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Trial Lecture – time and place
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Adjudication committee
- First opponent: Professor Anders Blomberg, Umeå University, Sweden
- Second opponent: Research leader Kjersti Oppen, Vestre Viken Hospital Trust, Norway
- Third member and chair of the evaluation committee: Associate professor Olav Inge Klingenberg, University of Oslo
Chair of the Defence
Associate Professor Lise Sofie Nissen-Meyer, University of Oslo
Principal Supervisor
Professor II Gunnar Einvik, University of Oslo
Summary
The conclusion from this thesis is that iron deficiency was more prevalent in patients with chronic obstructive pulmonary disease (COPD) than in individuals without COPD, and its prevalence increased with disease severity.
The primary aim of this PhD project was to improve understanding of biomarker-defined iron deficiency in individuals with COPD across different phenotypes. A further aim was to investigate whether isoforms of the iron-regulatory peptide hepcidin could help explain the iron deficiency observed in COPD. In the absence of bone marrow assessment, which is the gold standard for diagnosing iron deficiency, we relied on blood-based iron-related biomarkers.
Three biomarker-based criteria for iron deficiency were applied: a) ferritin below a predefined cutoff (＜30 µg/L without inflammation, ＜100 µg/L with inflammation) b) transferrin saturation ＜20% c) the combination of a) and b) These criteria were applied in two study populations: 1) 84 stable, hospital-referred COPD patients and 59 elderly individuals randomly drawn from the population registry 2) 1002 ever-smokers invited to a lung cancer screening programme, of whom 233 had COPD
In both populations, the iron deficiency criteria overlapped only partially. Among COPD patients with severe respiratory failure, the estimated prevalence of iron deficiency ranged from about 25% to 70%, depending on the criterion used. However, regardless of definition, the highest prevalence was consistently seen in those with the most severe COPD.
We found no evidence that levels of any hepcidin isoform explained iron deficiency in COPD.
Apart from low ferritin levels having a high positive predictive value for iron deficiency, existing biomarkers of iron deficiency demonstrated unknown diagnostic value in COPD patients.
Additional information
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