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Fu X, Huang X, Lin Z, Hong S, Cai Y, Zhou A, Wu N. Protective effect of teprenone on gastric mucosal injury induced by dual antiplatelet therapy in rats. Am J Transl Res 2021; 13:2702-2709. [PMID: 34017431 PMCID: PMC8129371] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/24/2020] [Accepted: 12/21/2020] [Indexed: 06/12/2023]
Abstract
OBJECTIVE To investigate the protective effect of teprenone on gastric mucosal injury induced by dual antiplatelet therapy in rats. METHODS Healthy, specifically pathogen free SD, rats were selected and divided into 4 groups: Normal group (normal rats, without any treatment), Model group (rats received dual antiplatelet therapy: aspirin and clopidogrel), Teprenone group (rats received dual antiplatelet therapy and teprenone) and Pantoprazole group (rats received dual antiplatelet therapy and pantoprazole). The gastric mucosal blood flow, ulcer index, gastric gel mucus thickness, the levels of gastrin (Gas), prostaglandin (PG), prostaglandin E2 (PGE2), endothelin-1 (ET-1) tumor necrosis factor (TNF)-α, interleukin (IL)-1β, IL-6 and IL-10 in serum, the levels of malondialdehyde (MDA), glutathione (GSH), superoxide dismutase (SOD) and myeloperoxidase (MPO) in the gastric mucosa, as well as the expression of vascular endothelial growth factor (VEGF) in the rat's stomach were measured. RESULTS Compared with the Normal group, the other groups showed more severe gastric injury, elevated levels of inflammatory factors (TNF-α, IL-1β, IL-6 and IL-10), elevated levels of MDA and MPO, as well as reduced levels of GSH, SOD and VEGF (all P<0.05). Compared with the Model group, the gastric mucosal lesions in the Teprenone group and the Pantoprazole group were improved significantly (both P<0.05). Compared with the Pantoprazole group, the Teprenone group had reduced levels of ET-1 and elevated levels of PG and PGE2 (all P<0.05). CONCLUSION Teprenone protects against gastric mucosal injury induced by dual antiplatelet therapy through inhibiting gastric mucosal inflammation inhibiting oxidative stress and improving gastric mucosa indices.
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Affiliation(s)
- Xinyang Fu
- Department of Pharmacy, Quanzhou First Hospital Affiliated to Fujian Medical University Quanzhou, Fujian Province, China
| | - Xiaowei Huang
- Department of Pharmacy, Quanzhou First Hospital Affiliated to Fujian Medical University Quanzhou, Fujian Province, China
| | - Zhiqiang Lin
- Department of Pharmacy, Quanzhou First Hospital Affiliated to Fujian Medical University Quanzhou, Fujian Province, China
| | - Shanshan Hong
- Department of Pharmacy, Quanzhou First Hospital Affiliated to Fujian Medical University Quanzhou, Fujian Province, China
| | - Yifeng Cai
- Department of Pharmacy, Quanzhou First Hospital Affiliated to Fujian Medical University Quanzhou, Fujian Province, China
| | - Apei Zhou
- Department of Gastroenterology, Quanzhou First Hospital Affiliated to Fujian Medical University Quanzhou, Fujian Province, China
| | - Namei Wu
- Department of Pharmacy, Quanzhou First Hospital Affiliated to Fujian Medical University Quanzhou, Fujian Province, China
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Lazzeroni D, Moderato L, Marazzi PL, Pellegrino C, Musiari E, Castiglioni P, Camaiora U, Bini M, Geroldi S, Brambilla L, Brambilla V, Coruzzi P. Red blood cell distribution width as a novel prognostic marker after myocardial revascularization or cardiac valve surgery. Sci Rep 2021; 11:7889. [PMID: 33846483 PMCID: PMC8041885 DOI: 10.1038/s41598-021-87075-4] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2020] [Accepted: 02/02/2021] [Indexed: 01/12/2023] Open
Abstract
The red blood cell distribution width (RDW) measures the variability in the size of circulating erythrocytes. Previous studies suggested a powerful correlation between RDW obtained from a standard complete blood count and cardiovascular diseases in both primary and secondary cardiovascular prevention. The current study aimed to evaluate the prognostic role of RDW in patients undergoing cardiac rehabilitation after myocardial revascularization and/or cardiac valve surgery. The study included 1.031 patients with available RDW levels, prospectively followed for a mean of 4.5 ± 3.5 years. The mean age was 68 ± 12 years, the mean RDW was 14.7 ± 1.8%; 492 patients (48%) underwent cardiac rehabilitation after myocardial revascularization, 371 (36%) after cardiac valve surgery, 102 (10%) after valve-plus-coronary artery by-pass graft surgery, 66 (6%) for other indications. Kaplan-Meier analysis and Cox hazard analysis were used to associate RDW with mortality. Kaplan-Meier analysis demonstrated worse survival curves free from overall (log-rank p < 0.0001) and cardiovascular (log-rank p < 0.0001) mortality in the highest RDW tertile. Cox analysis showed RDW levels correlated significantly with the probability of overall (HR 1.26; 95% CI 1.19-1.32; p < 0.001) and cardiovascular (HR 1.31; 95% CI 1.23-1.40; p < 0.001) mortality. After multiple adjustments for cardiovascular risk factors, hemoglobin, hematocrit, C-reactive protein, microalbuminuria, atrial fibrillation, glomerular filtration rate,left ventricular ejection fraction and number of exercise training sessions attended, the increased risk of overall (HR 1.10; 95% CI 1.01-1.27; p = 0.039) and cardiovascular (HR 1.13; 95% CI 1.01-1.34; p = 0.036)mortality with increasing RDW values remained significant. The RDW represents an independent predictor of overall and cardiovascular mortality in secondary cardiovascular prevention patients undergoing cardiac rehabilitation.
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Affiliation(s)
- Davide Lazzeroni
- IRCCS Fondazione Don Carlo Gnocchi, Milan, Italy.
- , Piazzale dei Servi, n°3, 43121, Parma, Italy.
| | | | | | | | | | | | | | | | | | | | | | - Paolo Coruzzi
- Department of Medicine and Surgery, University of Parma, Parma, Italy
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Knychala MA, Garrote-Filho MDS, Batista da Silva B, Neves de Oliveira S, Yasminy Luz S, Marques Rodrigues MO, Penha-Silva N. Red cell distribution width and erythrocyte osmotic stability in type 2 diabetes mellitus. J Cell Mol Med 2021; 25:2505-2516. [PMID: 33591627 PMCID: PMC7933938 DOI: 10.1111/jcmm.16184] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/23/2019] [Revised: 01/30/2020] [Accepted: 11/07/2020] [Indexed: 12/15/2022] Open
Abstract
This study aimed to investigate the relationship between red cell distribution width (RDW) and erythrocyte osmotic stability in non‐diabetic and diabetic individuals in both sexes. The study sample (N = 122) was constituted by 53 type 2 diabetics (DM) and 69 non‐diabetics (ND), being 21 and 22 men in each group, respectively. The osmotic stability of erythrocytes was obtained by the variation in saline concentration (dX) capable of determining hypoosmotic lysis. Higher RDW values and lower serum iron concentrations were found in the diabetic group when compared to the non‐diabetic volunteers. In the group of diabetic women, RDW was positively correlated with the reticulocyte index, and both RDW and dX were negatively correlated with iron, haemoglobin, transferrin saturation index, mean corpuscular haemoglobin and mean corpuscular haemoglobin concentration. In all the groups studied, RDW was positively correlated with dX, especially in the diabetic group, where the correlation was the strongest. RDW elevation in both women and men with type 2 diabetes mellitus was associated with decreased serum iron indicators. Furthermore, RDW has a similar meaning to dX, as small erythrocytes have less haemoglobin, resulting in both an increase of RDW and dX.
