Proinflammatory state and circulating erythropoietin in persons with and without anemia - 21/08/11
, Jack M. Guralnik, MD, PhD b, 1, Richard C. Woodman, MD c, 1, Stefania Bandinelli, MD d, Fulvio Lauretani, MD d, Anna Maria Corsi, PhD d, Paulo H.M. Chaves, MD, PhD e, 2, William B. Ershler, MD a, 4, Dan L. Longo, MD aResumen |
Purpose |
High circulating levels of proinflammatory cytokines cause anemia, perhaps by interacting with erythropoietin production or biological activity. We characterize the relationships of systemic inflammation, erythropoietin, and hemoglobin.
Methods |
Data are from the InCHIANTI (Invecchiare in Chianti, aging in the Chianti area) study population. A sample of 1270 persons aged 65 years or older and 30 men and 30 women from each age-decade 20 to 70 years were randomly selected from the residents in the Chianti, Italy, geographic area. Of the 1714 eligible persons, 1235 had complete data on inflammatory markers, erythropoietin, hemoglobin, potential causes of anemia, and other relevant covariates. Anemia was defined as hemoglobin less than 12 g/dL in women and less than 13 g/dL in men.
Results |
Independent of age, sex, and hemoglobin, the number of elevated inflammatory markers (C-reactive protein, interleukin-6, interleukin-1beta, and tumor necrosis factor-alpha) was associated with progressively higher erythropoietin in non-anemic participants but lower erythropoietin in anemic participants. Findings were consistent across different causes of anemia. The threshold at which the effect of inflammation on erythropoietin reversed was close to 13.0 g/dL of hemoglobin.
Conclusions |
Our findings suggest that anemia of inflammation evolves from a “pre-anemic” stage characterized by a compensatory increment of erythropoietin that maintains normal hemoglobin levels to a stage of clinically evident anemia in which erythropoietin levels are not high enough to maintain normal hemoglobin, possibly because of the inhibitory effect of inflammation on erythropoietin production. This hypothesis requires testing in a longitudinal study.
El texto completo de este artículo está disponible en PDF.Keywords : Anemia, Inflammation, Cytokines, Erythropoietin, InCHIANTI
Esquema
| The InCHIANTI study was supported as a “targeted project” (ICS 110.1\RS97.71) by the Italian Ministry of Health and in part by the U.S. National Institute on Aging (Contracts N01-AG-916413 and N01-AG-821336), an unrestricted grant from Ortho Biotech, and by the U.S. National Institute on Aging (Contracts 263 MD 916413 and 263 MD 821336). None of the sponsoring Institutions interfered with the collection, analysis, presentation, and interpretation of the data reported in this article. |
Vol 118 - N° 11
P. 1288.e11-1288.e19 - novembre 2005 Regresar al número
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