Red blood cell distribution width and globulin, noninvasive indicators of fibrosis and inflammation in chronic hepatitis patients

Wang, Huan; Xu, Hao; Qu, Limei; Wang, Xiaomei; Wu, Ruihong; Gao, Xiuzhu; Jin, Qinglong; Niu, Junqi

doi:10.1097/meg.0000000000000662

Cited by 42 publications

(34 citation statements)

References 30 publications

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“…In patients with chronic hepatitis B (CHB) and liver cirrhosis related to CHB, Huang et al[36] observed that RDW values were high and correlated with the severity of cirrhosis in terms of Child-Pugh scores and model for end-stage liver disease (MELD) scores. Wang et al[37] confirmed these findings by demonstrating that RDW may be useful for predicting liver fibrosis in patients with chronic autoimmune hepatitis and PBC, while globulin value may help assessing liver inflammation (Table 2)[38,39]. Several investigators studied the RDW to platelet ratio (RPR) in liver disorders, and analyzed its efficiency for predicting severity of liver fibrosis and cirrhosis.…”

Section: Role Of Rdw In Liver Disordersmentioning

confidence: 97%

Prognostic significance of red blood cell distribution width in gastrointestinal disorders

Goyal

Lippi

Gjymishka

et al. 2017

WJG

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The red blood cell distribution width (RDW) is a routinely measured and automatically reported blood parameter, which reflects the degree of anisocytosis. Recently, the baseline RDW was found to have clinical significance for assessing clinical outcome and severity of various pathological conditions including cardiovascular diseases, sepsis, cancers, leukemia, renal dysfunction and respiratory diseases. A myriad of factors, most of which ill-defined, have an impact on the red cell population dynamics (i.e., production, maturation and turnover). A delay in the red blood cell clearance in pathological conditions represents one of the leading determinants of increased anisocytosis. Further study of RDW may reveal new insight into inflammation mechanisms. In this review, we specifically discuss the current literature about the association of RDW in various disease conditions involving the gastrointestinal and hepatobiliary systems. We also present some of the related measurements for their value in predicting clinical outcomes in such conditions. According to our data, RDW was found to be a valuable prognostic index in gastrointestinal disorders along with additional inflammatory biomarkers (i.e., C reactive protein, erythrocyte sedimentation rate, and platelet count) and current disease severity indices used in clinical practice.

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Section: Role Of Rdw In Liver Disordersmentioning

confidence: 97%

Prognostic significance of red blood cell distribution width in gastrointestinal disorders

Goyal

Lippi

Gjymishka

et al. 2017

WJG

View full text Add to dashboard Cite

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“…A previous study has reported that the erythrocyte count in peripheral blood was associated with survival after surgery in patients with primary liver cancer (11). Several other studies have reported that the red blood cell distribution width (RDW) may serve as a predictive index for histological severity and a potential prognostic indicator of chronic liver diseases (12)(13)(14). While the mechanism underlying the clinical relevance of erythrocytes in PBC remains elusive, previous studies have indicated that erythroid parameters, including the erythrocyte count, are potential prognostic indicators for PBC (12,13).…”

Section: Introductionmentioning

confidence: 99%

Erythrocyte count is associated with prognosis in Chinese patients with primary biliary cholangitis

