Exploring the pathophysiology of anemia in COPD: Insights from chest CT and longitudinal clinical data

IF 3.5 3区医学 Q2 CARDIAC & CARDIOVASCULAR SYSTEMS

Respiratory medicine Pub Date : 2025-03-18 DOI:10.1016/j.rmed.2025.108046

Aya Takizawa , Takashi Shimada , Shotaro Chubachi , Tetsuya Arai , Akira Miyakawa , Hideto Iizuka , Shiro Otake , Kaori Sakurai , Naoya Tanabe , Yoshitake Yamada , Masahiro Jinzaki , Hidetoshi Nakamura , Koichiro Asano , Koichi Fukunaga

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引用次数: 0

Abstract

Background

Although anemia has been associated with chronic obstructive pulmonary disease (COPD) severity, the underlying risk factors, such as chest imaging indicators, remain poorly understood. In this study, we aimed to investigate the relationship between anemia and clinical features, including pulmonary and extrapulmonary indicators on chest computed tomography (CT), and to clarify the pathophysiology of anemia in COPD.

Methods

A total of 400 patients with COPD were prospectively followed for 3 years. Anemia was defined as hemoglobin <13 g/dl in males and <12 g/dl in females. Patients were categorized into the anemia and non-anemia groups, and their clinical characteristics were compared.

Results

The anemia group exhibited lower percentage of predicted forced expiratory volume in 1 s (%FEV₁) and body mass index (BMI) measurements, worse COPD assessment test (CAT) scores, and more frequent exacerbations. Imaging revealed more severe emphysema, lower cross-sectional areas of the pectoralis and erector spinae muscles, decreased subcutaneous fat, and more severe coronary artery calcification in this group. Additionally, echocardiography demonstrated a higher prevalence of pulmonary hypertension and reduced left ventricular ejection fraction in patients with anemia. Three-year longitudinal data analysis further showed that declining hemoglobin levels correlated with the worsening of nutritional status, a deterioration in bone mineral density (BMD), and an increase in CAT scores.

Conclusion

Anemia in COPD is a multifactorial comorbidity resulting in emphysema, decreased fat and muscle mass, and reduced BMD.

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来源期刊

Respiratory medicine 医学-呼吸系统

CiteScore

7.50

自引率

0.00%

发文量

199

审稿时长

38 days

期刊介绍： Respiratory Medicine is an internationally-renowned journal devoted to the rapid publication of clinically-relevant respiratory medicine research. It combines cutting-edge original research with state-of-the-art reviews dealing with all aspects of respiratory diseases and therapeutic interventions. Topics include adult and paediatric medicine, epidemiology, immunology and cell biology, physiology, occupational disorders, and the role of allergens and pollutants. Respiratory Medicine is increasingly the journal of choice for publication of phased trial work, commenting on effectiveness, dosage and methods of action.