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Biomarker-Defined Iron Deficiency in Heavy Smokers with and without COPD and/or Emphysema
Ingrid Marie Hardang1,2, Kirill Neumann2,3, Geir Tormod Gjønnes3
1Department of Multidisciplinary Laboratory Medicine and Medical Biochemistry, Akershus University Hospital, Lørenskog, Norway.
Summary
Iron deficiency is more common in heavy smokers with COPD, especially when defined by transferrin saturation <20%. Anemia is prevalent, with iron deficiency contributing to one-third of cases in heavy smokers.
Area of Science:
- Pulmonary Medicine
- Hematology
- Clinical Chemistry
Background:
- Heavy smoking is a risk factor for COPD and emphysema.
- Iron deficiency is common and can lead to anemia.
- The relationship between smoking, COPD, emphysema, and iron deficiency requires further investigation.
Purpose of the Study:
- To assess iron deficiency prevalence in heavy smokers with and without COPD/emphysema.
- To determine how different biomarkers impact iron deficiency prevalence estimates.
- To examine anemia and polycythemia prevalence in heavy smokers with and without COPD.
Main Methods:
- Cross-sectional analysis of 1002 participants from the Norwegian Early Lung Cancer Screening study.
- Chest CT scans, spirometry, and venous blood sampling for iron parameters, CRP, and hemoglobin.
- Iron deficiency defined by transferrin saturation (TSat) <20%, ferritin < cutoff (CRP-dependent), or both.
Main Results:
- Iron deficiency prevalence ranged from 3% to 30%, highest with TSat <20%.
- COPD was associated with higher iron deficiency prevalence; emphysema was not.
- Anemia (8%) was more common than polycythemia (4%), neither linked to COPD or emphysema.
Conclusions:
- Iron deficiency is more prevalent in heavy smokers with COPD, particularly when using TSat <20% for definition.
- Emphysema is not associated with iron deficiency in heavy smokers.
- Anemia is common in this population, with a significant portion attributable to iron deficiency.
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