51
|
Goyal H, Lippi G, Gjymishka A, John B, Chhabra R, May E. Prognostic significance of red blood cell distribution width in gastrointestinal disorders. World J Gastroenterol 2017; 23:4879-4891. [PMID: 28785142 PMCID: PMC5526758 DOI: 10.3748/wjg.v23.i27.4879] [Citation(s) in RCA: 35] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/28/2017] [Revised: 05/02/2017] [Accepted: 06/12/2017] [Indexed: 02/06/2023] Open
Abstract
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.
Collapse
|
52
|
Sargento L, Simões AV, Longo S, Lousada N, Palma Dos Reis R. Red blood cell distribution width is a survival predictor beyond anemia and Nt-ProBNP in stable optimally medicated heart failure with reduced ejection fraction outpatients. Clin Hemorheol Microcirc 2017; 65:185-194. [PMID: 27716652 DOI: 10.3233/ch-16155] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/29/2023]
Abstract
BACKGROUND RDW is an automatic value obtained with the blood count, and represents the erythrocytes dimension variation. OBJECTIVE To evaluate in optimally medicated outpatients with heart failure with reduced ejection fraction (HFrEF) the RDW prognostic value regarding survival in a multivariable model including anemia and Nt-ProBNP. METHODS 233 consecutive outpatients, LVEF <40%, clinically stable were followed-up for 3-years in an HF Unit. End-point was all-cause death. The RDW categorized according to the tertiles (T1 = <13.9; T2 14-15.2; T3> = 15.3). Anemia classified according to the WHO criteria. Cox survival model adjusted for clinical profile, optimal therapeutic, renal function, Nt-ProBNP, etiology, atrial fibrillation, and anemia. RESULTS (1) The 3-years death rate was 33.5%, and increased with the RDW tertiles (17.3%; 25%; 61.1%; p < 0.001). (2) The ROC curve for death associated with RDW (AUC 0.73; p < 0.001); (3) The adjusted death risk increased with the tertiles (Hazard-ratio '[HR] = 1.61; IC 95% 1.09-2.39; p = 0.017). RDW> = 15.3 had greater adjusted death risk than T1 (HR = 2.18; 95% CI 0.99-4.8; p = 0.05) and T1+T2 (HR = 1.54; 95% CI 1.13-2.09; p = 0.006). CONCLUSION RDW determined in optimally medicated outpatients with HFrEF, during dry-state, is a strong, cheap, and independent predictor of long-term survival.
Collapse
|
53
|
Caire MT, Kumar A, Stravitz RT, Kemmer N. Preliver transplant red cell distribution width predicts postliver transplant mortality. Clin Transplant 2017; 31. [PMID: 28054385 DOI: 10.1111/ctr.12908] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/02/2017] [Indexed: 12/19/2022]
Abstract
PURPOSE Prognostication following liver transplantation is limited. Red cell distribution width (RDW) has been associated with morbidity and mortality in a variety of diseases. We hypothesize RDW is predictive of mortality postliver transplantation. METHODS We performed a retrospective cohort study of all consecutive liver transplantation recipients at a tertiary care center from January 1, 2012 to December 31, 2012. The primary end point was association of RDW with one-year mortality. Statistical analysis was performed using the Mann-Whitney test, independent samples t test, and regression analysis. Discrimination was assessed by calculating area under receiver operating curves (AUC). A P-value <.05 was considered significant. RESULTS RDW was positively associated with one-year mortality (P<.001). The mean difference for survivors compared to nonsurvivors was 3.9% (95% CI 1.9%-5.9%). The AUC for RDW was 0.831 (95% CI 0.727-0.935), compared to 0.723 (0.539-0.908) for total bilirubin and 0.704 (0.479-0.929) for the international normalized ratio. CONCLUSIONS To our knowledge, this is the first report of an association of RDW with post-LT mortality and the results show the predictive value of pre-LT RDW for one-year mortality.
Collapse
Affiliation(s)
- M Thure Caire
- Hepatology and Liver Transplant, Tampa General Medical Group, Tampa, FL, USA
| | - Ambuj Kumar
- Evidence Based Medicine & Outcomes Research, University of South Florida, Tampa, FL, USA
| | - R Todd Stravitz
- Gastroenterology, Hepatology and Nutrition, Virginia Commonwealth University, Richmond, VA, USA
| | - Nyingi Kemmer
- Hepatology and Liver Transplant, Tampa General Medical Group, Tampa, FL, USA
| |
Collapse
|
54
|
Wei TT, Tang QQ, Qin BD, Ma N, Wang LL, Zhou L, Zhong RQ. Elevated red blood cell distribution width is associated with liver function tests in patients with primary hepatocellular carcinoma. Clin Hemorheol Microcirc 2017; 64:149-155. [PMID: 27002894 DOI: 10.3233/ch-162053] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Abstract
BACKGROUND Red blood cell distribution width (RDW), a routinely tested parameter of the complete blood count (CBC), has been reported to be increased in various cancers and correlated with the patients' clinical characteristics. However, the significance of RDW in primary hepatocellular carcinoma (pHCC) is largely unknown. The aim of this study was to evaluate the associations between RDW and the clinical characteristics of pHCC patients. METHODS Medical records of 110 treatment-naive pHCC patients were retrospectively reviewed. Their clinical characteristics on admission, including RDW, liver function tests and tumor stage, were extracted, and their relationships were analyzed using Spearman correlation and Kruskal-Wallis test. Sixty-eight healthy individuals were set as controls. RESULTS RDW was significantly increased in pHCC patients and correlated with the liver function tests. However, no correlation between RDW and tumor stage was found. CONCLUSION RDW may be used to assess the liver function, but not the tumor stage in pHCC patients.
Collapse
|
55
|
Guzel D, Yazici AB, Yazici E, Erol A. Alterations of the hematologic cells in synthetic cannabinoid users. J Clin Lab Anal 2017; 31. [PMID: 28169460 DOI: 10.1002/jcla.22131] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2016] [Accepted: 12/12/2016] [Indexed: 12/22/2022] Open
Abstract
BACKGROUND Functions, morphology, distributions, and index of the circulating cells are the most useful parameters that indicate various inflammatory and toxic conditions. The aim of this study was to investigate the clinical significance of these parameters in patients diagnosed with (synthetic) cannabis use disorder. METHODS This study included a total of 40 patients in the study group (SG) with synthetic cannabis use; and 40 healthy individuals as the control group (CG). Participants, who had hematological disorders and other chronic diseases, were excluded from the study. All hematological parameters of SG were compared with CG. Neutrophil/lymphocyte ratio (NLR) and platelet/lymphocyte ratio (PLR) values were calculated and compared between groups. RESULTS There were statistically significant differences between the groups in terms of WBC, MCH, RDW, MCV, MPV, and NEU, LYM%, MONO% parameters (P<.05). MPW and LYM% were significantly lower in SG compared to CG. WBC, MCH, RDW, MCV, MPV, MONO, and NEU parameters were significantly higher in SG compared to CG (P<.05). UIBC and TIBC levels were significantly higher in SG compared to CG (P<.001). Although there was statistically significant difference between groups in terms of NLR, there was no significant difference for PLR values. CONCLUSION Our data suggested that chronic use of cannabinoids can lead to deterioration of hematopoietic cells. Chronic use of cannabinoids was consistent with subthreshold/subclinical megaloblastic anemia with iron deficiency. Inflammatory cells, especially neutrophil and monocyte counts were higher in SG compared to CG. Thus, recovery of subclinical hematological parameters should be considered in cannabis use disorder patients.
Collapse
Affiliation(s)
- Derya Guzel
- Department of Physiology, Medical Faculty, Sakarya University, Sakarya, Turkey
| | - Ahmet Bulent Yazici
- Department of Psychiatry, Sakarya Research & Training Hospital, Sakarya, Turkey
| | - Esra Yazici
- Department of Psychiatry, Medical Faculty, Sakarya University, Sakarya, Turkey
| | - Atila Erol
- Department of Psychiatry, Medical Faculty, Sakarya University, Sakarya, Turkey
| |
Collapse
|
56
|
The Relationship between Inflammatory Marker Levels and Hepatitis C Virus Severity. Gastroenterol Res Pract 2016; 2016:2978479. [PMID: 28090206 PMCID: PMC5206414 DOI: 10.1155/2016/2978479] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/09/2016] [Accepted: 11/08/2016] [Indexed: 12/31/2022] Open
Abstract
Background. Red cell distribution width (RDW) and platelet-lymphocyte ratio (PLR) have been studied in a variety of etiological diseases. We aim to investigate the relationship between RDW and PLR and the severity of hepatitis C virus- (HCV-) related liver disease. Methods. We included fifty-two chronic HCV and 42 HCV-related cirrhosis patients and 84 healthy controls. Hematological and virological parameters and liver function biomarkers of HCV-related patients at admission were recorded. Results. RDW, RDW-to-platelet (RPR), and 1/PLR values in HCV-related cirrhosis patients were significantly higher than in chronic HCV patients and healthy controls (all P < 0.001). The aspartate aminotransferase (AST)/alanine aminotransferase (ALT) ratio (AAR), AST-to-platelet ratio index (APRI), and fibrosis index based on the four factors (FIB-4) scores in HCV-related cirrhosis patients were significantly higher than in chronic HCV patients (all P < 0.001). The areas under the curve of the RDW, RPR, and 1/PLR for predicting cirrhosis were 0.791, 0.960, and 0.713, respectively. Bivariate logistic regression analysis showed that RDW could independently predict the presence of cirrhosis in chronic HCV patients. Conclusions. RDW, RPR, and PLR may be potential markers for estimating HCV severity.
