Erythropoietin levels in geriatric anemia

Abstract

Background Defects in the production or action of erythropoietin (EPO) are important contributing factors in anemia. However, the exact impact of aging on levels of EPO and its role in the development of geriatric anemia is still underexplored. Moreover, the specific pattern of EPO in etiological subcategories such as nutritional anemia (NA), anemia of chronic disease (ACD), and unexplained anemia (UA) is not entirely known. Objective The aim of the study was to determine the serum EPO levels in geriatric anemia and compare them across NA, ACD, UA, and NA with ACD. Materials and Methods Ninety anemic geriatric patients (cases) along with 30 non-anemic geriatric controls were evaluated for serum EPO levels. A correlation between S.EPO and inflammatory markers was also done. Results Serum EPO levels were higher in cases as compared to controls (P < 0.00). After adjusting for outliers, the reference range of EPO in controls was the same as in normal young adults (2.21–20.95 mU/mL). The majority (37/58, 63.7%) of NA patients had increased S.EPO levels (highest among all four subcategories and controls). S.EPO also correlated inversely with high-sensitivity CRP (hsCRP) and serum ferritin (SF), reinforcing that the inflammatory state suppresses S.EPO levels. Conclusion Geriatric anemic patients have elevated S.EPO as compared to non-anemic controls (observed reference range similar to young adults). Raised EPO levels were detected more frequently in NA, while they were the lowest in UA.

Keywords

• erythropoietin
• geriatric anemia
• inflammatory markers
• unexplained anemia