Relation Between Red Blood Cell Distribution Width and Inflammatory Biomarkers in a Large Cohort of Unselected Outpatients

Abstract

Context.—A strong independent association has been recently observed between elevated red blood cell distribution width (RDW) and increased incidence of cardiovascular events. Objective.—To assess whether RDW is associated with plasma markers of inflammation since the mechanism(s) underlying this association remain unknown. Design.—We retrospectively analyzed results of RDW, hemoglobin, mean corpuscular volume, ferritin, high-sensitivity C-reactive protein (hsCRP), and erythrocyte sedimentation rate (ESR) in a large cohort of unselected adult outpatients who were consecutively referred by general practitioners for routine medical check-up. Results.—Cumulative results of RDW and other factors were retrieved from the database of our laboratory information system for 3845 adult outpatients during a 3-year period. When participants were grouped according to RDW quartiles, there were strong, graded increases of ESR and hsCRP (P < .001), both parameters being up to 3-fold higher in the fourth versus the first quartile. Accordingly, the percentages of those with hsCRP greater than 3 mg/L (from 28% to 63%; P < .001) and ESR greater than 40 mm/h (from 8% to 40%; P < .001) increased steadily across RDW quartiles. In multivariable regression analysis, ESR and hsCRP predicted RDW independently of age, sex, mean corpuscular volume, hemoglobin, and ferritin. Conclusions.—To our knowledge, our study demonstrates for the first time a strong, graded association of RDW with hsCRP and ESR independent of numerous confounding factors. If confirmed in future follow-up studies, this association might provide a rationale to introduce the easy, inexpensive RDW in algorithms for cardiovascular risk prediction.

Comparison of Hemogram Parameters in Febrile Seizures Types

“…In the limited number of studies in our country investigating the relationship between IDA and FS (14,19) RDW is a routinely used test to define the etiology of anemia, and is an index that automatically measures the heterogeneity of erythrocytes. Moreover, RDW has been shown to be positively correlated with inflammatory markers in the presence of certain diseases (such as cardiovascular and autoimmune diseases and cancer) and can therefore be considered as a potential inflammatory marker (21). In a study by Goksugur et al (22), RDW was shown to be a simple, effective and practical marker for the differentiation of FS types, while another study has reported that RDW was not significantly helpful in the differentiation of FS types (23).…”

Analysis of Personality Traits in Patients with Hodgkin Lymphoma

“…ESR is a well-known adverse prognostic factor in HL and is directly linked to the patient's pro-inflammatory status [45]. RDW is associated with age, comorbidities, and systemic inflammation [46,47]. All of this could suggest a potential link among neuroticism, low conscientiousness, pro-inflammation, and HL.…”

Construction and Evaluation of a Sepsis Risk Prediction Model for Urinary Tract Infection

“…RDW is strongly weighted as a risk factor for sepsis in UTI patients in the present nomogram. One study indicated that (28) there is a strong, positive, and independent association between RDW and traditional biomarkers of inflammation, possibly because inflammation reduces the survival rate of red blood cells, leading to differences in red blood cell volumes, and an increase in size heterogeneity among red blood cells. Other studies have indicated that oxidative stress may lead to increases in RDW by increasing erythrocyte turnover, therefore resulting in an association between cell-size inequality and human pathology (29).…”