Collapse
|
57
|
Effect of Entecavir and Tenofovir Treatment on Noninvasive Fibrosis Scores: Which One Is Better? Am J Ther 2016; 23:e429-38. [PMID: 25650531 DOI: 10.1097/mjt.0000000000000203] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
Liver biopsy is the best method for detecting fibrosis grade of the liver in chronic hepatitis B. However, the invasiveness of liver biopsy complicates its routine use in follow-up of treatment. We planned to determine the usage of fibrosis predicting noninvasive scores in the follow-up of the treatment of patients with chronic hepatitis B treated with entecavir or tenofovir. Two hundred twenty-eight patients with hepatitis B with liver biopsy were included in the study. Fibrosis grade was determined by Ishak score. The laboratory data at months 0, 12, and 24 during treatment were collected and noninvasive fibrosis scores (aspartate aminotransferase to alanine aminotransferase ratio [AAR], aspartate aminotransferase to platelet ratio index [APRI], fibrosis index based on the 4 factors [FIB-4] and red cell distribution width to platelet ratio [RPR]) were calculated. Statistically significant increase in all scores and decrease in platelet count were observed as the fibrosis level increased. For differentiation of patients with fibrosis ≥grade 2, the highest sensitivity and specificity rates were shown by APRI score (sensitivity 67%, specificity 69%, and cutoff ≥0.5). FIB-4 was the most successful score for differentiation of patients with fibrosis ≥grade 3 (sensitivity 83%, specificity 74%, and cutoff ≥1.45). A significant decrease in all noninvasive fibrosis scores was observed at months 12 and 24 during treatment with both entecavir and tenofovir (P < 0.001). Among these, only the improvement in APRI score was found better in entecavir group with statistical significance (P < 0.05). APRI score was effective in demonstrating early-stage fibrosis. FIB-4, RPR, and platelet count were better in demonstrating advanced fibrosis. Although noninvasive scores cannot replace liver biopsy for diagnosis, they can be used for monitoring the response to treatment.
Collapse
|
58
|
Vayá A, Alis R, Suescún M, Rivera L, Murado J, Romagnoli M, Solá E, Hernandez-Mijares A. Association of erythrocyte deformability with red blood cell distribution width in metabolic diseases and thalassemia trait. Clin Hemorheol Microcirc 2016; 61:407-15. [PMID: 25062717 DOI: 10.3233/ch-141859] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/02/2023]
Abstract
Increased red blood distribution width (RDW) in anemia is related to disturbances in the cellular surface/volume ratio, usually accompanied by morphological alterations, while it has been shown in inflammatory diseases that the activity of pro-inflammatory cytokines disturbing erythropoiesis increases RDW. Recently it has been reported that higher RDW is related with decreased erythrocyte deformability, and that it could be related with the association of RDW and increased risk of cardiovascular diseases. In order to analyze the influence of morphological alterations and proinflammatory status on the relationship between RDW and erythrocyte deformability, we analyzed erythrocyte deformability along with RDW and other hematological and biochemical parameters in 36 α-thalassemia, 20 β-thalassemia, 20 δβ-thalassemia trait carriers, 61 metabolic syndrome patients and 76 morbidly obese patients. RDW correlated inversely with erythrocyte deformability in minor β-thalassemia (r =-0.530, p < 0.05), and directly in both metabolic syndrome and morbidly obese patients (ρ= 0.270, p < 0.05 and ρ= 0.258, p < 0.05, respectively). Minor β-thalassemia is often accompanied by more marked cell-shaped perturbations than other thalassemia traits. This could be the reason for this negative association only in this setting. Higher anisocytosis seems to be associated with greater morphologic alterations (shape/volume), which reduce erythrocyte deformability. The proinflammatory profile in metabolic patients can be related to the positive association of RDW with erythrocyte deformability found in these patients. However, further research is needed to explain the mechanisms underlying this association.
Collapse
Affiliation(s)
- Amparo Vayá
- Hemorheology and Haemostasis Unit, Service of Clinical Pathology, La Fe University Hospital, Valencia, Spain
| | - Rafael Alis
- Research Universitary Institute "Dr. Viña Giner", Molecular and Mitochondrial Medicine, Catholic University of Valencia "San Vicente Mártir", Valencia, Spain.,Faculty of Medicine, Catholic University of Valencia "San Vicente Mártir", Valencia, Spain
| | - Marta Suescún
- Hemorheology and Haemostasis Unit, Service of Clinical Pathology, La Fe University Hospital, Valencia, Spain
| | - Leonor Rivera
- Hemorheology and Haemostasis Unit, Service of Clinical Pathology, La Fe University Hospital, Valencia, Spain
| | - Julian Murado
- Hemorheology and Haemostasis Unit, Service of Clinical Pathology, La Fe University Hospital, Valencia, Spain
| | - Marco Romagnoli
- Research Universitary Institute "Dr. Viña Giner", Molecular and Mitochondrial Medicine, Catholic University of Valencia "San Vicente Mártir", Valencia, Spain.,Department of Physical Education and Sports, Catholic University of Valencia "San Vicente Mártir", Valencia, Spain
| | - Eva Solá
- Endocrinology Service, Dr. Peset University Hospital, Valencia, Spain
| | | |
Collapse
|
59
|
Ichinose J, Murakawa T, Kawashima M, Nagayama K, Nitadori JI, Anraku M, Nakajima J. Prognostic significance of red cell distribution width in elderly patients undergoing resection for non-small cell lung cancer. J Thorac Dis 2016; 8:3658-3666. [PMID: 28149561 PMCID: PMC5227271 DOI: 10.21037/jtd.2016.12.44] [Citation(s) in RCA: 36] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2016] [Accepted: 11/24/2016] [Indexed: 12/31/2022]
Abstract
BACKGROUND The impact of red cell distribution width (RDW) on outcomes in elderly patients after surgery for non-small cell lung cancer (NSCLC) is not fully understood. METHODS We retrospectively analyzed 992 NSCLC patients who underwent curative resection between 1998 and 2012. The following variables were included in the analyses to evaluate the role of RDW: age, gender, smoking index, leukocyte count, neutrophil to lymphocyte ratio (NLR), hemoglobin, platelet count, albumin, C-reactive protein, carcinoembryonic antigen, respiratory function, histology, T factor, N factor, surgical approach, surgical procedures, complications and prognosis. RESULTS High RDW (>13.8) was an independent risk factor for morbidity [hazard ratio (HR) 2.1; P<0.01], recurrence (HR 2.0; P=0.01), overall survival (OS) (HR 2.1; P<0.01) and disease-free survival (DFS) (HR 2.0; P<0.01) in elderly patients (age ≥75 years, n=275), whereas it was not in younger patients (age <75 years, n=717). The surgical outcome was extremely poor in those older than 80 years with a RDW greater than 15% (morbidity, 56%; postoperative stay, 23 days; OS, 24%; DFS, 0%). RDW was unaffected by age (R =0.01; P=0.86) and elevated RDW without anemia was more prognostic than high RDW due to anemia in elderly patients. CONCLUSIONS High RDW was significantly associated with high morbidity and reduced survival in elderly patients who underwent resection for NSCLC. Therefore, this parameter should be taken into account when surgery is considered in the elderly.
Collapse
Affiliation(s)
- Junji Ichinose
- Department of Thoracic Surgery, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
| | - Tomohiro Murakawa
- Department of Thoracic and Cardiovascular Surgery, Kansai Medical University, Hirakata City, Japan
| | - Mitsuaki Kawashima
- Department of Thoracic Surgery, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
| | - Kazuhiro Nagayama
- Department of Thoracic Surgery, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
| | - Jun-ichi Nitadori
- Department of Thoracic Surgery, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
| | - Masaki Anraku
- Department of Thoracic Surgery, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
| | - Jun Nakajima
- Department of Thoracic Surgery, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
| |
Collapse
|
60
|
Tecer D, Sezgin M, Kanık A, İncel NA, Çimen ÖB, Biçer A, Şahin G. Can mean platelet volume and red blood cell distribution width show disease activity in rheumatoid arthritis? Biomark Med 2016; 10:967-74. [DOI: 10.2217/bmm-2016-0148] [Citation(s) in RCA: 45] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/11/2023] Open
Abstract
Aim: To evaluate the relationship between mean platelet volume (MPV) and red cell distribution width (RDW), and disease activity in rheumatoid arthritis (RA). Patients & methods: Hundred RA and 100 controls were included. Results: MPV and RDW were higher in RA (p < 0.0001). The cut-off levels of RDW and MPV were 14.8 and 10.4. Patients with RDW >14.8 had higher Disease Activity Score 28 (DAS28; p = 0.002) and pain score (p = 0.0007). RDW was positively correlated with DAS28 and pain. But, DAS28 and pain were not different between patients with MPV >10.4 and <10.4. Conclusion: MPV and RDW were significantly higher in RA. RDW and MPV were similar to erythrocyte sedimentation rate and C-reactive protein to indicate inflammatory activity. RDW was correlated with pain and DAS28, but MPV was not associated with them.
