title: Non-anaemic iron deficiency impairs response to pulmonary rehabilitation in COPD.
abstract: OBJECTIVE
  Non-anaemic iron deficiency (NAID) might alter the oxygen pathway in health and disease. The current study aims at assessing the impact of NAID on aerobic capacity in patients with chronic obstructive pulmonary disease (COPD).
  
  
  METHODS
  A prospective sample of 70 non-anaemic COPD patients candidate to participate in an 8-week pulmonary rehabilitation (PR) programme was studied. Incremental cycling exercise to peak oxygen uptake (V'O2peak ) and constant work-rate exercise at 80% V'O2peak to exhaustion were assessed pre- and post-PR. Training-induced increase of endurance time (ET) ≥33%, which represented the minimal clinically important difference, classified patients as responders to exercise training.
  
  
  RESULTS
  The prevalence of NAID was 48% (n = 34) showing no relationship with the Global Initiative for Chronic Obstructive Lung Disease stages (P = 0.209). Patients with NAID showed lower pre-training ET (P = 0.033) and V'O2peak (P = 0.007) than normal iron status (NIS) patients after adjustment for potential covariates. Significant training-induced physiological changes were seen in the NIS group (ΔV'O2peak 68(132) mL/min; P = 0.009), but not in the NAID group (ΔV'O2peak 26 (126) mL/min; P = 0.269). The NAID group showed lower percentage of responders to training (56%) than the NIS group (78%) (P = 0.041).
  
  
  CONCLUSIONS
  COPD patients with NAID showed lower pre-training aerobic capacity and reduced training-induced response than NIS patients after adjusting for potential confounding variables.
authors.affiliation: Hospital Clínic de Barcelona, Thorax Clinic Institute, Respiratory Diagnostic Centre, Barcelona, Catalonia, Spain.|August Pi i Sunyer Biomedical Research Institute (IDIBAPS), University of Barcelona, Barcelona, Catalonia, Spain.|Center for Biomedical Network Research in Respiratory Diseases (CIBERES), Barcelona, Catalonia, Spain.
authors.forename: Anael
authors.initials: A
authors.lastname: Barberan-Garcia
authors.affiliation: Center for Biomedical Network Research in Respiratory Diseases (CIBERES), Barcelona, Catalonia, Spain.|Parc de Salut Mar, Pulmonary Medicine Department, Hospital del Mar Medical Research Institute (IMIM), Pompeu Fabra University, Barcelona, Catalonia, Spain.
authors.forename: Diego Agustín
authors.initials: DA
authors.lastname: Rodríguez
authors.affiliation: Hospital Clínic de Barcelona, Thorax Clinic Institute, Respiratory Diagnostic Centre, Barcelona, Catalonia, Spain.|August Pi i Sunyer Biomedical Research Institute (IDIBAPS), University of Barcelona, Barcelona, Catalonia, Spain.|Center for Biomedical Network Research in Respiratory Diseases (CIBERES), Barcelona, Catalonia, Spain.
authors.forename: Isabel
authors.initials: I
authors.lastname: Blanco
authors.affiliation: Center for Biomedical Network Research in Respiratory Diseases (CIBERES), Barcelona, Catalonia, Spain.|Parc de Salut Mar, Pulmonary Medicine Department, Hospital del Mar Medical Research Institute (IMIM), Pompeu Fabra University, Barcelona, Catalonia, Spain.
authors.forename: Joaquim
authors.initials: J
authors.lastname: Gea
authors.affiliation: Hospital Clínic de Barcelona, Thorax Clinic Institute, Respiratory Diagnostic Centre, Barcelona, Catalonia, Spain.|Center for Biomedical Network Research in Respiratory Diseases (CIBERES), Barcelona, Catalonia, Spain.
authors.forename: Yolanda
authors.initials: Y
authors.lastname: Torralba
authors.affiliation: Epidemiology Department, Centre for Research in Environmental Epidemiology (CREAL), Barcelona, Catalonia, Spain.|Center for Biomedical Network Research in Epidemiology and Public Health (CIBERESP), Barcelona, Catalonia, Spain.
authors.forename: Ane
authors.initials: A
authors.lastname: Arbillaga-Etxarri
authors.affiliation: Hospital Clínic de Barcelona, Thorax Clinic Institute, Respiratory Diagnostic Centre, Barcelona, Catalonia, Spain.|August Pi i Sunyer Biomedical Research Institute (IDIBAPS), University of Barcelona, Barcelona, Catalonia, Spain.|Center for Biomedical Network Research in Respiratory Diseases (CIBERES), Barcelona, Catalonia, Spain.
authors.forename: Joan Albert
authors.initials: JA
authors.lastname: Barberà
authors.affiliation: Blanquerna Health Sciences Faculty, Ramon Llull University, Barcelona, Catalonia, Spain.
authors.forename: Jordi
authors.identifier: http://orcid.org/0000-0002-2150-8992
authors.initials: J
authors.lastname: Vilaró
authors.affiliation: Hospital Clínic de Barcelona, Thorax Clinic Institute, Respiratory Diagnostic Centre, Barcelona, Catalonia, Spain.|August Pi i Sunyer Biomedical Research Institute (IDIBAPS), University of Barcelona, Barcelona, Catalonia, Spain.|Center for Biomedical Network Research in Respiratory Diseases (CIBERES), Barcelona, Catalonia, Spain.
authors.forename: Josep
authors.initials: J
authors.lastname: Roca
authors.affiliation: Center for Biomedical Network Research in Respiratory Diseases (CIBERES), Barcelona, Catalonia, Spain.|Parc de Salut Mar, Pulmonary Medicine Department, Hospital del Mar Medical Research Institute (IMIM), Pompeu Fabra University, Barcelona, Catalonia, Spain.|Respiratory Department, Cardiovascular Foundation from Colombia Floridablanca, Santander, Colombia.
authors.forename: Mauricio
authors.initials: M
authors.lastname: Orozco-Levi
mesh_terms: D000368:Aged; D005080:Exercise Test / Q000379:methods; D005081:Exercise Therapy / Q000379:methods*; D017079:Exercise Tolerance / Q000502:physiology*; D005260:Female; D006801:Humans; D007501:Iron / Q000097:blood*; D019189:Iron Metabolism Disorders / Q000097:blood / Q000150:complications; D008297:Male; D008875:Middle Aged; D010101:Oxygen Consumption / Q000502:physiology; D011446:Prospective Studies; D029424:Pulmonary Disease, Chronic Obstructive / Q000097:blood / Q000150:complications / Q000503:physiopathology / Q000534:rehabilitation; D016896:Treatment Outcome
chemical_list: D007501:Iron
keywords: aerobic exercise; chronic obstructive pulmonary disease; exercise test; exercise therapy; iron metabolism disorder