Ershler William B, Sheng Shan, McKelvey Julie, Artz Andrew S, Denduluri Neelima, Tecson Josephine, Taub Dennis D, Brant Larry J, Ferrucci Luigi, Longo Dan L
Institute for Advanced Studies in Aging, Washington, DC, USA.
J Am Geriatr Soc. 2005 Aug;53(8):1360-5. doi: 10.1111/j.1532-5415.2005.53416.x.
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.
Clinical history, hematological parameters, and serum erythropoietin levels were examined at 1- to 2-year intervals for 8 to 30 years.
Baltimore Longitudinal Study on Aging (BLSA), National Institute on Aging.
One hundred forty-three BLSA participants.
Complete blood count and serum chemistries were performed at the time of each visit, and archived serum samples were used for erythropoietin level.
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.
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.
确定有无贫血患者血清促红细胞生成素随年龄的变化，并评估某些合并症对促红细胞生成素水平变化及贫血发生的重要性。
对143名巴尔的摩老年纵向研究（BLSA）参与者的临床病史、血液学参数和血清促红细胞生成素水平进行了8至30年的检查，检查间隔为1至2年。
国立衰老研究所巴尔的摩老年纵向研究（BLSA）。
143名BLSA参与者。
每次就诊时进行全血细胞计数和血清化学检测，并使用存档的血清样本检测促红细胞生成素水平。
尽管所有受试者在初次评估时均健康且无贫血，但一些人出现了慢性疾病，最显著的是高血压和糖尿病。整个组的促红细胞生成素水平显著升高，并且发现没有相关糖尿病或高血压的人的升高斜率更大。在随后的几年中，出现贫血但没有高血压或糖尿病的受试者促红细胞生成素随时间升高的斜率最大，而患有高血压或糖尿病且贫血的受试者促红细胞生成素斜率最低。
血清促红细胞生成素随年龄增加可能是对亚临床失血、红细胞更新增加或红细胞前体促红细胞生成素抵抗增加的一种代偿。据推测，在年龄非常大或肾功能受损（如糖尿病或高血压）的人群中，这种代偿机制变得不足，从而导致贫血。
