A decreased hemoglobin concentration is a common clinical condition in elderly subjects, and in at least 20% of the cases it is not possible to directly attribute the anemia to specific factors. The aim of the present study was to evaluate the relationship of different levels of insulin-like growth factor-binding protein 3 (IGFBP-3) with the blood concentration of hemoglobin in persons aged 80 years and older. Data are from a baseline evaluation of the Aging and Longevity in the Sirente Geographic Area (ilSIRENTE) study (n=253). Analysis of covariance was used to examine the effect of different IGFBP-3 levels on hemoglobin concentration. After adjustment for potential confounding variables, which included age, sex, number of diseases, renal failure, cancer, gastric ulcer, albumin, and iron concentrations, individuals in the group with higher IGFBP-3 concentrations showed a significantly higher mean hemoglobin concentration than participants in the group with lower IGFBP-3 concentrations (13.4 +/- 1.4 g/dL versus 12.9 +/- 1.9 g/dL, respectively; P=.03). In conclusion, the present study has shown that a higher IGFBP-3 level is associated with a higher hemoglobin concentration among older people living in the community. This finding suggests that the growth hormone/IGF axis may play an important role in hematopoiesis, and it may be implicated in the age-related decline in hemoglobin concentration.