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. 2024 Oct;13(10):4347-4353.
doi: 10.4103/jfmpc.jfmpc_29_24. Epub 2024 Oct 18.

Erythropoietin levels in geriatric anemia

O V Fathima  1 , Malvika Shastri  1 , Mrinalini Kotru  1 , Rajat Jain  1 , Ashish Goel  2 , Meera Sikka  1
Affiliations

Erythropoietin levels in geriatric anemia

O V Fathima et al. J Family Med Prim Care. 2024 Oct.

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.

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Conflict of interest statement

There are no conflicts of interest.

Figures

Figure 1
Figure 1
Inflammatory markers and EPO in UA in geriatrics (n = 8). Cut-off values: SF < 15 µg/L, hsCRP < 6 mg/L, S.EPO = 3.22–31.9 mIU/mL. The pattern of rise in levels of inflammatory markers in patients with UA was ESR (100%) > SF (75%) > hsCRP (38%). One-fourth of patients with UA lacked EPO elevation, while the remaining had normal to high values. However, these levels were still lower than non-anemic controls indicating an overall inadequate EPO response in these patients
See this image and copyright information in PMC

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