Red Blood Cell Distribution Width Levels Correlate With Liver Fibrosis and Inflammation

Abstract

We aimed to study whether red blood cell distribution width (RDW) could be one of the variables determining the extent of liver fibrosis and inflammation in patients with biopsy-proven hepatitis B.A total of 446 hepatitis B virus-infected patients who underwent liver biopsy were divided into 2 groups: absent or mild and moderate–severe according to the severity of liver fibrosis and inflammation. The independent variables that determine the severity of liver fibrosis and inflammation were explored.RDW values increased with progressive liver fibrosis and inflammation. After adjustments for other potent predictors, liver fibrosis (moderate–severe) was independently associated with RDW, platelet, and albumin (odds ratio = 1.121, 0.987, and 0.941, respectively), whereas increased odds ratios of significant inflammation were found for RDW, alanine aminotransferase, albumin, and PLT (odds ratio = 1.146, 1.003, 0.927, and 0.990, respectively). The sensitivity and specificity of model A were 70.0% and 62.9% for detection of significant liver fibrosis [area under the receiver-operating characteristic curve (AUC) = 0.713, P < .001]. The sensitivity and specificity of model B were 66.1% and 79.4% for predicting advanced liver inflammation (AUC = 0.765, P < .001). Compared with preexisting indicators, model A achieved the highest AUC, whereas model B showed a higher AUC than RDW to platelet ratio (0.670, P < .001) and FIB-4 (0.740, P = .32).RDW may provide a useful clinical value for predicting liver fibrosis and necroinflammation in hepatitis B-infected patients with other markers.

The ratio of hemoglobin to red cell distribution width as a novel prognostic parameter in esophageal squamous cell carcinoma: a retrospective study from southern China

“…Previous studies have identified RDW as an accurate predictor of inflammatory status of hepatitis B-infected patients, mortality of acute pancreatitis, and activity of inflammatory bowel disease [24, 26, 35]. Moreover, elevated RDW were found to be an indicator of risk and progression of multiple malignancies, while the prognostic value of RDW has also been discussed [28, 29, 31, 32].…”

Ceruloplasmin, a reliable marker of fibrosis in chronic hepatitis B virus patients with normal or minimally raised alanine aminotransferase

“…Non-invasive predictive models of fibrosis are therefore needed. Single markers have been proposed such as platelet count, AST and ALT, gamma-globulins, serum HBsAg levels, CP, red blood cell distribution width, Interleukin-2R, TGF-α, serum Golgi protein 73 (GP73), and miR-122[13,14,16,17,25,28-31]. However, currently, none of these markers are sufficiently liver-specific enough to accurately reflect fibrosis.…”

Evidence of hemolysis in pigs infected with highly virulent African swine fever virus

“…It appears in the viremia caused by different viruses: Hepatitis C virus [25], cytomegalovirus [26], by some hemorrhagic fever viruses [27,28]. Causes of hemolysis in viral diseases may be the following factors: Pathological immune response, as a type of acute autoimmune reaction [29], direct or indirect action of the virus on erythrocytes [30], the incidence of precursors of erythropoiesis [31], etc. There are two-ways in which the direct effect of the virus on the RBCs can happen: Direct infection of erythrocytes and/or hemadsorption.…”