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Affiliation(s)
| | | | | | | | - Sarah Yasminy Luz
- Institute of Biotechnology, Federal University of Uberlândia, Uberlândia, Brazil
| | | | - Nilson Penha-Silva
- Institute of Biotechnology, Federal University of Uberlândia, Uberlândia, Brazil
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Wang S, Song C, Cui H, Zhu C, Wu R, Huang X, Lai Y, Wang S. Red blood cell distribution width is associated with adverse cardiovascular events after septal myectomy. J Thorac Dis 2021; 13:582-591. [PMID: 33717531 PMCID: PMC7947493 DOI: 10.21037/jtd-20-2528] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
Background Red blood cell distribution width (RDW) is associated with increased morbidity and mortality in several cardiovascular diseases. However, the prognostic significance of RDW in patients with hypertrophic obstructive cardiomyopathy (HOCM) who underwent septal myectomy remains unclear as no studies have been conducted on this topic. This study aimed to assess the prognostic significance of RDW in these patients. Methods A total of 867 adults with HOCM who underwent septal myectomy at Fuwai Hospital from 2011 to 2017 were retrospectively studied. All patients were assessed comprehensively, including their medical history, echocardiograms, and blood test results. Results The median age of patients was 47.9 [interquartile range (IQR), 37.0–56.0] years and 61.5% of patients were men. During a median follow-up period of 32 (IQR, 17–53) months, 26 patients died and 23 had a cardiovascular death during follow-up. Compared to patients in the lowest RDW quartile, those in the highest quartile had a significantly lower 5-year survival free from all-cause and cardiovascular death (95.9% vs. 87.6%, P<0.001; 95.9% vs. 89.9%, P<0.001). Compared with lower RDW, higher RDW was significantly associated with all-cause and cardiovascular death after adjustment for age, sex, body mass index, and relevant clinical risk factors [per RDW standard deviation (SD) hazard ratio (HR) increase =1.76, 95% confidence interval (CI): 1.54–2.05, P<0.001; per RDW SD HR =1.91, 95% CI: 1.63–2.22, P for trend <0.001]. Conclusions Higher RDW is independently associated with all-cause and cardiovascular death in patients with HOCM after septal myectomy. Therefore, this readily available biomarker could be considered as an additive biomarker for risk stratification in these patients.
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Affiliation(s)
- Shengwei Wang
- Department of Cardiovascular Surgery Center, Beijing Anzhen Hospital, Capital Medical University, Beijing Institute of Heart, Lung and Blood Vascular Diseases, Beijing, China
| | - Changpeng Song
- Department of Special Medical Treatment Center, State Key Laboratory of Cardiovascular Disease, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Hao Cui
- Department of Cardiovascular Surgery, Mayo Clinic, Rochester, Minnesota, USA
| | - Changsheng Zhu
- Department of Cardiovascular Surgery, State Key Laboratory of Cardiovascular Disease, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Rong Wu
- Department of Cardiovascular Surgery, State Key Laboratory of Cardiovascular Disease, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Xiaohong Huang
- Department of Special Medical Treatment Center, State Key Laboratory of Cardiovascular Disease, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Yongqiang Lai
- Department of Cardiovascular Surgery Center, Beijing Anzhen Hospital, Capital Medical University, Beijing Institute of Heart, Lung and Blood Vascular Diseases, Beijing, China
| | - Shuiyun Wang
- Department of Cardiovascular Surgery, State Key Laboratory of Cardiovascular Disease, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
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Jia X, Cheng S, Zhang L, Zheng Y, Zou H, Huang S, Wang H, Lu J, Tang D. Elevated Red Blood Cell Distribution Width as a Poor Prognostic Factor in Patients With Hematopoietic Stem Cell Transplantation. Front Oncol 2021; 10:565265. [PMID: 33537231 PMCID: PMC7848151 DOI: 10.3389/fonc.2020.565265] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2020] [Accepted: 11/30/2020] [Indexed: 12/31/2022] Open
Abstract
Red cell distribution width (RDW), a measure of erythrocyte size variability, has been recently reported as an effective prognostic factor in critical illness. Hematopoietic stem cell transplantation (HSCT) has become the first choice of most patients with hematological malignancies. The aim of this study was to assess the changes of RDW in patients with HSCT and analyze the relationship between RDW and HSCT. In this study, we retrospectively enrolled 114 hematopoietic stem cell transplant patients during the period from 2015 to 2019. Logistic regression and Kaplan-Meier survival analysis were used for retrospective analysis. Multivariate analysis suggested that patients with elevated RDW (>14.5%) at three months post-transplantation have a poor clinical outcome compared with those with normal RDW ≤14.5% [odds ratio (OR) 5.12; P = 0.002]. Kaplan-Meier method analysis demonstrated that patients with elevated RDW levels (>14.5%) after hematopoietic stem cell transplantation experienced shorter progression-free survival compared to those with normal RDW levels (P = 0.008). Our study demonstrated that RDW could be an easily available and potential predictive biomarker for risk stratification in patients with HSCT. Further prospective studies are determined to confirm the prognostic value of RDW in HSCT patients.
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Affiliation(s)
- Xiaojiong Jia
- Department of Laboratory Medicine, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China
| | - Si Cheng
- Department of Orthopaedics, The Second Affiliated Hospital of Chongqing Medical University, Chongqing, China
| | - Long Zhang
- Department of Urinary Surgery, People's Hospital of Jiulongpo District, Chongqing, China
| | - Yuan Zheng
- Department of Laboratory Medicine, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China
| | - Hua Zou
- Department of Laboratory Medicine, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China
| | - Shifeng Huang
- Department of Laboratory Medicine, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China
| | - Hongxu Wang
- Department of Laboratory Medicine, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China
| | - Juan Lu
- Department of Otolaryngology-Head and Neck Surgery, Nanfang Hospital, Southern Medical University, Guangzhou, China
| | - Dijiao Tang
- Department of Laboratory Medicine, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China
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Abdel Hamid WG, Mansour W, Nafea OE. Factors associated with time to successful weaning in mechanically ventilated organophosphate poisoned patients. Drug Chem Toxicol 2021; 45:1748-1753. [PMID: 33430680 DOI: 10.1080/01480545.2020.1870487] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
We designed this study to identify the factors associated with time to successful weaning in mechanically ventilated organophosphate (OP)-poisoned patients as the primary outcomes while duration of mechanical ventilation (MV) support, intensive care unit (ICU), and hospital length of stay (LOS) and in-hospital mortality as the secondary outcomes. We conducted a retrospective study of mechanically ventilated OP-poisoned patients admitted to the ICU of Poison Control Center of Ain Shams, Cairo, Egypt, starting from January 2019 to December 2019. Weaning was considered successful if the patient succeeded in the first spontaneous breathing trial of weaning and did not need reinstitution of MV. We used Cox proportional hazards regression models to identify factors associated with time to successful weaning in the studied patients. A total of 55 patients were enrolled in the study. Thirty-eight patients were weaned successfully. Lower initial red cell distribution width (RDW) levels [adjusted hazard ratio (HR), 0.299, 95% confidence interval (CI) (0.184-0.486)] and lower initial doses of atropine [adjusted HR, 0.97, 95% CI (0.935-0.999)] were independently associated with shorter time to achieve successful weaning. Successfully weaned patients had significantly longer hospital LOS (p = 0.019) and no reported in-hospital mortality (p < 0.001) compared with patients who failed to wean. We concluded that initial RDW and initial doses of atropine were found to be the strongest factors associated with time to successful weaning in mechanically ventilated OP-poisoned patients. RDW and atropine can be used as simple risk assessment tools in OP poisoning.
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Affiliation(s)
- Walaa G Abdel Hamid
- Faculty of Medicine, Department of Forensic Medicine and Clinical Toxicology, Ain Shams University, Cairo, Egypt
| | - Waleed Mansour
- Faculty of Medicine, Chest Department, Zagazig University, Zagazig, Egypt
| | - Ola E Nafea
- Faculty of Medicine, Department of Forensic Medicine and Clinical Toxicology, Zagazig University, Zagazig, Egypt.,Department of Clinical Pharmacy, College of Pharmacy, Taif University, Taif, Saudi Arabia
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107
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Peters JL, Perry MJ, McNeely E, Wright RO, Heiger-Bernays W, Weuve J. The association of cadmium and lead exposures with red cell distribution width. PLoS One 2021; 16:e0245173. [PMID: 33429420 PMCID: PMC7801027 DOI: 10.1371/journal.pone.0245173] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/11/2020] [Accepted: 12/22/2020] [Indexed: 11/19/2022] Open
Abstract
Elevated red blood cell distribution width (RDW), traditionally an indicator of anemia, has now been recognized as a risk marker for cardiovascular disease incidence and mortality. Experimental and acute exposure studies suggest that cadmium and lead individually affect red blood cell production; however, associations between environmental exposures and RDW have not been explored. We evaluated relationships of environmental cadmium and lead exposures to RDW. We used data from 24,607 participants aged ≥20 years in the National Health and Nutrition Examination Survey (2003-2016) with information on blood concentrations of cadmium and lead, RDW and socio-demographic factors. In models adjusted for age, sex, race/ethnicity, education, poverty income ratio, BMI, alcohol consumption, smoking status and serum cotinine, RDW was increasingly elevated across progressively higher quartiles of blood cadmium concentration. A doubling of cadmium concentration was associated with 0.16 higher RDW (95% CI: 0.14, 0.18) and a doubling of lead concentration with 0.04 higher RDW (95% CI: 0.01, 0.06). Also, higher cadmium and lead concentrations were associated with increased odds of high RDW (RDW>14.8%). The associations were more pronounced in women and those with low-to-normal mean corpuscular volume (MCV) and held even after controlling for iron, folate or vitamin B12 deficiencies. In analysis including both metals, cadmium remained associated with RDW, whereas the corresponding association for lead was substantially attenuated. In this general population sample, blood cadmium and lead exposures were positively associated with RDW. The associations may indicate hemolytic or erythropoietic mechanisms by which exposure increases mortality risk.
