RDW values and RDW/Hgb ratios were compared between patients who had died and those who were still alive. Results: About 79.4% of the patients (n=77) were male and the rest of them 20 (20.6%) were female. The mean age was 73.01±9.54 years. The RDW values of patients with mortality were higher than the living COPD patients (p<0.001). The RDW/Hgb ratio was found to be higher in patients who had died than those who were living (p<0.001). The levels of C-Reactive protein were significantly higher in patients with COPD with mortality (p=0.034). Conclusion: The elevated RDW levels and the RDW/Hgb ratio were associated with an increased annual number of attacks, comorbidities, and an increased PO 2 and PCO 2 mortality risk in patients with COPD.

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Section: Discussionsupporting

confidence: 82%

Are Red Blood Cell Distribution Width and RDW / Hemoglobin Ratio Predictable in Mortality Among Patients with Chronic Obstructive Pulmonary Disease?

organ¹

2019

Erciyes Med J

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“…"Spillover" of such local inflammatory process has been hypothesized as the cause of various systemic inflammatory changes and comorbidities including osteoporosis. [ 2 67 68 69 ] Increased production of such cytokines, indeed, has been demonstrated, and some of them are considered as therapeutic targets of COPD. [ 69 70 71 ] Moreover, systemic inflammation reflected by elevated C-reactive protein (CRP) in the general population has been linked to osteoporosis and to an increased bone resorption.…”

Section: Disease-specific Risk Factors For Osteoporosis In Copdmentioning

confidence: 99%

Osteoporosis Associated with Chronic Obstructive Pulmonary Disease

2016

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Recent epidemiological studies have revealed that osteoporosis is closely associated with common chronic diseases including diabetes, hypertension, chronic kidney disorders, and chronic obstructive pulmonary disease (COPD). COPD is a chronic inflammatory airway disease but now well known to be associated with various systemic comorbidities including osteoporosis. Osteoporosis and osteoporotic fractures are extremely common in COPD patients, which have significant impacts on their quality of life (QOL), activities of daily life (ADL), respiratory function, and possibly their prognosis. COPD-associated osteoporosis is however extremely under-recognized, hence undertreated. Recent studies have suggested that both decreased bone mineral density (BMD) and impaired bone quality compromise bone strength causing fractures in COPD. In COPD patients, various general clinical risk factors for osteoporosis are present including smoking, older age, low body weight, and physical inactivity. In addition, disease-related risk factors such as decreased pulmonary function, inflammation, glucocorticoid use and vitamin D deficiency/insufficiency have been linked to the development of osteoporosis in COPD. Increased awareness of osteoporosis in COPD, especially that of high prevalence of vertebral fractures is called upon among general physicians as well as pulmonologists. Routine screening for osteoporosis and risk assessment of fractures will enable physicians to diagnose COPD patients with comorbid osteoporosis at an early stage. Timely prevention of developing osteoporosis together with appropriate treatment of established osteoporosis may improve QOL and ADL of the COPD patients, preserve their lung function and eventually result in better prognosis in these patients.

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“…Historically, especially before the introduction of domiciliary oxygen, secondary polycythemia was a striking feature in COPD, but today the prevalence seems to be low 11. Instead, anemia might be more common, with a reported prevalence of 6.2%–46.3% 12,13…”

Section: Introductionmentioning

confidence: 99%

“…Importantly, anemia might reflect iron deficiency, which has been linked to the development of pulmonary arterial hypertension14 and presence of chronic inflammation, which is associated with frailty 15. Concentrations of hemoglobin and hematocrit have been shown to provide prognostic information in different populations of COPD patients,16–25 but in many of these studies patients with diseases associated with chronic anemia were excluded 12. While this strategy provides estimates of the prevalence and prognostic importance of hemoglobin directly ascribable to COPD, it does not reflect the importance of hemoglobin in a real-life COPD population, where most patients have numerous chronic diseases 5.…”

Section: Introductionmentioning

confidence: 99%

Association between hemoglobin and prognosis in patients admitted to hospital for COPD

Toft-Petersen¹,

Torp‐Pedersen²,

Weinreich³

et al. 2016

COPD

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Low concentrations of hemoglobin have previously been demonstrated in many patients with COPD. There is evidence of anemia as a prognostic factor in acute exacerbations, but the detailed relationship between concentrations of hemoglobin and mortality is not known. A register-based cohort of patients admitted for the first time to Danish hospitals for acute exacerbations of COPD from 2007 through 2012 was established. Age, sex, comorbidities, medication, renal function, and concentrations of hemoglobin were retrieved. Sex-specific survival analyses were fitted for different rounded concentrations of hemoglobin. The cohort encompassed 6,969 patients. Hemoglobin below 130 g/L was present in 39% of males and below 120 g/L in 24% of females. The in-hospital mortality rates for patients with hemoglobin below or above these limits were 11.6% and 5.4%, respectively. After discharge, compared to hemoglobin 130 g/L, the hazard ratio (HR) for males with hemoglobin 120 g/L was 1.45 (95% confidence interval [CI] 1.22–1.73), adjusted HR 1.37 (95% CI 1.15–1.64). Compared to hemoglobin 120 g/L, the HR for females with hemoglobin 110 g/L was 1.4 (95% CI 1.17–1.68), adjusted HR 1.28 (95% CI 1.06–1.53). In conclusion, low concentrations of hemoglobin are frequent in COPD patients with acute exacerbations, and predict long-term mortality.

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Systematic review of anaemia and inflammatory markers in chronic obstructive pulmonary disease

Cited by 30 publications

References 56 publications

Are Red Blood Cell Distribution Width and RDW / Hemoglobin Ratio Predictable in Mortality Among Patients with Chronic Obstructive Pulmonary Disease?

Are Red Blood Cell Distribution Width and RDW / Hemoglobin Ratio Predictable in Mortality Among Patients with Chronic Obstructive Pulmonary Disease?

Osteoporosis Associated with Chronic Obstructive Pulmonary Disease

Association between hemoglobin and prognosis in patients admitted to hospital for COPD

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