Collapse
Affiliation(s)
- Duygu Tecer
- Department of Physical Medicine & Rehabilitation, Division of Rheumatology, Gazi University Medical Faculty, Ankara, Turkey
| | - Melek Sezgin
- Department of Physical Medicine & Rehabilitation Mersin, Mersin University Medical Faculty, Mersin, Turkey
| | - Arzu Kanık
- Department of Biostatistics & Medical Informatics, Mersin University Medical Faculty, Mersin, Turkey
| | - Nurgül Arıncı İncel
- Department of Physical Medicine & Rehabilitation Mersin, Mersin University Medical Faculty, Mersin, Turkey
| | - Özlem Bölgen Çimen
- Department of Physical Medicine & Rehabilitation Mersin, Mersin University Medical Faculty, Mersin, Turkey
| | - Ali Biçer
- Department of Physical Medicine & Rehabilitation Mersin, Mersin University Medical Faculty, Mersin, Turkey
| | - Günşah Şahin
- Department of Physical Medicine & Rehabilitation Mersin, Mersin University Medical Faculty, Mersin, Turkey
| |
Collapse
|
61
|
Mean platelet volume and red cell distribution width to platelet ratio for predicting the severity of hepatic fibrosis in patients with chronic hepatitis C. Eur J Gastroenterol Hepatol 2016; 28:744-8. [PMID: 27101403 DOI: 10.1097/meg.0000000000000647] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/25/2023]
Abstract
OBJECTIVE We designed this study to investigate the relationship between the severity of fibrosis and mean platelet volume (MPV), red cell distribution width, and red cell distribution width to platelet ratio (RPR) in patients with chronic hepatitis C (CHC). DESIGN Overall, 98 biopsy-proven naïve CHC cases were enrolled in the study. Complete blood count variables, including white blood cell, hemoglobin, platelet count, MPV, red cell distribution width, platelet distribution width as well as aspartate transaminase, alanine transaminase, total bilirubin, albumin, and other routine biochemical parameters, were tested. Liver biopsy samples were assessed according to the Ishak scoring system. Data analyses were carried out using SPSS-15 software. Statistical significance was set at a P-value of less than 0.05. RESULTS Of the 98 cases, 80 (81.6%) were men and 18 (18.4%) were women. Fibrosis scores of 69 cases (70.4%) (group 1) were less than 3, whereas 29 cases had fibrosis scores at least 3 (29.6%) (group 2). Significant differences in MPV and RPR were observed between these two groups (MPV: 8.19±1.002 vs. 8.63±0.67 fl, P<0.05; RPR: 0.0526±0.02 vs. 0.0726±0.02, P=0.001). The areas under the curve of the RPR and MPV for predicting significant fibrosis were 0.705 and 0.670, which was superior to the aspartate transaminase-to-alanine transaminase ratio and aspartate transaminase-to-platelet ratio index scores of the study group. Cut-off values were calculated for diagnostic performance, and the cut-off values for MPV and RPR were 8.5 and 0.07 fl, respectively. CONCLUSION MPV and RPR values were significantly higher in patients with CHC, associated with severity, and can be used to predict advanced histological liver damage. The use of MPV and RPR may reduce the need for liver biopsy. Further studies are required to determine the relationship between these parameters and the severity of fibrosis in hepatitis C patients.
Collapse
|
62
|
Pancar GS, Eyupoglu O. Red Cell Distribution Width and Mean Platelet Volume in Patients With Pityriasis Rosea. J Clin Med Res 2016; 8:445-8. [PMID: 27222672 PMCID: PMC4852777 DOI: 10.14740/jocmr2535w] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/22/2016] [Indexed: 12/30/2022] Open
Abstract
Background Pityriasis rosea (PR) is an inflammatory skin disorder of unknown etiology. However, it is suggested to be related with the reactivation of human herpes virus 7 (HHV-7) and/or HHV-6. It is sometimes diffucult to distinguish PR from PR-like drug eruptions and other inflammatory disorders, so we need new parameters which are cheap and easy in determining PR. Red blood cell distribution width (RDW) and mean platelet volume (MPV) have been studied as inflammatory markers in recent studies. However, the RDW and MPV in PR patients have not been investigated. This is the first study investigating RDW and MPV parameters in PR. Methods This was a retrospective study of 127 patients and 127 healthy controls. MPV, RDW and the other laboratory tests were recorded. Results RDW levels of patients with PR were significantly lower than those of the controls (13.66 ± 2.68 and 14.00 ± 1.39, P < 0.01). The other inflammatory markers such as MPV (9.97 ± 0.99 and 10.0 ± 1.06, P = 0.7) and platelet (2.66.29 ± 62.85 and 277.41 ± 63.50, P = 0.3) were studied and statistically significant differences were not obtained. There were no significant differences found between the patient group and healthy controls in terms of hemoglobin, hematocrite, C-reactive protein (CRP), sedimentation, mean corpuscular volume (MCV), aspartate aminotransferase (AST), red blood cell (RBC), alanine aminotransferase (ALT), blood urea nitrogen (BUN), and creatinine parameters (P > 0.05). Conclusion RDW can be used as a marker in diagnosing PR.
Collapse
Affiliation(s)
| | - Oznur Eyupoglu
- Department of Statistics, Ondokuz Mayis University School of Medicine Samsun, Turkey
| |
Collapse
|
63
|
Periša V, Zibar L, Sinčić-Petričević J, Knezović A, Periša I, Barbić J. Red blood cell distribution width as a simple negative prognostic factor in patients with diffuse large B-cell lymphoma: a retrospective study. Croat Med J 2016; 56:334-43. [PMID: 26321026 PMCID: PMC4576747 DOI: 10.3325/cmj.2015.56.334] [Citation(s) in RCA: 46] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022] Open
Abstract
Aim To determine the prognostic value of baseline red blood cell distribution width (RDW) in diffuse large B cell lymphoma (DLBCL) patients. Methods Data from 81 DLBCL patients diagnosed from 2006 to 2013 at the University Hospital Center Osijek, Osijek, Croatia, were reviewed. We evaluated disease outcome, overall survival (OS) and event-free survival (EFS), and demographic, clinical and laboratory factors affecting outcome. Univariate analysis and Cox regression analysis were used. Results Median age of patients was 64 years, 29 were men (35.8%). Higher RDW levels (%) were found in patients with advanced Ann Arbor clinical stage (14.94 ± 1.82 vs 13.55 ± 1.54, P = 0.001) and in those with poor response to therapy (14.94 ± 1.82 vs 13.55 ± 1.54, P = 0.001). Patients with RDW>15% (cut-off was calculated by receiver operating characteristics) had significantly worse OS (median [range], 33 months [20-46] vs 74 months [65-82], P < 0.001) and EFS (27 months [15-40] vs 68 months [59-77], P < 0.001). Cox regression analysis showed that RDW>15% was an independent prognostic factor for OS (HR 3.654, 95% CI 1.128-11.836) and EFS (HR 2.611, 95% CI 1.012-6-739). Conclusion High baseline RDW is an independent prognostic marker of poor outcome in patients with DLBCL. RDW could be an easily available and inexpensive marker for the risk stratification in patients with DLBCL.
Collapse
Affiliation(s)
- Vlatka Periša
- Vlatka Periša, Department of Hematology, Clinic of Internal Medicine, University Hospital Centre Osijek, Huttlerova 4, 31000 Osijek, Croatia,
| | | | | | | | | | | |
Collapse
|
64
|
Lee HW, Kang W, Kim BK, Kim SU, Park JY, Kim DY, Ahn SH, Park YN, Han KH. Red cell volume distribution width-to-platelet ratio in assessment of liver fibrosis in patients with chronic hepatitis B. Liver Int 2016; 36:24-30. [PMID: 25966326 DOI: 10.1111/liv.12868] [Citation(s) in RCA: 26] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/17/2015] [Accepted: 04/09/2015] [Indexed: 12/26/2022]
Abstract
BACKGROUND & AIMS Precise assessment of liver fibrosis is necessary in patients with chronic liver disease. We investigated the performance of red cell volume distribution width-to-platelet ratio for the assessment of liver fibrosis in patients with chronic hepatitis B. METHODS A total of 482 consecutive patients with chronic hepatitis B who underwent liver biopsy between October 2005 and May 2014 were recruited. Liver stiffness was measured using transient elastography. FIB-4 score, red cell volume distribution width-to-platelet ratio and the aspartate aminotransferase-to-platelet ratio index were also assessed. RESULTS A total of 271 (56.2%) patients were males. The median age was 44 years. F1, F2, F3 and F4 fibrosis stages were identified in 68 (14.1%), 137 (28.4%), 64 (13.3%) and 213 (44.2%) of the patients respectively. The mean red cell volume distribution width-to-platelet ratio increased with liver fibrosis severity: F1, 0.065; F2, 0.077; F3, 0.097 and F4, 0.121 (P < 0.01). The area under the receiver operating characteristic curve of the red cell volume distribution width-to-platelet ratio for predicting significant fibrosis (≥F2) was 0.747. This result was inferior to transient elastography (0.866, P = 0.004), but comparable to FIB-4 (0.782, P = 0.427) and aspartate aminotransferase-to-platelet ratio index (0.716, P = 0.507). The area under the receiver operating characteristic curve of red cell volume distribution width-to-platelet ratio for predicting cirrhosis (F4) was 0.811, which was inferior to liver stiffness (0.915, P < 0.001), but comparable to FIB-4 (0.804, P = 0.805) and superior to aspartate aminotransferase-to-platelet ratio index (0.680, P < 0.001). CONCLUSIONS The accuracy of red cell volume distribution width-to-platelet ratio was acceptable for the assessment of liver fibrosis in patients with chronic hepatitis B. When transient elastography is not available, red cell volume distribution width-to-platelet ratio assessment is a simple method that can be used to reduce the need for liver biopsy.