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Affiliation(s)
- Junenette L. Peters
- Department of Environmental Health, Boston University School of Public Health, Boston, Massachusetts, United States of America
- * E-mail:
| | - Melissa J. Perry
- Department of Environmental and Occupational Health, George Washington University, Washington, District of Columbia, United States of America
| | - Eileen McNeely
- Department of Environmental Health, Harvard T.H. Chan School of Public Health, Boston, Massachusetts, United States of America
| | - Robert O. Wright
- Icahn School of Medicine, Mount Sinai Hospital, New York, New York, United States of America
| | - Wendy Heiger-Bernays
- Department of Environmental Health, Boston University School of Public Health, Boston, Massachusetts, United States of America
| | - Jennifer Weuve
- Department of Epidemiology, Boston University School of Public Health, Boston, Massachusetts, United States of America
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Prognostic Value of Red Blood Cell Distribution Width in Resected pN1 Lung Adenocarcinoma. Cancers (Basel) 2020; 12:cancers12123677. [PMID: 33302343 PMCID: PMC7762373 DOI: 10.3390/cancers12123677] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/02/2020] [Revised: 11/12/2020] [Accepted: 12/07/2020] [Indexed: 12/25/2022] Open
Abstract
Simple Summary Red blood cell distribution width is a measure of the variation of erythrocyte volume. Impaired erythropoiesis can lead to a wide variation in erythrocyte dimension—defined as anisocytosis—indicating that pathological modifications are taking place. Recently, red blood cell distribution width has been advocated as an effective prognostic factor in cardiovascular diseases, acute kidney injury, autoimmune disease, and oncologic settings. In many advanced and several early-stage oncologic conditions, it has shown excellent prognostic efficacy; we therefore investigated what prognostic role red blood cell distribution width may have in resected lung cancer, focusing on pN1 adenocarcinoma patients in whom adjuvant treatments—although well-established—are still proposed case by case. Our findings suggest that red blood cell distribution width is strictly related to disease-free survival; it could therefore be considered as a further tool for planning postoperative adjuvant treatments and setting up an adequate follow-up program. Abstract Background: Red blood cell distribution width is a measure of the variation of erythrocyte volume and has recently been advocated as a prognostic tool in neoplastic and non-neoplastic diseases. We studied the prognostic role of preoperative red blood cell distribution width (RDW) in resected pN1 lung adenocarcinoma patients. Methods: Sixty-seven consecutive pN1 lung adenocarcinoma patients operated in the last two years were retrospectively evaluated in the present study. Age, sex, smoking status, type of surgical resection, neoadjuvant and adjuvant treatments, pathological stage, T and N status, tumor size, preoperative hemoglobin (Hb) and RDW, preoperative neutrophils, lymphocytes, and their ratio were collected for each patient. Outpatient follow-up was performed and date of relapse was recorded. Results: There were 24 females (35.8%). Twenty-eight patients (41.8%) belonged to stage 3A and thirty-nine patients (58.2%) to stage 2B. Mean preoperative RDW % was 14.1 (IQR: 12.9–14.8). Univariate analysis disclosed preoperative RDW as strictly related to disease-free survival (p = 0.02), which was confirmed in the exploratory multivariable analysis (p = 0.003). Conclusions: Pre-operative RDW is an effective prognostic factor of disease-free survival in resected pN1 lung adenocarcinoma; it could therefore be considered as a further tool for planning postoperative adjuvant treatments and setting up an adequate follow-up program.
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Tural K, Kara F, Avcı S, Erdoğdu Hİ. CAN COMPLETE BLOOD CELL COUNT PARAMETERS PREDICT DEEP VEIN THROMBOSIS? Acta Clin Croat 2020; 59:661-666. [PMID: 34285436 PMCID: PMC8253064 DOI: 10.20471/acc.2020.59.04.12] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2018] [Accepted: 10/19/2018] [Indexed: 01/30/2023] Open
Abstract
The aim of this study was to evaluate complete blood cell count parameters including red blood cell indices, white blood cell subtypes, and platelet indices for predicting deep vein thrombosis (DVT). A total of 71 (44 male and 27 female) patients with acute femoral and popliteal DVT diagnosed by doppler ultrasonography during a period of seven years (2011-2017) were included in the study. By matching age and gender, 142 (88 male and 54 female) subjects diagnosed with venous insufficiency in the same time interval were assigned as control group. Data were obtained by reviewing hospital records of the study participants, including clinical and demographic characteristics and complete blood cell parameters. Frequencies of hypertension, diabetes mellitus, chronic obstructive pulmonary disease, chronic renal failure, and coronary arterial disease were higher in DVT group as compared to non-DVT group (p<0.05). Hemoglobin and lymphocyte values were lower, and red blood cell distribution width, neutrophil, neutrophil to lymphocyte ratio, and platelet to lymphocyte ratio higher in DVT group as compared with non-DVT group (p<0.05). There was no significant between-group difference in terms of mean corpuscular volume, platelet, mean platelet volume, mean platelet volume to platelet ratio, and platelet distribution width (p>0.05). Hypertension, hemoglobin, neutrophil to lymphocyte ratio, and platelet to lymphocyte ratio were independent risk factors for DVT. We found that hypertension, anemia, neutrophil to lymphocyte ratio, and platelet to lymphocyte ratio were independent risk factors for DVT. In particular, neutrophil to lymphocyte ratio and hemoglobin may be used as novel, inexpensive, and reliable diagnostic tools for DVT.
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Affiliation(s)
| | - Fatih Kara
- 1Kafkas University, Medical Faculty, Department of Cardiovascular Surgery, Kars, Turkey; 2Kafkas University, Medical Faculty, Department of Biochemistry, Kars, Turkey; 3Amasya University, Medical Faculty, Department of Emergency Medicine, Amasya, Turkey; 4Kafkas University, Medical Faculty, Department of Internal Medicine, Kars, Turkey
| | - Sema Avcı
- 1Kafkas University, Medical Faculty, Department of Cardiovascular Surgery, Kars, Turkey; 2Kafkas University, Medical Faculty, Department of Biochemistry, Kars, Turkey; 3Amasya University, Medical Faculty, Department of Emergency Medicine, Amasya, Turkey; 4Kafkas University, Medical Faculty, Department of Internal Medicine, Kars, Turkey
| | - Halil İbrahim Erdoğdu
- 1Kafkas University, Medical Faculty, Department of Cardiovascular Surgery, Kars, Turkey; 2Kafkas University, Medical Faculty, Department of Biochemistry, Kars, Turkey; 3Amasya University, Medical Faculty, Department of Emergency Medicine, Amasya, Turkey; 4Kafkas University, Medical Faculty, Department of Internal Medicine, Kars, Turkey
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Rezaeifar P, Nouri-Vaskeh M, Nazemiyeh M, Dorraji A, Sharifi A. Clinical Utility of Red Cell Distribution Width in Patients with Pleural Effusion. TANAFFOS 2020; 19:364-370. [PMID: 33959174 PMCID: PMC8088153] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
BACKGROUND The red cell distribution width (RDW) value has been recently recognized as a valuable biomarker in clinical practice. The RDW value has not been evaluated so far in patients with pleural effusion. Thus, this study aimed to investigate whether RDW could distinguish between exudative and transudative pleural effusions. MATERIALS AND METHODS We measured protein and lactate dehydrogenase levels on both pleural fluids and serum samples from 223 cases and classified them as transudates or exudates based on the classic Light's criteria. We collected blood cell count elements such as RDW from the medical records. We also investigated the correlation between RDW and the nature of pleural effusion. RESULTS In 55.2% of the patients, pleural fluid was exudative. Although we found no significant association between RDW and the nature of the pleural fluid, we detected a significantly higher amount of RDW (14.9 ≤) in patients with exudative pleural effusion compared to transudate (66.7% vs. 33.3%; P= 0.01). In this category, neoplastic conditions were mostly observed in the patients (76.3%), followed by pulmonary thromboembolism (21.1%) and systemic lupus erythematous (2.6%). CONCLUSION The findings could not reveal any noticeable correlation between RDW and the Light criteria. However, it appears that elevated RDW levels give insights into the valuable nature of RDW in different conditions such as neoplastic diseases.
