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Non-Anemic Iron Deficiency Predicts COPD Exacerbations and Hospitalizations: Results from a Prospective Cohort
Carlos A Amado1,2,3, Cristina Ghadban1,2,3, Juan Agüero1
1Department of Pulmonology, Hospital Universitario Marqués de Valdecilla, 39005 Santander, Spain.
Journal of Clinical Medicine
|June 26, 2025
Summary
Non-anemic iron deficiency (NAID) is common in COPD patients and linked to poorer exercise capacity and increased exacerbation risk. NAID may serve as a key biomarker for stratifying COPD patient risk.
Area of Science:
- Pulmonary Medicine
- Nutritional Science
- Internal Medicine
Background:
- Non-anemic iron deficiency (NAID) is increasingly recognized as a factor influencing chronic obstructive pulmonary disease (COPD) outcomes.
- The prognostic significance of NAID in COPD exacerbations and hospitalizations requires further elucidation.
Purpose of the Study:
- To determine the prevalence of NAID in COPD patients.
- To assess the impact of NAID on functional parameters in COPD.
- To evaluate the predictive value of NAID for COPD exacerbations and hospitalizations.
Main Methods:
- Prospective observational study of 238 stable COPD patients and 60 controls.
- NAID defined by serum ferritin and transferrin saturation.
- Functional assessments included pulmonary function tests, 6-minute walk distance (6MWD), handgrip strength, and fat-free mass index (FFMI).
- 12-month follow-up for exacerbations; Cox regression analysis for predictive value.
Main Results:
- NAID prevalence was 68.9% in COPD patients versus 46.7% in controls (p=0.001).
- COPD patients with NAID exhibited significantly lower 6MWD, FFMI, and handgrip strength (p<0.001).
- NAID independently predicted moderate COPD exacerbations (HR 1.846, p=0.002) and hospitalizations (HR 2.537, p=0.024).
Conclusions:
- NAID is highly prevalent in COPD patients and associated with diminished exercise capacity and muscle mass.
- NAID serves as an independent predictor of increased exacerbation frequency and hospitalizations in COPD.
- NAID may be a valuable biomarker for risk stratification in COPD, suggesting a need for research into iron metabolism interventions.
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