Chang

Guo

et al. 2020

Exp Ther Med

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Erythroid parameters have been indicated to be important prognostic factors for liver diseases. The present study aimed to evaluate the prognostic value of the erythrocyte count in Chinese patients with primary biliary cholangitis (PBC) and develop a prognostic model. The clinical data of 301 patients with PBC were retrospectively reviewed. Univariate and multivariate Cox regression analysis was performed to identify potential prognostic risk factors. Bivariate correlation analysis was used to determine the correlation coefficient of the erythrocyte count and biochemical indices. The prognostic values of different factors were compared by receiver operating characteristic (ROC) curve analysis. A novel prognostic model was constructed using multivariate logistic regression. Multivariate regression analysis suggested that the erythrocyte count was an independent risk factor/prognostic index (P=0.042). The erythrocyte count in peripheral blood decreased as the histological stage progressed (P<0.001). The erythrocyte count was correlated with albumin, liver stiffness and Fibrosis-4. Compared with that of platelets, the area under the ROC curve of the erythrocyte count was significantly greater. A similar area under the ROC curve was determined for the erythrocyte count, albumin and total bilirubin (P>0.05). A novel prognostic model was established as follows: P=1/{1 + e-[6. 140-3.193 x Ln(erythrocyte count) -0.184 x albumin + 0.827 x Ln(total bilirubin)]}. The novel model had a comparable prognostic value to that of the GLOBE score and UK-PBC risk score, and had a better performance than the Mayo risk score at baseline (0.838 vs. 0.787). In conclusion, the erythrocyte count is an independent risk factor/prognostic index in Chinese patients with PBC. It was correlated with liver function and fibrosis in Chinese patients. The novel model incorporating the erythrocyte count and biochemical indices at baseline may serve as a prognostic tool in Chinese patients with PBC (Trial registration number,

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“…The effective and accurate prediction of different levels of liver fibrosis of chronic hepatitis is a prerequisite for estimating the prognosis of disease and developing plans for management. The development of new noninvasive indicators and the construction of new noninvasive models, and the evaluation of new noninvasive indicators and models for predicting different levels of liver fibrosis have been an intensive area of liver fibrosis research . In the past 15 years, much progress has been made in the prediction of different levels of liver fibrosis in chronic hepatitis B (CHB) .…”

Section: Introductionmentioning

confidence: 99%

Comparative evaluation of GPR versus APRI and FIB‐4 in predicting different levels of liver fibrosis of chronic hepatitis B

Liu

Zhang

et al. 2018

Journal of Viral Hepatitis

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It is of great significance to develop and evaluate noninvasive indexes predicting the level of liver fibrosis. The aim of this study was to comparatively evaluate gamma-glutamyl transpeptidase-to-platelet ratio (GPR) versus aspartate aminotransferase-to-platelet ratio index (APRI) and fibrosis index based on 4 factors (FIB-4) in predicting different levels of liver fibrosis of chronic hepatitis B (CHB) within the framework of HBeAg-positive and HBeAg-negative patients. A total of 1157 HBeAg-positive and 859 HBeAg-negative CHB patients were enrolled, among whom the pathological stage ≥S2, ≥S3, ≥S4 were defined as significant fibrosis, extensive fibrosis and cirrhosis, respectively. Receiver operating characteristic (ROC) curves were used to evaluate the performance of GPR, APRI and FIB-4 in predicting different levels of liver fibrosis. In HBeAg-positive patients, the area under ROC curves (AUROCs) of GPR in predicting extensive fibrosis and cirrhosis were both significantly larger than those of APRI (P = .0001 and P < .0001). In HBeAg-negative patients, the AUROCs of GPR in predicting significant fibrosis and cirrhosis were significantly larger than those of FIB-4 (P = .0006 and P = .0041). The AUROC of GPR in predicting extensive fibrosis was significantly larger than that of APRI and FIB-4 (P = .0320 and P = .0018). Using a cut-off of GPR > 0.500 as standard, the sensitivities and specificities of GPR in predicting significant fibrosis in HBeAg-positive patients were 59.6% and 81.2%, and for cirrhosis 80.9% and 63.8%, respectively; and those of HBeAg-negative patients were 60.3% and 78.3%, 84.5% and 66.1%, respectively. Regardless of HBeAg-positive or HBeAg-negative status, GPR had the best performance in predicting different levels of liver fibrosis.

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Red blood cell distribution width and globulin, noninvasive indicators of fibrosis and inflammation in chronic hepatitis patients

Abstract: RDW may provide a useful clinical value for predicting liver fibrosis; meanwhile, globulin may provide a useful clinical value for predicting liver inflammation in chronic hepatitis patients with other markers.

Cited by 42 publications

References 30 publications

Prognostic significance of red blood cell distribution width in gastrointestinal disorders

Prognostic significance of red blood cell distribution width in gastrointestinal disorders

Erythrocyte count is associated with prognosis in Chinese patients with primary biliary cholangitis

Comparative evaluation of GPR versus APRI and FIB‐4 in predicting different levels of liver fibrosis of chronic hepatitis B

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