Collapse
Affiliation(s)
- Hye Won Lee
- Department of Internal Medicine, Yonsei University College of Medicine, Seoul, Korea
| | - Wonseok Kang
- Department of Internal Medicine, Yonsei University College of Medicine, Seoul, Korea.,Institute of Gastroenterology, Yonsei University College of Medicine, Seoul, Korea.,Liver Cirrhosis Clinical Research Center, Seoul, Korea
| | - Beom Kyung Kim
- Department of Internal Medicine, Yonsei University College of Medicine, Seoul, Korea.,Institute of Gastroenterology, Yonsei University College of Medicine, Seoul, Korea.,Liver Cirrhosis Clinical Research Center, Seoul, Korea
| | - Seung Up Kim
- Department of Internal Medicine, Yonsei University College of Medicine, Seoul, Korea.,Institute of Gastroenterology, Yonsei University College of Medicine, Seoul, Korea.,Liver Cirrhosis Clinical Research Center, Seoul, Korea
| | - Jun Yong Park
- Department of Internal Medicine, Yonsei University College of Medicine, Seoul, Korea.,Institute of Gastroenterology, Yonsei University College of Medicine, Seoul, Korea.,Liver Cirrhosis Clinical Research Center, Seoul, Korea
| | - Do Young Kim
- Department of Internal Medicine, Yonsei University College of Medicine, Seoul, Korea.,Institute of Gastroenterology, Yonsei University College of Medicine, Seoul, Korea.,Liver Cirrhosis Clinical Research Center, Seoul, Korea
| | - Sang Hoon Ahn
- Department of Internal Medicine, Yonsei University College of Medicine, Seoul, Korea.,Institute of Gastroenterology, Yonsei University College of Medicine, Seoul, Korea.,Liver Cirrhosis Clinical Research Center, Seoul, Korea
| | - Young Nyun Park
- Department of Pathology, Yonsei University College of Medicine, Seoul, Korea
| | - Kwang Hyub Han
- Department of Internal Medicine, Yonsei University College of Medicine, Seoul, Korea.,Institute of Gastroenterology, Yonsei University College of Medicine, Seoul, Korea.,Liver Cirrhosis Clinical Research Center, Seoul, Korea
| |
Collapse
|
65
|
Comparative diagnostic accuracy of red cell distribution width-to-platelet ratio versus noninvasive fibrosis scores for the diagnosis of liver fibrosis in biopsy-proven nonalcoholic fatty liver disease. Eur J Gastroenterol Hepatol 2015; 27:1293-9. [PMID: 26302023 DOI: 10.1097/meg.0000000000000445] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Abstract
OBJECTIVE Nonalcoholic fatty liver disease (NAFLD) is a chronic liver disease and assessment of liver fibrosis is important. We aimed to investigate the performance of red cell volume distribution width-to-platelet ratio (RPR) in predicting liver fibrosis in patients with NAFLD and to compare it with well-known noninvasive predicting fibrosis scores (alanine aminotransferase ratio, aspartate aminotransferase platelet ratio index, fibrosis index, fibrosis 4, and fibrosis, cirrhosis index). MATERIALS AND METHODS Serum samples of consecutive biopsy-proven NAFLD patients were used to calculate the RPR index. Fibrosis stages were evaluated using the Brunt Criteria. Area under receiver operating characteristics curve was used to calculate predicting performance and compare with other noninvasive fibrosis scores. RESULTS One hundred and twenty-three consecutive patients with biopsy-confirmed NAFLD were recruited; 54 patients (43.9%) were women. The median age of the patients was 49 years. Fibrosis scores were F0-1, F2, F3, and F4 in 79 (64.2%), 27 (22%), 11 (8.9%), and 6 (4.9%) patients, respectively. The median RPR increased as the fibrosis scores progressed: F0, 0.0524; F1, 0.0534; F2, 0.0606; F3, 0.0815; and F4 0.2022. Area under receiver operating characteristics curve of the RPR was 0.69 in predicting significant fibrosis (≥ F2), 0.81 in advanced fibrosis (≥ F3), and 0.85 in F4, and all were statistically significant (P<0.001). Comparisons with other noninvasive fibrosis scores were not statistically significant (P>0.05). RPR was correlated with fibrosis r: 0.37, 95% confidence interval: (0.21-0.52), P<0.001. RPR was an independent predicting factor for identifying both significant and advanced fibrosis in regression analysis (P<0.05). CONCLUSION RPR was both correlated and able to predict liver fibrosis and may be suggested to reduce liver biopsy in NAFLD.
Collapse
|
66
|
Bello S, Fandos S, Lasierra A, Mincholé E, Panadero C, Simon A, Gavin O, De Pablo F, Menendez R, Torres A. Red blood cell distribution width [RDW] and long-term mortality after community-acquired pneumonia. A comparison with proadrenomedullin. Respir Med 2015. [DOI: 10.1016/j.rmed.2015.07.003] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/01/2023]
|
67
|
Zhang J, Feng G, Zhao Y, Zhang J, Feng L, Yang J. Association between lymphocyte-to-monocyte ratio (LMR) and the mortality of HBV-related liver cirrhosis: a retrospective cohort study. BMJ Open 2015; 5:e008033. [PMID: 26297362 PMCID: PMC4550728 DOI: 10.1136/bmjopen-2015-008033] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/25/2015] [Revised: 07/24/2015] [Accepted: 07/30/2015] [Indexed: 12/20/2022] Open
Abstract
OBJECTIVE Infection with hepatitis B virus (HBV) remains a major cause of liver cirrhosis (LC) in China. Recent reports suggest that the lymphocyte-to-monocyte ratio (LMR) is a potential biomarker for predicting clinical outcomes. In our study, we investigated if LMR can be used as a prognostic marker of mortality in patients with HBV-related LC. DESIGN A retrospective cohort study. SETTING HBV-infected patients with LC and patients with chronic hepatitis B infection (CHB) from the Department of Infectious Disease were enrolled and 240 healthy individuals were recruited from the healthcare centre at the First Affiliated Hospital of Zhejiang University. PARTICIPANTS 479 HBV-infected patients with LC, 134 patients with CHB and 240 healthy individuals were enrolled. PRIMARY AND SECONDARY OUTCOME MEASURES The receiver operating characteristic (ROC) curve and multivariable logistic regression analysis after adjusting for total protein, albumin, total bilirubin and the model for end-stage liver disease (MELD) score were used to evaluate the power of LMR for predicting 1 year mortality in patients with LC. RESULTS The LMR was statistically lower in patients with LC. The MELD score and mortality were statistically higher in patients with LC compared with the CHB and control groups. The area under the ROC curve, cut-off values, sensitivity and specificity of LMR for predicting mortality LC in the training cohort were 0.817 (95% CI 0.746 to 0.888; p<0.001), 2.10, 82.6 and 78.8%, and these data were confirmed in the validation cohort. The multivariate logistic regression analysis showed that LMR was an independent predictive factor of mortality in LC (OR 2.370, 95% CI (1.070 to 5.249); p=0.033). CONCLUSIONS Our results strongly suggest that low LMR can be considered as an independent biomarker for predicting mortality in patients with LC.
Collapse
Affiliation(s)
- Jie Zhang
- Department of Laboratory Medicine, The First Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou, China
| | - Guofang Feng
- Department of Reproductive Endocrinology, Women's Hospital, School of Medicine, Zhejiang University, Hangzhou, China
| | - Ying Zhao
- Department of Laboratory Medicine, The First Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou, China
| | - Juanwen Zhang
- Department of Laboratory Medicine, The First Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou, China
| | - Limin Feng
- Department of Laboratory Medicine, The First Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou, China
| | - Jing Yang
- Department of Clinical Laboratory, The Hospital of Stomatology, Sun Yat-sen University, Guangzhou, China
| |
Collapse
|
68
|
Red cell distribution width to platelet ratio, a useful indicator of liver fibrosis in chronic hepatitis patients. Hepatol Int 2015; 9:454-60. [PMID: 26088296 DOI: 10.1007/s12072-015-9638-9] [Citation(s) in RCA: 33] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/27/2015] [Accepted: 05/11/2015] [Indexed: 12/28/2022]
Abstract
AIMS We investigated the correlation between the red cell distribution width (RDW) and RDW-to-platelet ratio (RPR) with the degree of inflammation and fibrosis in chronic hepatitis patients with different etiologies and in native and transplanted liver. METHODS Between 2010 and 2013, patients from the MedStar Washington Hospital Center and Georgetown University Hospital with chronic hepatitis B, chronic hepatitis C, alcoholic hepatitis, and primary biliary cirrhosis who had a biopsy of the liver done in this time period were included. The correlation among the RDW, RPR, and model for end-stage liver disease (MELD) score with the degree of liver inflammation, fibrosis, and cirrhosis in separate groups of native and transplanted liver was calculated. RESULTS A total of 152 cases with native liver and 70 cases with transplanted liver were included. The majority of patients had hepatitis C in both groups. None of the investigated variables showed significant correlation with the degree of inflammation in either group. The strongest correlation with the degree of fibrosis in the native liver group was for the RPR with 0.51 (p < 0.001) and then the RDW and MELD with 0.34 (p < 0.001) and 0.31 (p < 0.001), respectively. In the transplanted liver group, none of the variables showed significant correlation with the degree of fibrosis. The receiver-operator curve showed that only the RDW and RPR in the native liver group, with areas under the curve of 0.770 and 0.684, respectively, have significantly positive association with the risk of cirrhosis. In the transplanted group, none of the predictors were associated with risk of cirrhosis. In the native liver group, a cutoff value of 0.088 in the RPR led to 82.7% sensitivity and 61.0% specificity to predict cirrhosis. CONCLUSION The RPR can be a strong predictor of the degree of fibrosis and cirrhosis in patients with chronic hepatitis and native liver. It shows higher accuracy compared to the RDW and MELD score. However, its use in predicting inflammation is limited.