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Affiliation(s)
- Parisa Rezaeifar
- Tuberculosis and Lung Diseases Research Center, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Masoud Nouri-Vaskeh
- Immunology Research Center, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Masoud Nazemiyeh
- Tuberculosis and Lung Diseases Research Center, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Amir Dorraji
- Tuberculosis and Lung Diseases Research Center, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Akbar Sharifi
- Tuberculosis and Lung Diseases Research Center, Tabriz University of Medical Sciences, Tabriz, Iran,,Correspondence to: Sharifi A Address: Tuberculosis and Lung Diseases Research Center, Tabriz University of Medical Sciences, Tabriz, Iran Email address:
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Hu Y, He B, Han Z, Wang Y, Tao C, Wang Y, Jin H, Du J. Risk Factors for Orthostatic Hypertension in Children. J Pediatr 2020; 227:212-217.e1. [PMID: 32668285 DOI: 10.1016/j.jpeds.2020.07.030] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/04/2020] [Revised: 07/05/2020] [Accepted: 07/08/2020] [Indexed: 10/23/2022]
Abstract
OBJECTIVE To investigate the risk factors for orthostatic hypertension in children. STUDY DESIGN Eighty children with orthostatic hypertension were enrolled in the group with orthostatic hypertension, and 51 healthy children served as the control group. Demographic characteristics, clinical history, daily water intake, nightly sleep duration, the results of the standing test, and complete blood count were recorded and compared between the 2 groups. The risk factors for pediatric orthostatic hypertension were determined by logistic regression analysis. RESULTS Body mass index and red blood cell distribution width were higher in the group with orthostatic hypertension than in healthy children, whereas daily water intake and sleep duration were lower. Logistic regression analyses showed that, if a child suffered from overweight, suffered from obesity, had a daily water intake of less than 800 mL, or had a red blood cell distribution width that was increased by 1%, the risk of orthostatic hypertension would be increased by 6.069 times (95% CI, 1.375-26.783; P < .05), 7.482 times (95% CI, 1.835-30.515; P < .01), 4.027 times (95% CI, 1.443-11.241; P < .01), or 4.008 times (95% CI, 1.698-9.461; P < .01), respectively. However, if the sleep duration was increased by 1 hour, the risk of developing orthostatic hypertension would be decreased by 74.3% (95% CI, 54.6%-85.4%, P < .01). CONCLUSIONS Increased body mass index, inadequate water intake and sleep duration, and elevated red blood cell distribution width were identified as risk factors for pediatric orthostatic hypertension.
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Affiliation(s)
- Yang Hu
- Department of Pediatrics, Peking University First Hospital, Beijing, China; Research Unit of Clinical Diagnosis and Treatment of Pediatric Syncope and Cardiovascular Diseases, Chinese Academy of Medical Sciences, Beijing, China
| | - Bing He
- Department of Pediatrics, People's Hospital of Wuhan University, Hubei, China
| | - Zhenhui Han
- Department of Pediatrics, Children's Hospital of Kaifeng, Henan, China
| | - Yuanyuan Wang
- Department of Pediatrics, Peking University First Hospital, Beijing, China
| | - Chunyan Tao
- Department of Pediatrics, Peking University First Hospital, Beijing, China
| | - Yaru Wang
- Department of Pediatrics, Peking University First Hospital, Beijing, China
| | - Hongfang Jin
- Department of Pediatrics, Peking University First Hospital, Beijing, China.
| | - Junbao Du
- Department of Pediatrics, Peking University First Hospital, Beijing, China; Key Laboratory of Cardiovascular Sciences, Ministry of Education, Beijing, China.
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112
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Initial red cell distribution width as a predictor of poor neurological outcomes in out-of-hospital cardiac arrest survivors in a prospective, multicenter observational study (the KoCARC study). Sci Rep 2020; 10:17549. [PMID: 33067528 PMCID: PMC7568563 DOI: 10.1038/s41598-020-74842-y] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2019] [Accepted: 10/06/2020] [Indexed: 12/29/2022] Open
Abstract
This study aimed to investigate whether the initial red cell distribution width (RDW) at the emergency department (ED) is associated with poor neurological outcomes in out-of-hospital cardiac arrest (OHCA) survivors. We performed a prospective observational analysis of patients admitted to the ED between October 2015 and June 2018 from the Korean Cardiac Arrest Research Consortium registry. We included OHCA patients who visited the ED and achieved return of spontaneous circulation. Initial RDW values were measured at the time of the ED visit. The primary outcome was a poor neurological (Cerebral Performance Category, or CPC) score of 3–5. A total of 1008 patients were ultimately included in this study, of whom 712 (70.6%) had poor CPC scores with unfavorable outcomes. Higher RDW quartiles (RDW 13.6–14.9%, RDW ≥ 15.0%), older age, female sex, nonshockable initial rhythm at the scene, unwitnessed cardiac arrest, bystander cardiopulmonary resuscitation (CPR), medical history, low white blood cell counts and high glucose levels were associated with poor neurological outcomes in univariate analysis. In multivariate analysis, the highest RDW quartile was independently associated with poor neurological outcomes (odds ratio 2.04; 95% confidence interval 1.12–3.69; p = 0.019) at hospital discharge after adjusting for other confounding factors. Other independent factors including age, initial rhythm, bystander CPR and high glucose were also associated with poor neurological outcomes. These results show that an initial RDW in the highest quartile as of the ED visit is associated with poor neurological outcomes at hospital discharge among OHCA survivors.
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113
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Chang TI, Wu X, Boström KI, Tran HA, Friedlander AH. Red Cell Distribution Width, Unlike Neutrophil Lymphocyte Ratio Is Unable to Accurately Gauge Enhanced Systemic Inflammation Associated With Panoramic Imaged Carotid Plaque. Mil Med 2020; 186:39-43. [PMID: 33005942 DOI: 10.1093/milmed/usaa302] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2020] [Revised: 07/15/2020] [Accepted: 08/14/2020] [Indexed: 11/13/2022] Open
Abstract
INTRODUCTION We have previously shown that panoramic X-rays (PXs) demonstrating calcified carotid artery atheromas (CCAA) are associated with increased systemic inflammation demonstrating increased neutrophil lymphocyte ratios (NLRs), a validated risk indicator of fatal myocardial infarctions arising from coronary artery atherosclerosis. Using this same cohort of patients (with minor adjustments because of missing data), we sought to determine if a like association existed between PXs evidencing CCAA and elevated red blood cell distribution width (RDW) given conflicting data as its reliability relative to NLR as a biologic marker of system inflammation. We hypothesized that CCAAs on PXs would simultaneously be associated with both increased NLR and RDW. MATERIALS AND METHODS Investigators implemented a cross-sectional study design. Study sample consisted of patient medical records and PXs of white men ≥ 55 years. Two groups (N = 50 each) were constituted, one with atheromas (CCAA+) and without atheromas (CCAA-). The predictor variable was CCAA+ and outcome variables were NLR and RDW. Bootstrapping analysis was employed to analyze the differences in mean NLRs and RDWs between groups since the data was not normally distributed. Statistical significance determined to be ≤ 0.05 for all tests. The Medical Center's Institutional Review Board approved the research protocol. RESULTS A study group of 50 CCAA+ men (mean age 71; range 58-89 years) demonstrated a mean NLR of 2.98 ± 1.38 and an RDW of 13.21 ± 0.85. A control group of 50 CCAA- males (mean age 70 range; 55-91 years) evidenced a mean NLR of 2.38 ± 0.77 and an RDW of 13.16 ± 0.77. Bootstrapping comparison of NLR values evidenced significant (P = 0.008) difference (95% confidence interval of difference of mean: - 0.4272, 0.4384; observed effect size: 0.579) between groups; however, there was no significant difference in RDW values between the groups. Furthermore, logistic regression modeling demonstrated that for a one unit increase in NLR the odds of being CCAA+ (vs. CCAA-) increases by a factor of 1.659. CONCLUSION The existence of CCAA seen on PXs of elderly white men is associated with significantly (P = 0.008) elevated NLR values but is not associated with increases in RDW.
