Moreover, even if there is strong evidence that many markers of inflammation, including TNF-α and IL-6, are increased in the elderly population, studies detailing evidence for a chronic proinflammatory state contributing to the pathogenesis of elderly anemia are few in number and limited by small sample sizes, lack of correlation with hepcidin and EPO levels, and reliance on measurements of peripheral blood cytokine levels as determinants of the presence of a chronic inflammatory state [45]. Here, EPO is linked to anemia (phenotype).