Collapse
|
69
|
Xu WS, Qiu XM, Ou QS, Liu C, Lin JP, Chen HJ, Lin S, Wang WH, Lin SR, Chen J. Red blood cell distribution width levels correlate with liver fibrosis and inflammation: a noninvasive serum marker panel to predict the severity of fibrosis and inflammation in patients with hepatitis B. Medicine (Baltimore) 2015; 94:e612. [PMID: 25761184 PMCID: PMC4602467 DOI: 10.1097/md.0000000000000612] [Citation(s) in RCA: 41] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/23/2022] Open
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 < 0.001]. The sensitivity and specificity of model B were 66.1% and 79.4% for predicting advanced liver inflammation (AUC = 0.765, P < 0.001). 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 < 0.001) and FIB-4 (0.740, P = 0.32). RDW may provide a useful clinical value for predicting liver fibrosis and necroinflammation in hepatitis B-infected patients with other markers.
Collapse
Affiliation(s)
- Wen-Shen Xu
- From the First Clinical College (W-HW, S-RL); Department of Laboratory Medicine (W-SX, X-MQ); Genetic Diagnostic Laboratory (Q-SO, CL, J-PL, H-JC, SL, JC); and First Affiliated Hospital of Fujian Medical University, Fuzhou, China
| | | | | | | | | | | | | | | | | | | |
Collapse
|
70
|
Salvagno GL, Sanchis-Gomar F, Picanza A, Lippi G. Red blood cell distribution width: A simple parameter with multiple clinical applications. Crit Rev Clin Lab Sci 2014; 52:86-105. [PMID: 25535770 DOI: 10.3109/10408363.2014.992064] [Citation(s) in RCA: 592] [Impact Index Per Article: 59.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Abstract
The red blood cell distribution width (RDW) is a simple and inexpensive parameter, which reflects the degree of heterogeneity of erythrocyte volume (conventionally known as anisocytosis), and is traditionally used in laboratory hematology for differential diagnosis of anemias. Nonetheless, recent evidence attests that anisocytosis is commonplace in human disorders such as cardiovascular disease, venous thromboembolism, cancer, diabetes, community-acquired pneumonia, chronic obstructive pulmonary disease, liver and kidney failure, as well as in other acute or chronic conditions. Despite some demographic and analytical issues related to the routine assessment that may impair its clinical usefulness, an increased RDW has a high negative predictive value for diagnosing a variety of disorders, but also conveys important information for short- and long-term prognosis. Even more importantly, the value of RDW is now being regarded as a strong and independent risk factor for death in the general population. Although it has not been definitely established whether an increased value of RDW is a risk factor or should only be considered an epiphenomenon of an underlying biological and metabolic imbalance, it seems reasonable to suggest that the assessment of this parameter should be broadened far beyond the differential diagnosis of anemias. An increased RDW mirrors a profound deregulation of erythrocyte homeostasis involving both impaired erythropoiesis and abnormal red blood cell survival, which may be attributed to a variety of underlying metabolic abnormalities such as shortening of telomere length, oxidative stress, inflammation, poor nutritional status, dyslipidemia, hypertension, erythrocyte fragmentation and alteration of erythropoietin function. As such, the aim of this article is to provide general information about RDW and its routine assessment, to review the most relevant implications in health and disease and give some insights about its potential clinical applications.
Collapse
Affiliation(s)
- Gian Luca Salvagno
- Clinical Chemistry Section, Department of Life and Reproductive Sciences, Academic Hospital of Verona , Verona , Italy
| | | | | | | |
Collapse
|
71
|
Red cell distribution width is associated with presence, stage, and grade in patients with renal cell carcinoma. DISEASE MARKERS 2014; 2014:860419. [PMID: 25580051 PMCID: PMC4280806 DOI: 10.1155/2014/860419] [Citation(s) in RCA: 39] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/29/2014] [Revised: 11/08/2014] [Accepted: 12/01/2014] [Indexed: 12/18/2022]
Abstract
It has been reported that red blood cell width (RDW) is a marker associated with the presence and adverse outcomes of various diseases. However, no data are available on the correlation of RDW with presence, stage, and grade in patients with renal cell carcinoma (RCC) yet. By retrospectively analyzing clinical and laboratory data at baseline of histologically confirmed RCC cases and controls, the present study demonstrated that the RDW values were significantly higher in patients with RCC than those in controls, and the baseline RDW value was independently associated with the presence of RCC. Besides, the data revealed a positive association between RCC stage and grade and the level of RDW. These findings may have important clinical implications due to future application using a RDW value in predicting RCC.
Collapse
|
72
|
Huang R, Yang C, Wu K, Cao S, Liu Y, Su R, Xiong Y, Huang A, Wu C. Red cell distribution width as a potential index to assess the severity of hepatitis B virus-related liver diseases. Hepatol Res 2014; 44:E464-70. [PMID: 24720373 DOI: 10.1111/hepr.12342] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/26/2013] [Revised: 04/02/2014] [Accepted: 04/07/2014] [Indexed: 12/27/2022]
Abstract
AIM To investigate the association between red cell distribution width (RDW) and the severity of hepatitis B virus (HBV)-related liver diseases. METHODS Sixty-nine patients with chronic hepatitis B (CHB) and 61 patients with HBV-related liver cirrhosis were enrolled in the present study. Forty-one healthy individuals were included as controls. Hematological parameters, hepatitis B e-antigen (HBeAg) status, HBV DNA levels and liver biochemistry were analyzed. Child-Pugh scores and Model for End-Stage Liver Disease (MELD) scores of the patients with HBV-related liver cirrhosis were calculated. RESULTS The RDW was significantly higher in patients with HBV-related liver cirrhosis as compared with CHB patients and healthy controls. RDW was slightly higher in CHB patients as compared with healthy controls. An increasing correlation of RDW with Child-Pugh grades was found. RDW was positively correlated with Child-Pugh scores and MELD scores. In patients with HBV-related liver cirrhosis, RDW was also positively correlated with total bilirubin and negatively correlated with hemoglobin and serum albumin concentration. However, no significant difference was found between HBeAg positive and negative patients and no significant correlation between RDW and HBV DNA levels was found. CONCLUSION The RDW was elevated in CHB patients and patients with HBV-related liver cirrhosis and was positively correlated with the severity of HBV-related liver cirrhosis. RDW is a potential index to assess the severity of HBV-related liver diseases.
Collapse
Affiliation(s)
- Rui Huang
- Department of Infectious Diseases, Nanjing Drum Tower Hospital Clinical College of Traditional Chinese and Western Medicine, Nanjing University of Chinese Medicine, Nanjing, China
| | | | | | | | | | | | | | | | | |
Collapse
|
73
|
Hu ZD, Sun Y, Guo J, Huang YL, Qin BD, Gao Q, Qin Q, Deng AM, Zhong RQ. Red blood cell distribution width and neutrophil/lymphocyte ratio are positively correlated with disease activity in primary Sjögren's syndrome. Clin Biochem 2014; 47:287-90. [DOI: 10.1016/j.clinbiochem.2014.08.022] [Citation(s) in RCA: 63] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/24/2014] [Revised: 08/04/2014] [Accepted: 08/29/2014] [Indexed: 12/21/2022]
|
74
|
Clinical usefulness of mean platelet volume and red blood cell distribution width to platelet ratio for predicting the severity of hepatic fibrosis in chronic hepatitis B virus patients. Eur J Gastroenterol Hepatol 2014; 26:1320-4. [PMID: 25210777 DOI: 10.1097/meg.0000000000000203] [Citation(s) in RCA: 39] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
OBJECTIVE Hepatitis B virus infection is still one of the leading causes of cirrhosis and hepatocellular carcinoma worldwide. Liver biopsy is the gold-standard method to assess the severity of liver fibrosis, but the invasive nature of this method limits its usage. Currently, noninvasive parameters are utilized to estimate liver histology. In the present study, we aimed to investigate the relationship between the severity of fibrosis and red blood cell distribution width (RDW), platelet distribution width (PDW), mean platelet volume (MPV), and MPV and red blood cell distribution width to platelet ratio (RPR) in patients with chronic hepatitis B (CHB). DESIGN A total of 229 biopsy-proven naïve CHB cases were included in the study. The complete blood count variables including white blood cell, hemoglobin, hematocrit value, platelet count, RDW, MPV and PDW, as well as aspartate aminotransferase, alanine aminotransferase, total bilirubin, albumin, and other routine biochemical parameters were tested. Liver biopsy samples were examined using the Ishak scoring system. Data analyses were carried out using SPSS 15 software. Statistical significance was set at a P-value of less than 0.05. RESULTS Of the 229 cases, 210 (91.7%) were men and 19 (8.3%) were women. The mean age of the patients was 30.9 years, and 85 cases (37.1%) had HBeAg positivity. Fibrosis scores of 41 cases (17.9%) were greater than or equal to 3, whereas 188 cases (82.1%) had fibrosis scores less than 3. There was a significant difference between these two groups for MPV (group 1=7.98±1.20, group 2=8.77±1.44, P<0.05). There was also a significant difference between these two groups for RDW (P<0.05). The RDW value in group 1 patients was 11.83±0.89, whereas this value was 12.57±1.32 in group 2. Moreover, the RPR was significantly higher in group 2 than in group 1 (P<0.001). There was no significant difference between the groups for PDW. We have compared the receiver operating characteristic curves for the diagnostic performance of aspartate aminotransferase, alanine aminotransferase, platelet count, RDW, MPV, and RPR in identifying fibrosis in CHB and area under the curve values for these variables were 0.666, 0.463, 0.657, 0.672, 0.677, and 0.758, respectively. CONCLUSION MPV and RDW values are significantly higher in hepatitis B virus-infected patients, associated with severity, and can be defined as independent predicting factors in hepatic fibrosis. Further studies are required to determine the associations between MPV and the severity of fibrosis in hepatitis B patients.