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Affiliation(s)
- Tina I Chang
- Dental Service, Veterans Affairs Greater Los Angeles Healthcare System, Los Angeles, CA 90073, USA
| | - Xiuju Wu
- Department of Cardiology, David Geffen/University of California, Los Angeles, Los Angeles, CA 90095, USA
| | - Kristina I Boström
- Cardiology Division, Veterans Affairs Greater Los Angeles Healthcare System, Los Angeles, CA 90073, USA
| | - Hoang-Anh Tran
- Dental Service, Veterans Affairs Greater Los Angeles Healthcare System, Los Angeles, CA 90073, USA
| | - Arthur H Friedlander
- Graduate Medical Education, Veterans Affairs Greater Los Angeles Healthcare System, Los Angeles, CA 90073, USA
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114
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Red cell distribution width levels in Parkinson's disease patients. Acta Neurol Belg 2020; 120:1147-1150. [PMID: 31367945 DOI: 10.1007/s13760-019-01197-1] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2019] [Accepted: 07/23/2019] [Indexed: 12/28/2022]
Abstract
Parkinson's disease (PD) is a neurodegenerative disorder with motor and non-motor impairment. It has been known for a while that oxidative stress, protein changes and mitochondrial dysfunction have the role of contribution to the pathogenesis. Disturbance of red blood cell function may play a role in the pathophysiology of neurodegenerative diseases such as Huntington's, Parkinson's and Alzheimer's disease. RDW was found to be strongly associated with inflammatory markers in diseases such as acute pancreatitis, myocardial injury and hepatocellular carcinoma. The data about RDW levels and PD are scarce. In this study, we aimed to investigate the RDW values and their relationship with the severity of the disease in patients with Parkinson's disease. 94 patients with Parkinson's disease were included into the study, 97 healthy individuals without history of PD were considered as control group. The United Parkinson's Disease Rating Scale (UPDRS) and the modified Hoehn and Yahr staging scale were used to assess the severity of PD. Although RDW levels were significantly higher than the healthy subjects, there was not any relation between the severity of PD, duration of the disease, RDW levels, other blood parameters, mean UPDRS score or mean mH&Y score. In conclusion, RDW levels are higher than the healthy subjects in PD patients but there is no relation between RDW levels and disease duration. Larger studies are needed to explain the role of RDW as an inflammatory marker.
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115
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Silva NCD, Prestes IV, Gontijo WA, Pena GDG. High red blood cell distribution width is associated with a risk of short-term mortality in hospitalized surgical, but not clinical patients. Clin Nutr ESPEN 2020; 39:150-156. [PMID: 32859310 DOI: 10.1016/j.clnesp.2020.06.023] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2019] [Revised: 06/29/2020] [Accepted: 06/30/2020] [Indexed: 12/06/2022]
Abstract
BACKGROUND & AIMS The distribution width of red blood cells (RDW) is a known factor risk for mortality. However, the association between high RDW and short-term mortality in surgical patients is poorly understood. The aim of this study was to evaluate the association of high RDW with all-cause in-hospital mortality, in surgical and non-surgical patients. METHODS A retrospective study was performed with patients aged 18 years or older, hospitalized in Clinical Medical and Surgery wards, using adjustments based on a conceptual model. Cox regression was used to determine the independent predictors of in-hospital mortality. The RDW cutoff value was 13.6%. RESULTS Of the 2923 patients, 46.1% were over 60 years old, 58.7% were male and 4.7% died. The area under the ROC curve was 0.677 (CI 95%: 0.619-0.712). RDW was associated with an adjusted risk for all-cause in-hospital mortality in surgical (HR 1.17 - CI 95%: 1.03-1.32), but not in clinical patients. For every 1% increase in RDW, the risk of all-cause hospital death in surgical patients increased by 17%. RDW ≥13.6% was associated with an adjusted risk of all cause in-hospital mortality in surgical (HR 2.65 - 95%CI: 1.22-5.73), but not in clinical patients. CONCLUSIONS High RDW was associated with a risk of in-hospital mortality independent of age, sex, hemoglobin level, multimorbidity, nutritional status and immunological condition. We therefore recommend the use of RDW as a possible marker of mortality risk in clinical practice in surgical patients.
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Affiliation(s)
- Nayara Cristina da Silva
- Graduate Program in Health Sciences, Federal University of Uberlandia, Pará Av, 1720, Campus Umuarama, 38400-902, Uberlândia, Minas Gerais, Brazil.
| | - Isaías Valente Prestes
- Statistician, Federal University of Rio Grande Do Sul, Ramiro Barcelos St., 2600, Sala 414, 90035-003, Porto Alegre, Rio Grande do Sul, Brazil.
| | - Wander Antônio Gontijo
- Systems Analyst, Clinical Hospital of the Federal University of Uberlandia, Pará Av., 1720, Bloco 2Y, Campus Umuarama, CEP: 38400-902, Uberlândia, Minas Gerais, Brazil.
| | - Geórgia das Graças Pena
- Graduate Program in Health Sciences, Federal University of Uberlandia, Pará Av, 1720, Campus Umuarama, 38400-902, Uberlândia, Minas Gerais, Brazil.
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116
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Thavaraputta S, Dennis JA, Ball S, Laoveeravat P, Nugent K. Relation of hematologic inflammatory markers and obesity in otherwise healthy participants in the National Health and Nutrition Examination Survey, 2011-2016. Proc (Bayl Univ Med Cent) 2020; 34:17-21. [PMID: 33456138 DOI: 10.1080/08998280.2020.1799482] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/10/2023] Open
Abstract
This study investigated the association between hematologic inflammatory markers derived from complete blood counts and obesity. We undertook a cross-sectional study that included self-reported healthy subjects above the age of 18 years from the 2011-2016 National Health and Nutrition Examination Survey, a US population database. Study parameters included mean corpuscular volume, red cell distribution width, mean platelet volume, total platelet count, neutrophil-to-lymphocyte ratio, platelet-to-lymphocyte ratio, and systemic immune-inflammation index. Body mass index was used as an index of obesity and was correlated with each hematologic inflammatory marker. Our analysis found a statistically significant association between each inflammatory parameter and higher body mass indices. We demonstrated an association between complete blood count-derived indices of inflammation and obesity, and these results provide the basis for future studies using complete blood count-derived variables and outcomes in patients with some chronic diseases.
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Affiliation(s)
- Subhanudh Thavaraputta
- Department of Internal Medicine, Texas Tech University Health Sciences Center, Lubbock, Texas.,Division of Endocrinology and Metabolism, Department of Medicine, University of Pittsburgh, Pittsburgh, Pennsylvania
| | - Jeff A Dennis
- Department of Public Health, Texas Tech University Health Sciences Center, Lubbock, Texas
| | - Somedeb Ball
- Department of Internal Medicine, Texas Tech University Health Sciences Center, Lubbock, Texas
| | - Passisd Laoveeravat
- Department of Internal Medicine, Texas Tech University Health Sciences Center, Lubbock, Texas
| | - Kenneth Nugent
- Department of Internal Medicine, Texas Tech University Health Sciences Center, Lubbock, Texas
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117
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Rezaee M, Putrenko I, Takeh A, Ganna A, Ingelsson E. Development and validation of risk prediction models for multiple cardiovascular diseases and Type 2 diabetes. PLoS One 2020; 15:e0235758. [PMID: 32726343 PMCID: PMC7390268 DOI: 10.1371/journal.pone.0235758] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/26/2019] [Accepted: 06/22/2020] [Indexed: 12/20/2022] Open
Abstract
Accurate risk assessment of an individuals’ propensity to develop cardiovascular diseases (CVDs) is crucial for the prevention of these conditions. Numerous published risk prediction models used for CVD risk assessment are based on conventional risk factors and include only a limited number of biomarkers. The addition of novel biomarkers can boost the discriminative ability of risk prediction models for CVDs with different pathogenesis. The present study reports the development of risk prediction models for a range of heterogeneous CVDs, including coronary artery disease (CAD), stroke, deep vein thrombosis (DVT), and abdominal aortic aneurysm (AAA), as well as for Type 2 diabetes mellitus (DM2), a major CVD risk factor. In addition to conventional risk factors, the models incorporate various blood biomarkers and comorbidities to improve both individual and population stratification. An automatic variable selection approach was developed to generate the best set of explanatory variables for each model from the initial panel of risk factors. In total, up to 254,220 UK Biobank participants (ranging from 215,269 to 254,220 for different CVDs and DM2) were included in the analyses. The derived prediction models utilizing Cox proportional hazards regression achieved consistent discrimination performance (C-index) for all diseases: CAD, 0.794 (95% CI, 0.787–0.801); DM2, 0.909 (95% CI, 0.903–0.916); stroke, 0.778 (95% CI, 0.756–0.801); DVT, 0.743 (95% CI, 0.737–0.749); and AAA, 0.893 (95% CI, 0.874–0.912). When validated on various subpopulations, they demonstrated higher discrimination in healthier and middle-age individuals. In general, calibration of a five-year risk of developing the CVDs and DM2 demonstrated incremental overestimation of disease-related conditions amongst the highest decile of risk probabilities. In summary, the risk prediction models described were validated with high discrimination and good calibration for several CVDs and DM2. These models incorporate multiple shared predictor variables and may be integrated into a single platform to enhance clinical stratification to impact health outcomes.
