Serum erythropoietin and aging: a longitudinal analysis.
OBJECTIVE
To determine the changes in serum erythropoietin with age in patients with and without anemia and to assess the importance of certain comorbidities on changes in erythropoietin level and the development of anemia.


METHODS
Clinical history, hematological parameters, and serum erythropoietin levels were examined at 1- to 2-year intervals for 8 to 30 years.


METHODS
Baltimore Longitudinal Study on Aging (BLSA), National Institute on Aging.


METHODS
One hundred forty-three BLSA participants.


METHODS
Complete blood count and serum chemistries were performed at the time of each visit, and archived serum samples were used for erythropoietin level.


RESULTS
Although all subjects were healthy and without anemia at the time of initial evaluation, some developed chronic illness-most notably hypertension and diabetes mellitus. Erythropoietin levels rose significantly for the group as a whole, and the slope of the rise was found to be greater for those who did not have associated diabetes mellitus or hypertension. During the subsequent years, subjects who developed anemia but did not have hypertension or diabetes mellitus had the greatest slope in erythropoietin rise over time, whereas those with hypertension or diabetes mellitus and anemia had the lowest erythropoietin slope.


CONCLUSIONS
The increase in serum erythropoietin with aging may be compensation for subclinical blood loss, increased red blood cell turnover, or increased erythropoietin resistance of red cell precursors. It is suspected that, with very advanced age, or in those with compromised renal function (e.g., diabetes mellitus or hypertension), the compensatory mechanism becomes inadequate and anemia results.
Ershler
William B
WB
Institute for Advanced Studies in Aging, Washington, DC, USA. ershlerwi@grc.nia.nih.gov
Sheng
Shan
S
McKelvey
Julie
J
Artz
Andrew S
AS
Denduluri
Neelima
N
Tecson
Josephine
J
Taub
Dennis D
DD
Brant
Larry J
LJ
Ferrucci
Luigi
L
Longo
Dan L
DL
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000375:Aging / Q000097:blood*; D000740:Anemia / Q000097:blood; D048909:Diabetes Complications; D004921:Erythropoietin / Q000097:blood*; D005260:Female; D006454:Hemoglobins / Q000032:analysis; D006801:Humans; D006973:Hypertension / Q000150:complications; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged
D006454:Hemoglobins; D004921:Erythropoietin