Collapse
|
75
|
Karagöz E, Doğan M, Tanoglu A. Red cell distribution width: a novel prognostic factor of pulmonary embolism? Wien Klin Wochenschr 2014; 127:77-8. [PMID: 25367800 DOI: 10.1007/s00508-014-0625-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2014] [Accepted: 09/28/2014] [Indexed: 11/29/2022]
Affiliation(s)
- Ergenekon Karagöz
- Department of Infectious Diseases and Clinical Microbiology, GATA Haydarpasa Training Hospital, 34668, Istanbul, Uskudar, Turkey,
| | | | | |
Collapse
|
76
|
Lorente L, Martín MM, Abreu-González P, Solé-Violán J, Ferreres J, Labarta L, Díaz C, González O, García D, Jiménez A, Borreguero-León JM. Red blood cell distribution width during the first week is associated with severity and mortality in septic patients. PLoS One 2014; 9:e105436. [PMID: 25153089 PMCID: PMC4143268 DOI: 10.1371/journal.pone.0105436] [Citation(s) in RCA: 55] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2014] [Accepted: 07/20/2014] [Indexed: 12/12/2022] Open
Abstract
Objective Higher values of red blood cell distribution width (RDW) have been found in non-surviving than in surviving septic patients. However, it is unknown whether RDW during the first week of sepsis evolution is associated with sepsis severity and early mortality, oxidative stress and inflammation states, and these were the aims of the study. Methods We performed a prospective, observational, multicenter study in six Spanish Intensive Care Units with 297 severe septic patients. We measured RDW, serum levels of malondialdehyde (MDA) to assess oxidative stress, and tumour necrosis factor (TNF)-α to assess inflammation at days 1, 4, and 8. The end-point was 30-day mortality. Results We found higher RDW in non-surviving (n = 104) than in surviving (n = 193) septic patients at day 1 (p = 0.001), day 4 (p = 0.001), and day 8 (p = 0.002) of ICU admission. Cox regression analyses showed that RDW at day 1 (p<0.001), 4 (p = 0.005) and 8 (p = 0.03) were associated with 30-day mortality. Receiver operating characteristic curves showed that RDW at day 1 (p<0.001), 4 (p<0.001), and 8 (p<0.001) could be used to predict 30-day mortality. RDW showed a positive correlation with serum MDA levels at day 1 and day 4, with serum TNF-α levels at days 4 and 8, and with SOFA score at days 1, 4 and 8. Conclusions The major findings of our study were that non-surviving septic patients showed persistently higher RDW during the first week of ICU stay than survivors, that RDW during the first week was associated with sepsis severity and mortality, that RDW during the first week could be used as biomarker of outcome in septic patients, and that there was an association between RDW, serum MDA levels, and serum TNF-α levels during the first week.
Collapse
Affiliation(s)
- Leonardo Lorente
- Intensive Care Unit, Hospital Universitario de Canarias, La Laguna, Tenerife, Spain
- * E-mail:
| | - María M. Martín
- Intensive Care Unit, Hospital Universitario Nuestra Señora Candelaria, Santa Cruz de Tenerife, Tenerife, Spain
| | - Pedro Abreu-González
- Deparment of Phisiology, Faculty of Medicine, University of the La Laguna, La Laguna, Tenerife, Spain
| | - Jordi Solé-Violán
- Intensive Care Unit, Hospital Universitario Dr. Negrín, Las Palmas de Gran Canaria, Gran Canria, Spain
| | - José Ferreres
- Intensive Care Unit, Hospital Clínico Universitario de Valencia, Valencia, Spain
| | | | - César Díaz
- Intensive Care Unit, Hospital Insular, Las Palmas de Gran Canaria, Gran Canaria, Spain
| | - Oswaldo González
- Intensive Care Unit, Hospital Universitario de Canarias, La Laguna, Tenerife, Spain
| | - Daida García
- Intensive Care Unit, Hospital Universitario Nuestra Señora Candelaria, Santa Cruz de Tenerife, Tenerife, Spain
| | - Alejandro Jiménez
- Research Unit, Hospital Universitario de Canarias, La Laguna, Tenerife, Spain
| | | |
Collapse
|
77
|
Huang YL, Hu ZD, Liu SJ, Sun Y, Qin Q, Qin BD, Zhang WW, Zhang JR, Zhong RQ, Deng AM. Prognostic value of red blood cell distribution width for patients with heart failure: a systematic review and meta-analysis of cohort studies. PLoS One 2014; 9:e104861. [PMID: 25133510 PMCID: PMC4136732 DOI: 10.1371/journal.pone.0104861] [Citation(s) in RCA: 76] [Impact Index Per Article: 7.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2014] [Accepted: 07/13/2014] [Indexed: 12/30/2022] Open
Abstract
Aims Multiple studies have investigated the prognostic role of red blood cell distribution width (RDW) for patients with heart failure (HF), but the results have been inconsistent. The aim of the present study was to estimate the impact of RDW on the prognosis of HF by performing a systematic review and meta-analysis. Methods and Results The Embase, PubMed, and Web of Science databases were searched up to November 16, 2013 to identify eligible cohort studies. The quality of each study was assessed using the Newcastle-Ottawa Scale (NOS). The association between RDW, either on admission or at discharge, and HF outcomes (all-cause mortality [ACM], heart transplantation, cardiovascular mortality, and rehospitalization, etc.) were reviewed. The overall hazard ratio (HR) for the effect of RDW on ACM was pooled using a random-effects model, and the publication bias was evaluated using funnel plots and Eggers' tests. Seventeen studies, with a total of 18288 HF patients, were included for systematic review. All eligible studies indicated that RDW on admission and RDW at discharge, as well as its change during treatment, were of prognostic significance for HF patients. The HR for the effect of a 1% increase in baseline RDW on ACM was 1.10 (95% confidence interval: 1.07–1.13), based on pooling of nine studies that provided related data. However, publication bias was observed among these studies. Conclusions HF patients with higher RDW may have poorer prognosis than those with lower RDW. Further studies are needed to explore the potential mechanisms underlying this association.
Collapse
Affiliation(s)
- Yuan-Lan Huang
- Department of Laboratory Medicine, NO. 455 Hospital of People's Liberation Army, Shanghai, P. R. China
- Department of Laboratory Diagnosis, Changhai Hospital, Second Military Medical University, Shanghai, P. R. China
- Department of Laboratory Diagnosis, Changzheng Hospital, Second Military Medical University, Shanghai, P. R. China
| | - Zhi-De Hu
- Department of Laboratory Diagnosis, Changzheng Hospital, Second Military Medical University, Shanghai, P. R. China
- Department of Laboratory Medicine, General Hospital of Ji'nan Military Region of People's Liberation Army, Ji'nan, Shandong Province, P. R. China
| | - Shi-Jian Liu
- Department of Biobank and Biostatistics, Pediatric Translational Institute, Shanghai Children's Medical Center, School of Medicine, Shanghai Jiaotong University, Shanghai, P. R. China,
| | - Yi Sun
- Department of Laboratory Diagnosis, Changhai Hospital, Second Military Medical University, Shanghai, P. R. China
| | - Qin Qin
- Department of Laboratory Diagnosis, Changhai Hospital, Second Military Medical University, Shanghai, P. R. China
| | - Bao-Dong Qin
- Department of Laboratory Diagnosis, Changzheng Hospital, Second Military Medical University, Shanghai, P. R. China
| | - Wei-Wei Zhang
- Department of Laboratory Diagnosis, Changhai Hospital, Second Military Medical University, Shanghai, P. R. China
| | - Jian-Rong Zhang
- Department of Laboratory Diagnosis, Changhai Hospital, Second Military Medical University, Shanghai, P. R. China
| | - Ren-Qian Zhong
- Department of Laboratory Diagnosis, Changzheng Hospital, Second Military Medical University, Shanghai, P. R. China
- * E-mail: (AMD); (RQZ)
| | - An-Mei Deng
- Department of Laboratory Diagnosis, Changhai Hospital, Second Military Medical University, Shanghai, P. R. China
- * E-mail: (AMD); (RQZ)
| |
Collapse
|
78
|
Shin HS, Kim SP, Han SH, Kim DY, Ahn SH, Han KH, Chon CY, Park JY. Prognostic indicators for acute liver failure development and mortality in patients with hepatitis A: consecutive case analysis. Yonsei Med J 2014; 55:953-9. [PMID: 24954323 PMCID: PMC4075399 DOI: 10.3349/ymj.2014.55.4.953] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/20/2022] Open
Abstract
PURPOSE Due to the seroepidemiological shift in hepatitis A (HA), its severity, mortality, and complications have increased in recent years. Thus, the aim of this study was to identify predictive factors associated with poor prognosis among patients with HA. MATERIALS AND METHODS A total of 304 patients with HA admitted to our institution between July 2009 and June 2011 were enrolled consecutively. Patients with complications defined as acute liver failure (ALF) were evaluated, and mortality was defined as death or liver transplantation. RESULTS The mean age of patients (204 males, 100 females) was 32 years. Eighteen (5.9%) patients had progressed to ALF. Of the patients with ALF, 10 patients (3.3%) showed spontaneous survival while 8 (2.6%) died or underwent liver transplantation. Multivariate regression analysis showed that Model for End-Stage Liver Disease (MELD) and systemic inflammatory response syndrome (SIRS) scores were significant predictive factors of ALF. Based on receiver operating characteristics (ROC) analysis, a MELD≥23.5 was significantly more predictive than a SIRS score≥3 (area under the ROC: 0.940 vs. 0.742, respectively). In addition, of patients with a MELD score≥23.5, King's College Hospital criteria (KCC) and SIRS scores were predictive factors associated with death/transplantation in multivariate analysis. CONCLUSION MELD and SIRS scores≥23.5 and ≥3, respectively, appeared to be related to ALF development. In addition, KCC and SIRS scores≥3 were valuable in predicting mortality of patients with a MELD≥23.5.