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Affiliation(s)
- Mehrdad Rezaee
- Mynomx Inc., Palo Alto, CA, United States of America
- Cardiac and Vascular Care Inc., San Jose, CA, United States of America
- * E-mail:
| | - Igor Putrenko
- Mynomx Inc., Palo Alto, CA, United States of America
| | - Arsia Takeh
- Mynomx Inc., Palo Alto, CA, United States of America
| | - Andrea Ganna
- Program in Medical and Population Genetics, Broad Institute of MIT and Harvard, Cambridge, MA, United States of America
- Stanley Center for Psychiatric Research, Broad Institute of MIT and Harvard, Cambridge, MA, United States of America
- Analytic and Translational Genetics Unit, Department of Medicine, Massachusetts General Hospital, Boston, MA, United States of America
| | - Erik Ingelsson
- Division of Cardiovascular Medicine, Department of Medicine, Stanford University School of Medicine, Stanford, CA, United States of America
- Stanford Cardiovascular Institute, Stanford, CA, United States of America
- Stanford Diabetes Research Center, Stanford, CA, United States of America
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Santi D, Spaggiari G, Casonati A, Casarini L, Grassi R, Vecchi B, Roli L, De Santis MC, Orlando G, Gravotta E, Baraldi E, Setti M, Trenti T, Simoni M. Multilevel approach to male fertility by machine learning highlights a hidden link between haematological and spermatogenetic cells. Andrology 2020; 8:1021-1029. [PMID: 32449608 DOI: 10.1111/andr.12826] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2020] [Revised: 05/15/2020] [Accepted: 05/19/2020] [Indexed: 12/13/2022]
Abstract
BACKGROUND Male infertility represents a complex clinical condition requiring an accurate multilevel assessment, in which machine learning technology, combining large data series in non-linear and highly interactive ways, could be innovatively applied. METHODS A longitudinal, observational, retrospective, big data study was carried out, applying for the first time the ML in the context of male infertility. A large database including all semen samples collected between 2010 and 2016 was generated, together with blood biochemical examinations, environmental temperature and air pollutants exposure. First, the database was analysed with principal component analysis and multivariable linear regression analyses. Second, classification analyses were performed, in which patients were a priori classified according to semen parameters. Third, machine learning algorithms were applied in a training phase (80% of the entire database) and in a tuning phase (20% of the data set). Finally, conventional statistical analyses were applied considering semen parameters and those other variables extracted during machine learning. RESULTS The final database included 4239 patients, aggregating semen analyses, blood and environmental parameters. Classification analyses were able to recognize oligozoospermic, teratozoospermic, asthenozoospermic and patients with altered semen parameters (0.58 accuracy, 0.58 sensitivity and 0.57 specificity). Machine learning algorithms detected three haematological variables, that is lymphocytes number, erythrocyte distribution and mean globular volume, significantly related to semen parameters (0.69 accuracy, 0.78 sensitivity and 0.41 specificity). CONCLUSION This is the first machine learning application to male fertility, detecting potential mathematical algorithms able to describe patients' semen characteristics changes. In this setting, a possible hidden link between testicular and haematopoietic tissues was suggested, according to their similar proliferative properties.
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Affiliation(s)
- Daniele Santi
- Unit of Endocrinology, Department of Biomedical, Metabolic and Neural Sciences, University of Modena and Reggio Emilia, Modena, Italy.,Unit of Endocrinology, Department of Medical Specialties, Azienda Ospedaliero-Universitaria of Modena, Modena, Italy
| | - Giorgia Spaggiari
- Unit of Endocrinology, Department of Medical Specialties, Azienda Ospedaliero-Universitaria of Modena, Modena, Italy
| | | | - Livio Casarini
- Unit of Endocrinology, Department of Biomedical, Metabolic and Neural Sciences, University of Modena and Reggio Emilia, Modena, Italy.,Center for the Genomic Research, University of Modena and Reggio Emilia, Modena, Italy
| | | | | | - Laura Roli
- Department of Laboratory Medicine and Anatomy Pathology, Azienda USL of Modena, Modena, Italy
| | | | | | - Enrica Gravotta
- Medical Affairs Fertility EMEA, Merck KGaA, Darmstadt, Germany
| | - Enrica Baraldi
- Department of Laboratory Medicine and Anatomy Pathology, Azienda USL of Modena, Modena, Italy
| | - Monica Setti
- Service of Clinical Engineering, Azienda Ospedaliero-Universitaria of Modena, Modena, Italy
| | - Tommaso Trenti
- Department of Laboratory Medicine and Anatomy Pathology, Azienda USL of Modena, Modena, Italy
| | - Manuela Simoni
- Unit of Endocrinology, Department of Biomedical, Metabolic and Neural Sciences, University of Modena and Reggio Emilia, Modena, Italy.,Unit of Endocrinology, Department of Medical Specialties, Azienda Ospedaliero-Universitaria of Modena, Modena, Italy
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119
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Hong RH, Zhu J, Li ZZ, Yuan J, Zhao P, Ding J, Fan QL, Yang J, Liu BG, Cai J, Zhu DS, Guan YT. Red blood cell distribution width is associated with neuronal damage in acute ischemic stroke. Aging (Albany NY) 2020; 12:9855-9867. [PMID: 32445553 PMCID: PMC7288978 DOI: 10.18632/aging.103250] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2020] [Accepted: 04/20/2020] [Indexed: 12/16/2022]
Abstract
Elevated red blood cell distribution width (RDW) has been found to be associated with the occurrence of ischemic stroke. However, there is no defined relationship between RDW and neuronal damage in acute ischemic stroke (AIS). This study was designed to determine the relationship between RDW and neuronal damage in AIS patients. A total of 442 consecutive AIS patients from January 2018 to June 2019 were evaluated for neuronal damage, which was estimated by serum neuron-specific enolase (NSE) levels. Red blood cell distribution width-standard deviation (RDW-SD), a parameter that reflects the heterogeneity of red blood cell volume, was also assessed. We evaluated the association between the RDW-SD and serum NSE level through multivariate-adjusted linear regression analysis. Both the serum NSE level and the incidence of high NSE increased according to the increased RDW-SD tertile in AIS patients (p<0.01). There was a positive correlation between RDW-SD and serum NSE levels (r=0.275, 95% CI: 0.187-0.359, p<0.001). The beta coefficients (95% CI) between RDW-SD and serum NSE levels were 0.32 (0.21-0.42, p<0.001) and 0.26 (0.15-0.38, p<0.001), respectively, in AIS patients before and after adjusting for potential confounders. In conclusion, we found a significant positive association between RDW-SD and neuronal damage in AIS patients.
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Affiliation(s)
- Rong-Hua Hong
- Department of Neurology, Baoshan Branch, Renji Hospital, School of Medicine, Shanghai Jiaotong University, Shanghai 200444, China
| | - Jian Zhu
- Department of Neurology, Baoshan Branch, Renji Hospital, School of Medicine, Shanghai Jiaotong University, Shanghai 200444, China
| | - Ze-Zhi Li
- Department of Neurology, Renji Hospital, School of Medicine, Shanghai Jiaotong University, Shanghai 200127, China
| | - Jian Yuan
- Department of Neurology, Baoshan Branch, Renji Hospital, School of Medicine, Shanghai Jiaotong University, Shanghai 200444, China
| | - Pei Zhao
- Department of Neurology, Baoshan Branch, Renji Hospital, School of Medicine, Shanghai Jiaotong University, Shanghai 200444, China
| | - Jie Ding
- Department of Neurology, Renji Hospital, School of Medicine, Shanghai Jiaotong University, Shanghai 200127, China
| | - Qing-Lei Fan
- Department of Neurology, Baoshan Branch, Renji Hospital, School of Medicine, Shanghai Jiaotong University, Shanghai 200444, China
| | - Jin Yang
- Department of Neurology, Baoshan Branch, Renji Hospital, School of Medicine, Shanghai Jiaotong University, Shanghai 200444, China
| | - Bao-Guo Liu
- Department of Neurology, Baoshan Branch, Renji Hospital, School of Medicine, Shanghai Jiaotong University, Shanghai 200444, China
| | - Jian Cai
- Department of Neurology, Baoshan Branch, Renji Hospital, School of Medicine, Shanghai Jiaotong University, Shanghai 200444, China.,Department of Neurology, Renji Hospital, School of Medicine, Shanghai Jiaotong University, Shanghai 200127, China
| | - De-Sheng Zhu
- Department of Neurology, Baoshan Branch, Renji Hospital, School of Medicine, Shanghai Jiaotong University, Shanghai 200444, China.,Department of Neurology, Renji Hospital, School of Medicine, Shanghai Jiaotong University, Shanghai 200127, China
| | - Yang-Tai Guan
- Department of Neurology, Renji Hospital, School of Medicine, Shanghai Jiaotong University, Shanghai 200127, China
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Silva M, Vargas S, Coelho A, Ferreira E, Mendonça J, Vieira L, Maia R, Dias A, Ferreira T, Morais A, Soares IM, Lavinha J, Silva R, Kjöllerström P, Faustino P. Biomarkers and genetic modulators of cerebral vasculopathy in sub-Saharan ancestry children with sickle cell anemia. Blood Cells Mol Dis 2020; 83:102436. [PMID: 32434137 DOI: 10.1016/j.bcmd.2020.102436] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2020] [Revised: 04/05/2020] [Accepted: 04/05/2020] [Indexed: 01/18/2023]
Abstract
We investigated biomarkers and genetic modulators of the cerebral vasculopathy (CV) subphenotype in pediatric sickle cell anemia (SCA) patients of sub-Saharan African ancestry. We found that one VCAM1 promoter haplotype (haplotype 7) and VCAM1 single nucleotide variant rs1409419_T were associated with stroke events, stroke risk, as measured by time-averaged mean of maximum velocity in the middle cerebral artery, and with high serum levels of the hemolysis biomarker lactate dehydrogenase. Furthermore, VCAM-1 ligand coding gene ITGA4 variants rs113276800_A and rs3770138_T showed a positive association with stroke events. An additional positive relationship between a genetic variant and stroke risk was observed for ENPP1 rs1044498_A. Conversely, NOS3 variants were negatively associated with silent cerebral infarct events (VNTR 4b_allele and haplotype V) and CV globally (haplotype VII). The -alpha3.7kb-thal deletion did not show association with CV. However, it was associated with higher red blood cell and neutrophil counts, and lower mean corpuscular volume, mean corpuscular hemoglobin and red cell distribution width. Our results underline the importance of genetic modulators of the CV sub-phenotype and their potential as SCA therapeutic targets. We also propose that a biomarker panel comprising biochemical, hematological, imaging and genetic data would be instrumental for CV prediction, and prevention.
