Erythropoietin in chronic obstructive pulmonary disease patients without anemia

Abstract

Background: The dynamics of erythropoietin (EPO) in chronic obstructive pulmonary disease (COPD) is studied mostly in patients with anemia [Budnevsky A et al, 2017; Hoepers A et al, 2015]. There is lack of data on EPO in COPD patients without anemia. Aim: To evaluate EPO levels in patients with COPD of varying severity in the absence of anemia. Methods: 102 patients with COPD (average age 64.3±8.5 yrs, men/women 82/20, ABCD groups 14/18/37/33 patients respectively, GOLD 2017) and 20 age and sex matched healthy controls were included in the study. All the subjects underwent COPD symptoms and exacerbation history assessment, CAT and mMRC questionnaires, bloodanalysis, spirometry and reversibility test with Salbutamol 400 ug (Spirovit SP-260, SCHILLER). EPO levels in the blood samples obtained in the morning were determined by enzyme-linked immunosorbent assay EPO-ELISA-BEST (“Vector-Best”, Russia). Statistical data processing was carried out with Statistica 7.0 (Statsoft, USA). Results: The medians and interquartile ranges of EPO differed significantly: 12.0 (7.4-16.1) mIU/mL in COPD patients and 7.5 (5.7-8.1) mIU/ml in controls (U=513; p=0.000454). The EPO concentration growth in patients with COPD increased with the group letter: A - 8.1 (7.4–3.0) mIU/ml, B - 9.8 (6.9–15.1) mIU/ml, C - 12.1 (8.2–14.1) mIU/ml, D - 14.9 (8.4–21.6) mIU/ml. Significant EPO increase in groups C (pcontrol-C=0.022) and D (pcontrol-D=0.0007) was revealed in comparison with controls. Conclusions: The EPO serum level in patients with COPD without anemia is higher than in healthy controls. It depends on the severity of COPD symptoms (ABCD assessment). EPO can be considered a hypoxia marker in COPD patients without anemia.