Collapse
Affiliation(s)
- Hye Sun Shin
- Department of Internal Medicine, Yonsei University College of Medicine, Seoul, Korea
| | - Sae Pyul Kim
- Department of Internal Medicine, Yonsei University College of Medicine, Seoul, Korea
| | - Sang Hoon Han
- Department of Internal Medicine, Yonsei University College of Medicine, Seoul, Korea
| | - Do Young Kim
- Department of Internal Medicine, Yonsei University College of Medicine, Seoul, Korea. ; Institute of Gastroenterology, Yonsei University College of Medicine, Seoul, Korea. ; Liver Cirrhosis Clinical Research Center, Seoul, Korea
| | - Sang Hoon Ahn
- Department of Internal Medicine, Yonsei University College of Medicine, Seoul, Korea. ; Institute of Gastroenterology, Yonsei University College of Medicine, Seoul, Korea. ; Liver Cirrhosis Clinical Research Center, Seoul, Korea. ; Brain Korea 21 Project of Medical Science, Seoul, Korea
| | - Kwang-Hyub Han
- Department of Internal Medicine, Yonsei University College of Medicine, Seoul, Korea. ; Institute of Gastroenterology, Yonsei University College of Medicine, Seoul, Korea. ; Liver Cirrhosis Clinical Research Center, Seoul, Korea. ; Brain Korea 21 Project of Medical Science, Seoul, Korea
| | - Chae Yoon Chon
- Department of Internal Medicine, Yonsei University College of Medicine, Seoul, Korea. ; Institute of Gastroenterology, Yonsei University College of Medicine, Seoul, Korea. ; Liver Cirrhosis Clinical Research Center, Seoul, Korea
| | - Jun Yong Park
- Department of Internal Medicine, Yonsei University College of Medicine, Seoul, Korea. ; Institute of Gastroenterology, Yonsei University College of Medicine, Seoul, Korea. ; Liver Cirrhosis Clinical Research Center, Seoul, Korea
| |
Collapse
|
79
|
As an inexpensive and easily attainable marker red cell distribution width is associated with nonalcoholic fatty liver disease. Eur J Gastroenterol Hepatol 2014; 26:494. [PMID: 24598386 DOI: 10.1097/meg.0000000000000055] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/10/2022]
|
80
|
Braun E, Kheir J, Mashiach T, Naffaa M, Azzam ZS. Is elevated red cell distribution width a prognostic predictor in adult patients with community acquired pneumonia? BMC Infect Dis 2014; 14:129. [PMID: 24597687 PMCID: PMC3973886 DOI: 10.1186/1471-2334-14-129] [Citation(s) in RCA: 35] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2013] [Accepted: 02/25/2014] [Indexed: 11/22/2022] Open
Abstract
Background Community acquired pneumonia (CAP) is a major cause of morbidity and mortality. We recently demonstrated that among young patients (<60 years old) with CAP, elevated red blood cell distribution width (RDW) level on admission was associated with significant higher rates of mortality and severe morbidity. We aimed to investigate the prognostic predictive value of RDW among CAP patients in general population of internal wards. Methods The cohort included patients of 18 years old or older who were diagnosed with CAP (defined as pneumonia identified 48 hours or less from hospitalization) between January 1, 2005 and December 31, 2010. Patients were retrospectively analyzed for risk factors for a primary endpoint of 90-day mortality. Secondary endpoint was defined as complicated hospitalization (defined as at least one of the following: In- hospital mortality, length of stay of at least 10 days or ICU admission). Binary logistic regression analysis was used for the calculation of the odds ratios (OR) and p values in univariate and multivariate analysis to identify association between patient characteristic, 90-day mortality and complicated hospitalization. Results The cohort included 3815 patients. In univariate analysis, patients with co-morbid conditions tended to have a complicated course of CAP. In multivariate regression analysis, variables associated with an increased risk of 90-day mortality included age > 70 years, high Charlson comorbidity index (>2), Hb < 10 mg/dl, Na <130 meq/l, blood urea nitrogen (BUN) >30 mg/dl, systolic blood pressure < 90 mmHg and elevated RDW >15%. Variables associated with complicated hospitalization included high Charlson comorbidity index, BUN > 30 mg/dl, hemoglobin < 10 g/dl, heart rate >124 bpm, systolic blood pressure < 90 mmHg and elevated RDW. Mortality rate and complicated hospitalization were significantly higher among patients with increased RDW regardless of the white blood cell count or hemoglobin levels. Conclusions Elevated RDW levels on admission are associated with significant higher rates of mortality and severe morbidity in adult patients with CAP. RDW as a prognostic marker was unrelated with hemoglobin levels, WBC count, age or Charlson score.
Collapse
Affiliation(s)
- Eyal Braun
- Departments of Medicine H and B, Rambam Health Care Campus, P,O, Box 9602, 31096 Haifa, Israel.
| | | | | | | | | |
Collapse
|
81
|
Red Blood cell distribution width: an emerging diagnostic factor of acute appendicitis? World J Emerg Surg 2013; 8:54. [PMID: 24369056 PMCID: PMC3877950 DOI: 10.1186/1749-7922-8-54] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2013] [Accepted: 12/19/2013] [Indexed: 11/30/2022] Open
Abstract
Acute appendicitis is the most common surgical abdominal emergency. Immidiate diagnosis of this disease is crucial, because this condition can lead to appendiceal perforation, potential peritonitis, and even death. We read with great interest the article ‘The role of red cell distribution width (RDW) in the diagnosis of acute appendicitis: a retrospective case-controlled study’ by Narci et al. and wanted to discuss whether RDW alone provide certain information about the inflammatory status of the patient with acute appendicitis.
Collapse
|
82
|
Cengiz M, Candır BA, Yılmaz G, Akyol G, Ozenirler S. Is increased red cell distribution width an indicating marker of nonalcoholic steatohepatitis and fibrotic stage? World J Gastroenterol 2013; 19:7412-7418. [PMID: 24259972 PMCID: PMC3831223 DOI: 10.3748/wjg.v19.i42.7412] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/09/2013] [Revised: 08/09/2013] [Accepted: 09/17/2013] [Indexed: 02/06/2023] Open
Abstract
AIM: To evaluate the red cell distribution width (RDW) as an indicator of the presence of non-alcoholic steatohepatitis (NASH) and its association with fibrotic scores.
METHODS: A retrospective study was carried out that included sixty-two biopsy proven NASH, 32 simple steatosis patients and 30 healthy controls. The correlation between the clinical and histopathological features of NASH patients and RDW values was evaluated. Liver fibrosis scores were measured using a 0 to 4 point scale and were divided in to two groups; fibrosis scores 0-1 were termed mild and fibrosis scores 2-4 were termed advanced fibrosis. RDW values were compared between NASH, simple steatosis and healthy controls. Univariate and multivariate analyses were performed to evaluate the independent predicting factors for the presence of liver fibrosis caused by NASH.
RESULTS: Patients with NASH had higher RDW values compared with simple steatosis and healthy control groups [14.28% ± 0.25% vs 13.37% ± 0.12%, 12.96% ± 0.14% (P < 0.01), respectively]. Patients with advanced fibrosis had higher RDW values than the mild fibrosis group (15.86% ± 0.4% vs 13.63% ± 0.67%, P < 0.01, respectively). RDW also correlated with fibrotic scores (r = 0.579 and P < 0.01). The variables that were significant in the univariate analysis were evaluated in multivariate logistic regression analysis, and RDW was an independent predicting factor of NASH (OR = 1.75, 95%CI: 1.129-2.711, P < 0.05).
CONCLUSION: RDW a new non-invasive marker that can be used to demonstrate the presence of NASH and indicate advanced fibrotic scores.
Collapse
|
83
|
Koma Y, Onishi A, Matsuoka H, Oda N, Yokota N, Matsumoto Y, Koyama M, Okada N, Nakashima N, Masuya D, Yoshimatsu H, Suzuki Y. Increased red blood cell distribution width associates with cancer stage and prognosis in patients with lung cancer. PLoS One 2013; 8:e80240. [PMID: 24244659 PMCID: PMC3823700 DOI: 10.1371/journal.pone.0080240] [Citation(s) in RCA: 178] [Impact Index Per Article: 16.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2013] [Accepted: 10/01/2013] [Indexed: 12/18/2022] Open
Abstract
Background Red cell distribution width (RDW), one of many routinely examined parameters, shows the heterogeneity in erythrocyte size. We investigated the association of RDW levels with clinical parameters and prognosis of lung cancer patients. Methods Clinical and laboratory data from 332 patients with lung cancer in a single institution were retrospectively studied by univariate analysis. Kaplan-Meier survival analysis and Cox proportional hazard models were used to examine the effect of RDW on survival. Results The RDW levels were divided into two groups: high RDW (>=15%), n=73 vs. low RDW, n=259 (<15%). Univariate analysis showed that there were significant associations of high RDW values with cancer stage, performance status, presence of other disease, white blood cell count, hemoglobin, mean corpuscular volume, platelet count, albumin level, C-reactive protein level, and cytokeratin 19 fragment level. Kruskal-Wallis tests revealed an association of RDW values with cancer stage in patients irrespective of comorbidity (patient with/without comorbidity: p<0.0001, patient without comorbidity: p<0.0001). Stages I-IV lung cancer patients with higher RDW values had poorer prognoses than those with lower RDW values (Wilcoxon test: p=0.002). In particular, the survival rates of stage I and II patients (n=141) were lower in the high RDW group (n=19) than in the low RDW group (n=122) (Wilcoxon test: p<0.001). Moreover, multivariate analysis showed higher RDW is a significant prognostic factor (p=0.040). Conclusion RDW is associated with several factors that reflect inflammation and malnutrition in lung cancer patients. Moreover, high levels of RDW are associated with poor survival. RDW might be used as a new and convenient marker to determine a patient’s general condition and to predict the mortality risk of lung cancer patients.