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Affiliation(s)
- Marisa Silva
- Departamento de Genética Humana, Instituto Nacional de Saúde Dr. Ricardo Jorge, Lisbon, Portugal
| | - Sofia Vargas
- Departamento de Genética Humana, Instituto Nacional de Saúde Dr. Ricardo Jorge, Lisbon, Portugal
| | - Andreia Coelho
- Departamento de Genética Humana, Instituto Nacional de Saúde Dr. Ricardo Jorge, Lisbon, Portugal
| | - Emanuel Ferreira
- Departamento de Genética Humana, Instituto Nacional de Saúde Dr. Ricardo Jorge, Lisbon, Portugal
| | - Joana Mendonça
- Departamento de Genética Humana, Instituto Nacional de Saúde Dr. Ricardo Jorge, Lisbon, Portugal
| | - Luís Vieira
- Departamento de Genética Humana, Instituto Nacional de Saúde Dr. Ricardo Jorge, Lisbon, Portugal; ToxOmics, Faculdade de Ciências Médicas, Universidade Nova de Lisboa, Lisboa, Portugal
| | - Raquel Maia
- Unidade de Hematologia, Hospital de Dona Estefânia, Centro Hospitalar Universitário de Lisboa Central (CHULC), Lisbon, Portugal
| | - Alexandra Dias
- Núcleo de Hematologia, Departamento de Pediatria, Hospital Prof. Doutor Fernando Fonseca, Amadora, Portugal
| | - Teresa Ferreira
- Núcleo de Hematologia, Departamento de Pediatria, Hospital Prof. Doutor Fernando Fonseca, Amadora, Portugal
| | - Anabela Morais
- Departamento de Pediatria, Hospital de Santa Maria, Centro Hospitalar Universitário de Lisboa Norte, Lisbon, Portugal
| | | | - João Lavinha
- Departamento de Genética Humana, Instituto Nacional de Saúde Dr. Ricardo Jorge, Lisbon, Portugal; BioISI, Faculdade de Ciências, Universidade de Lisboa, Lisbon, Portugal
| | - Rita Silva
- Unidade de Neuropediatria, Hospital de Dona Estefânia, CHULC, Lisbon, Portugal
| | - Paula Kjöllerström
- Unidade de Hematologia, Hospital de Dona Estefânia, Centro Hospitalar Universitário de Lisboa Central (CHULC), Lisbon, Portugal
| | - Paula Faustino
- Departamento de Genética Humana, Instituto Nacional de Saúde Dr. Ricardo Jorge, Lisbon, Portugal; Instituto de Saúde Ambiental (ISAMB), Faculdade de Medicina, Universidade de Lisboa, Lisbon, Portugal.
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The interaction between current smoking and hemoglobin on the risk of advanced fibrosis in patients with biopsy-proven nonalcoholic fatty liver disease. Eur J Gastroenterol Hepatol 2020; 32:597-600. [PMID: 31524771 DOI: 10.1097/meg.0000000000001536] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
BACKGROUND Higher hemoglobin levels have been associated with an increased risk for nonalcoholic fatty liver disease. Although the mechanism underlying this association is elusive, smoking has been previously related to both higher hemoglobin concentrations and an increased risk of fibrosis in nonalcoholic fatty liver disease. The present study was conducted to investigate formally the interaction among current smoking, hemoglobin levels, and risk for advanced fibrosis in patients with biopsy-proven nonalcoholic fatty liver disease. PATIENTS AND METHODS We examined 433 Turkish patients with biopsy-proven nonalcoholic fatty liver disease. Advanced fibrosis (F ≥ 3) was identified on liver biopsy in 80 cases, whereas 84 patients were current smokers. Logistic regression models were used to evaluate the effect of current smoking on risk for advanced fibrosis, after adjusting for the effects of age, sex, BMI, diabetes, and metabolic syndrome. RESULTS Preliminary analyses revealed the presence of substantial statistical interaction between current smoking and hemoglobin levels (P < 0.001). In separate multivariable analyses conducted in the entire cohort and in the subgroups of patients with high and low hemoglobin levels (according to median value in the study cohort: 14.4 g/l), current smoking was associated with increased risk for advanced fibrosis in patients with high hemoglobin (odds ratio: 3.32, 95% confidence interval: 1.23-7.21, P < 0.01) but neither in those with low hemoglobin (odds ratio: 0.71, 95% confidence interval: 0.28-1.81, P = 0.52) nor in the entire study cohort (odds ratio: 1.18, 95% confidence interval: 0.73-2.14, P = 0.79). CONCLUSION Hemoglobin acts as a modifier in the association between current smoking and advanced fibrosis in nonalcoholic fatty liver disease.
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Xiao J, Borné Y, Gottsäter A, Pan J, Acosta S, Engström G. Red Cell Distribution Width is Associated with Future Incidence of Abdominal Aortic Aneurysm in a Population-Based Cohort Study. Sci Rep 2020; 10:7230. [PMID: 32350354 PMCID: PMC7190826 DOI: 10.1038/s41598-020-64331-7] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2020] [Accepted: 04/15/2020] [Indexed: 12/11/2022] Open
Abstract
Red cell distribution width (RDW) has been suggested to have a predictive potential for several cardiovascular diseases, but its association with abdominal aortic aneurysm (AAA) is unknown. We examined whether RDW is associated with the risk of AAA among 27,260 individuals from the population-based Malmö Diet and Cancer Study cohort. Data of baseline characteristics were collected during 1991–1996. Cox regression was used to estimate hazard ratios (HR) with 95% confidence intervals (CI) for AAA across quartiles of RDW. During a median follow-up of 21.7 years, 491 subjects developed AAA. After adjustment for other confounding factors, participants in the highest quartile of RDW experienced 61% increased risk of AAA as compared to those with the lowest quartile (HR = 1.61, CI = 1.20, 2.12). RDW showed similar relationship with severe (i.e. ruptured or surgically repaired) AAA or non-severe AAA (adjusted HR 1.58 and 1.60, respectively). The observed association between RDW and AAA risk was significant in current smokers (adjusted HR = 1.68, CI = 1.18, 2.38) but not in former smokers (adjusted HR = 1.13, CI = 0.72, 1.79), or never-smokers (adjusted HR = 1.77, CI = 0.74, 4.22). Elevated RDW is associated with increased future incidence of AAA, however the causal and pathophysiological mechanisms remain to be explored.
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Affiliation(s)
- Jun Xiao
- Department of Cardiovascular Surgery, Fujian Medical University Union Hospital, Fuzhou, China. .,Department of Clinical Sciences in Malmö, Lund University, Malmö, Sweden.
| | - Yan Borné
- Department of Clinical Sciences in Malmö, Lund University, Malmö, Sweden
| | - Anders Gottsäter
- Department of Clinical Sciences in Malmö, Lund University, Malmö, Sweden.,Vascular Centre, Department of Cardiothoracic and Vascular Surgery, Skåne University Hospital, Malmö, Sweden
| | - Jingxue Pan
- Department of Clinical Sciences in Malmö, Lund University, Malmö, Sweden
| | - Stefan Acosta
- Department of Clinical Sciences in Malmö, Lund University, Malmö, Sweden.,Vascular Centre, Department of Cardiothoracic and Vascular Surgery, Skåne University Hospital, Malmö, Sweden
| | - Gunnar Engström
- Department of Clinical Sciences in Malmö, Lund University, Malmö, Sweden.
