Mechanism of Normocytic Anemia, Osteoporosis, and Diabetes in COPD

[LichenPlanus]

---

Members don't see this ad.

Can anyone clarify why Normocytic Anemia, Osteoporosis, and Diabetes commonly occur secondary to COPD?

From gathering my knowledge from resources I've studied so far, COPD causes chronic inflammation:

• Anemia: shouldn't it be like Fe deficency anemia? Or is it normocytic since not severe enough?
• Osteoporosis: ischemia, catabolic state if inflammation continuous?
• Diabetes: ischemia?

Anyone have any insight? Thanks

 

[syoung]

chronic inflammation locks iron away so you'd get normocytic anemia, you're not losing blood or iron truly
i think there's a similar mechanism by which DM develops
osteoporosis, not really sure; may be because COPDers are less mobile and exercise less -> faster bone loss

 

[Jabbed]

Can anyone clarify why Normocytic Anemia, Osteoporosis, and Diabetes commonly occur secondary to COPD?

From gathering my knowledge from resources I've studied so far, COPD causes chronic inflammation:

• Anemia: shouldn't it be like Fe deficency anemia? Or is it normocytic since not severe enough?
• Osteoporosis: ischemia, catabolic state if inflammation continuous?
• Diabetes: ischemia?

Anyone have any insight? Thanks

The anemia of COPD is an example of the ubiquitous 'anemia of chronic disease' which is related to the effect of hepcidin on macrophages inducing a low serum iron state. This is classically normocytic, although it can be microcytic.

Osteoporosis is related to the chronic inflammatory state associated with COPD. Recall that IL-1 is also known as osteoclast stimulating factor.

I'm not aware of the effect that COPD has on predisposing to or affecting diabetes status. I would venture a guess that long term steroid therapy for COPD contributes to the hyperglycemic state.

 

[pd1112]

IL-6 and TNF-a have bone resorptive properties as well. TNF-a phosphorylates Ser/Thr residues on the insulin receptor, which prevents the signaling cascade -> insulin resistance.