Journal of the Korea Academia-Industrial cooperation Society (한국산학기술학회논문지)

The Korea Academia-Industrial cooperation Society (한국산학기술학회)
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Association between Chronic Obstructive Pulmonary Disease and Hemoglobin Concentration in the Elderly: Based on National Health and Nutrition Survey

국민건강영양조사 자료를 이용한 노인의 만성폐쇄성폐질환과 헤모글로빈 농도의 상관관계

  • Cho, Hyoung Jun (Department of Physical Medicine and Rehabilitation, Ajou University Hospital) ;
  • Huh, Yool-Gang (Department of Physical Medicine and Rehabilitation, Ajou University Hospital) ;
  • Kim, Dae hwan (Department of Physical Medicine and Rehabilitation, Ajou University Hospital)
  • 조형준 (아주대학교병원 재활의학과) ;
  • 허율강 (아주대학교병원 재활의학과) ;
  • 김대환 (아주대학교병원 재활의학과)
  • Received : 2019.08.27
  • Accepted : 2019.11.01
  • Published : 2019.11.30
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Abstract

This study determines the difference in prevalence of anemia and hemoglobin concentration between chronic obstructive pulmonary disease (COPD) and control groups in the elderly. Moreover, this study also examines the prevalence of anemia and hemoglobin concentration according to the severity of COPD in the elderly. Medical records of 8150 participants who answered the 7th National Health and Nutritional Survey conducted in 2016 were reviewed, and a total of 694 participants was included in the analysis. Participants were classified into two groups: COPD and control groups. Laboratory studies on hemoglobin, hematocrit, red blood cell concentration and prevalence of anemia were collected. Subgroup analysis was also conducted according to the severity of COPD. No significant differences were determined for the prevalence of anemia and hemoglobin concentration between both groups. Hemoglobin concentration was significantly higher in the COPD group. Although not statistically significant, there was a tendency for decrease in the prevalence of anemia and increase in the hemoglobin concentration as the severity of COPD increased. Our findings present specific data about the prevalence of anemia and hemoglobin concentration in elderly patients with COPD. Hence, we propose that occurrence of anemia in elderly patients with COPD requires further evaluation of the causes.

본 연구는 노인 인구에서 대조군과 만성폐쇄성폐질환 환자의 빈혈 유병률과 헤모글로빈 농도의 차이를 살펴보고자 시행되었다. 또한, 본 연구는 노인 인구에서 만성폐쇄성폐질환의 중증도에 따른 빈혈 유병률과 헤모글로빈 농도를 조사하였다. 제 7기 국민건강영양조사 1차 년도(2016) 조사에 참여한 8150명의 의무기록을 분석하여 총 694명이 연구에 포함되었다. 대상자를 만성폐쇄성폐질환군과 비질환 대조군으로 분류하였고, 헤모글로빈, 헤마토크리트, 적혈구 농도 및 빈혈 유병 유무를 조사하였다. 만성폐쇄성폐질환군은 중증도에 따라 하위그룹으로 나누어 동일한 분석을 시행하였다. 비질환 대조군과 만성폐쇄성폐질환군의 빈혈 유병률은 그룹 간에 차이가 없었다. 비질환 대조군에 비해 만성폐쇄성폐질환군의 헤모글로빈, 헤마토크리트 및 적혈구 농도가 통계적으로 유의하게 높았다. 통계적으로 유의하진 않았으나, 만성폐쇄성폐질환의 중증도가 심해짐에 따라 빈혈 유병률은 감소하고 헤모글로빈, 헤마토크리트 및 적혈구 농도는 증가하는 경향성을 보였다. 본 연구를 통해 노인 만성폐쇄성폐질환 환자의 빈혈 유병률 및 헤모글로빈 농도에 대한 구체적인 자료를 제시할 수 있었다. 노인 만성폐쇄성폐질환 환자에서 빈혈이 발생한다면 원인에 대한 추가적인 평가를 고려해 봐야 한다.