Collapse
Affiliation(s)
- Yasuko Koma
- Respiratory Center, Shinko Hospital, Kobe-city, Hyogo, Japan
- * E-mail:
| | - Akira Onishi
- Department of Health Promotion & Human Behavior, Kyoto University Graduate School of Medicine / School of Public Health, Kyoto-city, Kyoto, Japan
| | | | - Nao Oda
- Respiratory Center, Shinko Hospital, Kobe-city, Hyogo, Japan
| | - Naoya Yokota
- Respiratory Center, Shinko Hospital, Kobe-city, Hyogo, Japan
| | | | - Midori Koyama
- Respiratory Center, Shinko Hospital, Kobe-city, Hyogo, Japan
| | - Nobuhiko Okada
- Respiratory Center, Shinko Hospital, Kobe-city, Hyogo, Japan
| | | | - Daiki Masuya
- Respiratory Center, Shinko Hospital, Kobe-city, Hyogo, Japan
| | | | - Yujiro Suzuki
- Respiratory Center, Shinko Hospital, Kobe-city, Hyogo, Japan
| |
Collapse
|
84
|
An MLP classifier for prediction of HBV-induced liver cirrhosis using routinely available clinical parameters. DISEASE MARKERS 2013; 35:653-60. [PMID: 24302810 PMCID: PMC3834663 DOI: 10.1155/2013/127962] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/29/2013] [Revised: 09/25/2013] [Accepted: 10/09/2013] [Indexed: 12/13/2022]
Abstract
Background. Liver cirrhosis (LC) is the final stage of most of chronic liver diseases and is almost caused by chronic hepatitis B (CHB) in China. Liver biopsy is the reference method for the evaluation of liver cirrhosis. However, it is an invasive procedure with inherent risk. The aim of this study was to construct a new classifier based on the routine clinical markers for the prediction of HBV-induced LC. Subjects and Methods. We collected routine clinical parameters from 124 LC patients with CHB and 115 with CHB. Training set (n = 120) and test set (n = 119) were built for model construction and evaluation, respectively. Results. We describe a new classifier, MLP, for prediction of LC with CHB. MLP was built with seven routinely available clinical parameters, including age, ALT, AST, PT, PLT, HGB, and RDW. With optimal cutoff, we obtained a sensitivity of 95.2%, a specificity of 84.2%, and an overall accuracy of 89.9% on an independent test set, which were superior to those of FIB-4 and APRI. Conclusions. Our study suggests that the MLP classifier can be implemented for discriminating LC and non-LC cohorts by using machine learning method based on the routine available clinical parameters. It could be used for clinical practice in HBV-induced LC assessment.
Collapse
|
85
|
Chen B, Ye B, Zhang J, Ying L, Chen Y. RDW to platelet ratio: a novel noninvasive index for predicting hepatic fibrosis and cirrhosis in chronic hepatitis B. PLoS One 2013; 8:e68780. [PMID: 23874760 PMCID: PMC3714293 DOI: 10.1371/journal.pone.0068780] [Citation(s) in RCA: 103] [Impact Index Per Article: 9.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2012] [Accepted: 06/03/2013] [Indexed: 12/28/2022] Open
Abstract
Objective To develop a simple predictive model for significant fibrosis and cirrhosis in chronic hepatitis B (CHB) using the routine hematological parameters of a complete blood count. Methods A total of 458 eligible CHB patients who had undergone a liver biopsy were randomly divided into two cohorts: an estimation group (n = 310) and a validation group (n = 148). Liver histology was assessed according to the Metavir scoring scheme. All common demographics, hematological parameters, HBeAg status, HBV DNA, and liver biochemistry were analyzed. Results Based on routinely available clinical parameters (age, sex, HBeAg status, HBV DNA, common hematological parameters of a complete blood cell count), a model for predicting significant fibrosis (Metavir score ≥2) in the estimation group was derived using platelets and red cell distribution width (RDW), and another model for predicting cirrhosis (Metavir score = 4) was derived using platelets, RDW and hemoglobin. A novel index, the RDW to platelet ratio (RPR), was developed to amplify the opposing effects of liver fibrosis on the RDW and platelets. The AUCs of the RPR for predicting significant fibrosis and cirrhosis were 0.825 and 0.884, respectively, which is superior to the AAR, FIB-4 and APRI in the estimation group. Compared with the two derived models, the RPR has a comparable predictive power for significant fibrosis and cirrhosis. Using optimized cutoffs (0.10 and 0.16), the RPR accurately predicted 63.1% of cases with significant fibrosis and 73.7% of cases with cirrhosis and accurately excluded 85.5% of the cases with mild fibrosis and 93.0% of the cases with no cirrhosis. Conclusion The RPR, a routinely available, inexpensive and easily calculated index, can predict significant fibrosis and cirrhosis in CHB patients with relatively high accuracy. The application of this index may reduce the need for liver biopsy in CHB patients.
Collapse
Affiliation(s)
- Baode Chen
- Department of Laboratory Medicine, The First Affiliated Hospital of the Medical College, Zhejiang University, Hangzhou, China
| | - Bo Ye
- Department of Laboratory Medicine, The First Affiliated Hospital of the Medical College, Zhejiang University, Hangzhou, China
| | - Jian Zhang
- Department of Anesthesiology, The First Affiliated Hospital of the Medical College, Zhejiang University, Hangzhou, China
| | - Lixiong Ying
- Department of Pathology, The First Affiliated Hospital of the Medical College, Zhejiang University, Hangzhou, China
| | - Yu Chen
- Department of Laboratory Medicine, The First Affiliated Hospital of the Medical College, Zhejiang University, Hangzhou, China
- * E-mail:
| |
Collapse
|
86
|
Celikbilek A, Zararsiz G, Atalay T, Tanik N. Red cell distribution width in migraine. Int J Lab Hematol 2013; 35:620-8. [DOI: 10.1111/ijlh.12100] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2013] [Accepted: 03/27/2013] [Indexed: 11/30/2022]
Affiliation(s)
- A. Celikbilek
- Department of Neurology; Bozok University; Yozgat Turkey
| | - G. Zararsiz
- Department of Biostatistics and Medical Informatics; Erciyes University; Kayseri Turkey
| | - T. Atalay
- Department of Neurosurgery; Bozok University; Yozgat Turkey
| | - N. Tanik
- Department of Neurology; Bozok University; Yozgat Turkey
| |
Collapse
|
87
|
Öztürk ZA, Ünal A, Yiğiter R, Yesil Y, Kuyumcu ME, Neyal M, Kepekçi Y. Is increased red cell distribution width (RDW) indicating the inflammation in Alzheimer's disease (AD)? Arch Gerontol Geriatr 2012; 56:50-4. [PMID: 23103090 DOI: 10.1016/j.archger.2012.10.002] [Citation(s) in RCA: 37] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/27/2012] [Revised: 09/27/2012] [Accepted: 10/02/2012] [Indexed: 10/27/2022]
Abstract
Increasing evidence indicates that inflammation has a substantial role in the pathogenesis and progression of AD. RDW, a measure of heterogeneity in the size of circulating erythrocytes, is associated with inflammatory markers in many numerous diseases. Present study was undertaken to assess the interrelationships between RDW and AD. A total of 197 patients with AD (male/female: 96/101, mean age 76.2 ± 6.9) and 133 patients as controls with normal cognitive function (male/female: 72/61, mean age 71.68 ± 5.3) were enrolled in this cross-sectional study. RDW values of all participants were measured. Mini-Mental State Examination (MMSE) and clock drawing tests were performed for cognitive assessment. DSM-IV and NINCDS-ADRDA criteria were used for diagnosis of AD. The mean RDW values were significantly higher in AD group (13.93 ± 1.1 vs. 13.24 ± 1.2; p<0.001) and also a negative moderate correlation between RDW and MMSE was identified (r: -0.453; p<0.001). After adjusting for confounders, RDW has the strongest association with AD (odd ratio (OR) 1.51, CI=1.10-2.07). In present study RDW levels were significantly increased in patients with AD. Whereas elevated RDW value is usually considered as a novel biomarker of inflammation, the results of our study may support the role of inflammation in pathophysiology of AD. Furthermore the correlation of RDW with poorer cognition status suggests that it may be used as a marker of AD severity.
Collapse
Affiliation(s)
- Zeynel Abidin Öztürk
- Gaziantep University, Faculty of Medicine, Department of Internal Medicine, Division of Geriatric Medicine, 27100 Sahinbey, Gaziantep, Turkey.
| | | | | | | | | | | | | |
Collapse
|