Keywords

References

  1. Barnes PJ, "Chronic obstructive pulmonary disease", N Engl J Med, Vol.343, No.4, pp.269-280. 2000. DOI: https://doi.org/10.1056/NEJM200007273430407
  2. Mannino DM, Buist AS, "Global burden of COPD: risk factors, prevalence, and future trends", Lancet, Vol.370, No.9589, pp.765-773, 2007. DOI: https://doi.org/10.1016/S0140-6736(07)61380-4
  3. Murray CJ, Lopez AD, "Alternative projections of mortality and disability by cause 1990-2020: Global Burden of Disease Study", Lancet, Vol.349, No.9064, pp.1498-1504, 1997. DOI: https://doi.org/10.1016/S0140-6736(96)07492-2
  4. Celli BR, Cote CG, Lareau SC, Meek PM, "Predictors of Survival in COPD: more than just the FEV1", Respir Med, Vol.102, Suppl 1, pp.S27-35, 2008. DOI: https://doi.org/10.1016/S0954-6111(08)70005-2
  5. Vestbo J, Hurd SS, Rodriguez-Roisin R, "The 2011 revision of the global strategy for the diagnosis, management and prevention of COPD (GOLD) - why and what?", Clin Respir J, Vol.6, No.4, pp.208-214, 2012. DOI: https://doi.org/10.1111/crj.12002
  6. Weiss G, Goodnough LT. "Anemia of chronic disease", N Engl J Med, Vol.352, No.10, pp.1011-1023, 2005. DOI: https://doi.org/10.1056/NEJMra041809
  7. Krishnan G, Grant BJ, Muti PC, et al, "Association between anemia and quality of life in a population sample of individuals with chronic obstructive pulmonary disease", BMC Pulmonary Medicine, Vol.5, No.6, pp.23, 2006. DOI: https://doi.org/10.1186/1471-2466-6-23
  8. Cote C, Zilberberg MD, Mody SH, Dordelly LJ, Celli B, "Haemoglobin level and its clinical impact in a cohort of patients with COPD", Eur Respir J, Vol.29, No.5, pp.923-929, 2007. DOI: https://doi.org/10.1183/09031936.00137106
  9. Celli BR, Cote CG, Marin JM, et al, "The body-mass index, airflow obstruction, dyspnea, and exercise capacity index in chronic obstructive pulmonary disease", N Engl J Med, Vol.350, No.10, pp.1005-1012, 2004. DOI: https://doi.org/10.1056/NEJMoa021322
  10. John M, Lange A, Hoernig S, Witt C, Anker SD, "Prevalence of anemia in chronic obstructive pulmonary disease: comparison to other chronic diseases", Int J Cardiol, Vol.111, No.3, pp.365-370, 2006. DOI:https://doi.org/10.1016/j.ijcard.2005.07.043
  11. John M, Hoernig S, Doehner W, Okonko DD, Witt C, Anker SD, "Anemia and inflammation in COPD", Chest, Vol.127, No.3, pp.825-829, 2005. DOI: https://doi.org/10.1378/chest.127.3.825
  12. Park HJ, Leem AY, Lee SH, et al, "Comorbidities in obstructive lung disease in Korea: data from the fourth and fifth Korean National Health and Nutrition Examination Survey", Int J Chron Obstruct Pulmon Dis, Vol.10, No.1, pp.1571-1582, 2015. DOI: https://doi.org/10.2147/COPD.S85767
  13. Joo H, Park J, Lee SD, Oh YM, "Comorbidities of chronic obstructive pulmonary disease in Koreans: a population-based study", J Korean Med Sci, Vol.27, No.8, pp.901-906, 2012. DOI: https://doi.org/10.3346/jkms.2012.27.8.901
  14. Epstein AA, "A Contribution to the study of the chemistry of blood serum", J Exp Med, Vol.216, No.9, pp.719-731, 1912. DOI: https://doi.org/10.1084/jem.16.6.719
  15. Cote C, Zilberberg MD, Mody SH, Dordelly LJ, Celli B, "Haemoglobin level and its clinical impact in a cohort of patients with COPD", Eur Respir J, Vol.29, No.5, pp.923-929, 2007. DOI: https://doi.org/10.1183/09031936.00137106
  16. Kontis V, Bennett JE, Mathers CD, Li G, Foreman K, Ezzati M, "Future life expectancy in 35 industrialised countries: projections with a Bayesian model ensemble", Lancet, Vol.389, No.10076, pp.1323-1335, 2017. DOI: https://doi.org/10.1016/S0140-6736(16)32381-9
  17. Fabricius P, Lokke A, Marott JL, Vestbo J, Lange P, "Prevalence of COPD in Copenhagen", Respir Med, Vol.105, No.3, pp.410-417, 2011. DOI: https://doi.org/10.1016/j.rmed.2010.09.019
  18. Pauwels RA, Buist AS, Calverley PM, Jenkins CR, Hurd SS, Committee GS, "Global strategy for the diagnosis, management, and prevention of chronic obstructive pulmonary disease. NHLBI/WHO Global Initiative for Chronic Obstructive Lung Disease (GOLD) Workshop summary", Am J Respir Crit Care Med, Vol.163, No.5, pp.1256-1276, 2001. DOI: https://doi.org/10.1164/ajrccm.163.5.2101039
  19. World Health Organization, "Nutritional anemias. Report of a WHO Scientific Group", World Health Organ Tech Rep Ser, Vol.405, No.1, pp.5-37, 1968.
  20. Izaks GJ, Westendorp RG, Knook DL, "The definition of anemia in older persons", JAMA, Vol.281, No.18, pp.1714-1717, 1999. DOI: https://doi.org/10.1001/jama.281.18.1714
  21. Silverberg DS, Mor R, Weu MT, Schwartz D, Schwartz IF, Chernin G, "Anemia and iron deficiency in COPD patients: prevalence and the effects of correction of the anemia with erythropoiesis stimulating agents and intravenous iron", BMC Pulm Med, Vol.14, pp.24, 2014. DOI: https://doi.org/10.1186/1471-2466-14-24
  22. Semenza GL, "Regulation of oxygen homeostasis by hypoxia-inducible factor 1", Physiology (Bethesda), Vol.24, No.2, pp.97-106, 2009. DOI: https://doi.org/10.1152/physiol.00045.2008
  23. Balkwill F, Osborne R, Burke F, et al, "Evidence for tumour necrosis factor/cachectin production in cancer", Lancet, Vol.330, No.8570, pp.1229-1232, 1987. DOI: https://doi.org/10.1016/S0140-6736(87)91850-2
  24. Crosato M, Steinborn W, Anker SD, "Anemia in chronic congestive heart failure: frequency, prognosis, and treatment", Heart Fail Monit, Vol.4, No.1, pp.2-6, 2003.
  25. Miravitlles M, Guerrero T, Mayordomo C, Sanchez-Agudo L, Nicolau F, Segu JL, "Factors associated with increased risk of exacerbation and hospital admission in a cohort of ambulatory COPD patients: a multiple logistic regression analysis", Respiration, Vol.67, No.5, pp.495-501, 2000. DOI: https://doi.org/10.1159/000067462
  26. Martinez-Rivera C, Portillo K, Munoz-Ferrer A, et al, "Anemia is a Mortality Predictor in Hospitalized Patients for COPD Exacerbation", COPD: Journal of Chronic Obstructive Pulmonary Disease, Vol.9, No.3, pp.243-250, 2012. DOI: https://doi.org/10.3109/15412555.2011.647131