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123
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Li B, Liu S, Liu X, Fang J, Zhuang W. Association between red cell distribution width level and risk of stroke: A systematic review and meta-analysis of prospective studies. Medicine (Baltimore) 2020; 99:e19691. [PMID: 32311945 PMCID: PMC7220702 DOI: 10.1097/md.0000000000019691] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/06/2019] [Revised: 02/15/2020] [Accepted: 03/02/2020] [Indexed: 02/05/2023] Open
Abstract
BACKGROUND Red cell distribution width level may have relations with the incidence and prognosis of cerebrovascular diseases. Recent researches have reported that red cell distribution width level was linked to the occurrence of stroke. However, the predicted effect of red cell distribution width in stroke is still disputed. We sought to assess the relationship between red cell distribution width and risk of stroke in this meta-analysis. METHODS Relevant studies were picked out from the databases of Embase, PubMed, and Cochrane Library. Hazard ratio with 95% confidence interval was chosen to analyze each trial, which was extracted from results of the highest and lowest red cell distribution width group. Funnel plots, Begg and Egger test were used to assess publication bias in the meta-analysis. Stata(12.0) was utilized to perform statistic analysis in the process. RESULTS A total of 6 studies with 5783 patients were included in this meta-analysis. The results showed that red cell distribution width level in patients with stroke was significantly higher than it in those without stroke (HR = 1.34, 95%CI:1.23-1.47, P < .001), in particular ischemic stroke(HR = 1.34,95% confidence interval:1.1-1.54, P < .001). There was no evidence of heterogeneity across the studies (P = .355, I = 5.53%). CONCLUSIONS The higher red cell distribution width level was associated with an increased risk of stroke, especially ischemic infarction.
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Affiliation(s)
- Bingxian Li
- Neurology Department, First Affiliated Hospital of Shantou University Medical College
- Shantou University Medical College, Shantou, Guangdong, China
| | - Shuo Liu
- Neurology Department, First Affiliated Hospital of Shantou University Medical College
| | - Xiaoqiang Liu
- Neurology Department, First Affiliated Hospital of Shantou University Medical College
| | - Jingnian Fang
- Neurology Department, First Affiliated Hospital of Shantou University Medical College
| | - Weiduan Zhuang
- Neurology Department, First Affiliated Hospital of Shantou University Medical College
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Biochemical and Hematological Correlates of Elevated Homocysteine in National Surveys and a Longitudinal Study of Urban Adults. Nutrients 2020; 12:nu12040950. [PMID: 32235453 PMCID: PMC7230768 DOI: 10.3390/nu12040950] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2020] [Revised: 03/25/2020] [Accepted: 03/26/2020] [Indexed: 02/07/2023] Open
Abstract
Elevated blood homocysteine (Hcy) among middle-aged adults can increase age-related disease risk, possibly through other biochemical and hematological markers. We selected markers for hyperhomocysteinemia among middle-aged adults, studied time-dependent Hcy-marker associations and computed highly predictive indices of hyperhomocysteinemia, with cross-sectional and longitudinal validations. We used data from the National Health and Nutrition Examination Survey (NHANES III, phase 2, nmax = 4000), the NHANES 1999–2006 (nmax = 10,151) and pooled NHANES (cross-sectional validation). Longitudinal validation consisted of mixed-effects linear regression models (Hcy predicting markers’ annual rates of change), applied to the Healthy Aging in Neighborhoods of Diversity Across the Life Span (HANDLS, n = 227–244 participants, k = 2.4 repeats/participant, Agebase: 30–65 years) data. Machine learning detected nine independent markers for Hcy > 14 µmol/L (NHANES III, phase 2): older age; lower folate and B-12 status; higher serum levels of creatinine, uric acid, alkaline phosphatase, and cotinine; mean cell hemoglobin and red cell distribution widths (RDW); results replicated in the 1999–2006 NHANES [AUC = 0.60–0.80]. Indices combining binary markers increased elevated Hcy odds by 6.9–7.5-fold. In HANDLS, first-visit Hcy predicted annual increase in creatinine, RDW and alkaline phosphatase, with third-visit index (2013–2018) directly predicting Hcy (2004–2009). We provide evidence of the internal and external validity of indices composed of several biomarkers that are strongly associated with elevated Hcy.
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125
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Wang Y, Zhou Y, Zhou K, Li J, Che G. Prognostic value of pre-treatment red blood cell distribution width in lung cancer: a meta-analysis. Biomarkers 2020; 25:241-247. [PMID: 32064949 DOI: 10.1080/1354750x.2020.1731763] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/08/2023]
Abstract
Objective: In recent years, increasing studies found that pre-treatment red blood cell distribution width (RDW) could predict clinical outcomes in various cancers. However, the prognostic value of pre-treatment RDW in lung cancer was inconsistent. Therefore, we performed a meta-analysis to determine prognostic value of pre-treatment RDW in lung cancer.Methods: We performed a search in PubMed, The Cochrane Library, EMBASE (via OVID), Web of Science, CNKI, Wanfang, VIP, SinoMed databases, then we identified all records up to February 15, 2019. Outcomes of interest were overall survival (OS) and disease-free survival (DFS). Hazard ratios (HRs) and corresponding 95% confidence intervals (95% CIs) were calculated to assess the relevance of pre-treatment RDW to OS in lung cancer.Results: We included ten articles in total. Pooled results revealed that elevated pre-treatment RDW was significantly associated with poor OS (HR = 1.55, 95% CI: 1.26-1.92, p < 0.001) and DFS (HR = 1.53, 95% Cl: 1.15-2.05; p = 0.004) in lung cancer. Further subgroup analysis manifested that lung cancer patients with elevated pre-treatment RDW had worse prognosis.Conclusions: A higher value of pre-treatment RDW indicated worse survival of patients with lung cancer. RDW may serve as a reliable and economical marker for prediction of lung cancer prognosis.
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Affiliation(s)
- Yan Wang
- Department of Thoracic Surgery, West China Hospital, Sichuan University, Chengdu, P.R. China.,West China School of Medicine, Sichuan University, Chengdu, P.R. China
| | - Yaojie Zhou
- West China School of Medicine, Sichuan University, Chengdu, P.R. China
| | - Kun Zhou
- Department of Thoracic Surgery, West China Hospital, Sichuan University, Chengdu, P.R. China
| | - Jue Li
- Department of Thoracic Surgery, West China Hospital, Sichuan University, Chengdu, P.R. China
| | - Guowei Che
- Department of Thoracic Surgery, West China Hospital, Sichuan University, Chengdu, P.R. China
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Prognostic value of red cell distribution width (RDW) in colorectal cancer. Results from a single-center cohort on 591 patients. Sci Rep 2020; 10:1072. [PMID: 31974409 PMCID: PMC6978334 DOI: 10.1038/s41598-020-57721-4] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2019] [Accepted: 12/31/2019] [Indexed: 02/06/2023] Open
Abstract
Increasing evidence advocates the prognostic role of RDW in various tumours. We analysed 591 patients to assess whether RDW is a prognostic factor for overall (OS) and cancer-related survival (CRS) for patients with colorectal cancer (CRC). The data were retrieved from a retrospective database. The optimal cut-off value for RDW was set at 14.1%; accordingly, two groups were considered: those with a value equal or lower than 14.1% (L-RDW), and those with a value higher than 14.1% (H-RDW). The mean value of RDW rose from pT1 to pT4 tumours. H-RDW correlated with age above the mean, colonic location of the lesion, pT and TNM stage. Finally, H-RDW was significantly associated with the intent of surgery: almost 50% of patients who underwent a non-curative resection presented H-RDW, compared to 19.3% in R0 resections. OS was significantly lower in patients with H-RDW. CRS was similar in the two groups. Stratifying patients according to TNM stage worse OS was associated with H-RDW only in early stages, whereas there was no difference for stages II-IV. Multivariate analysis confirmed that H-RDW was not an independent prognostic factor. Although H-RDW correlated with some negative clinical-pathological factors, it did not seem to independently influence OS and CRS.
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127
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Psoriasis and Psoriatic Arthritis Cardiovascular Disease Endotypes Identified by Red Blood Cell Distribution Width and Mean Platelet Volume. J Clin Med 2020; 9:jcm9010186. [PMID: 31936662 PMCID: PMC7019311 DOI: 10.3390/jcm9010186] [Citation(s) in RCA: 47] [Impact Index Per Article: 11.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2019] [Revised: 12/27/2019] [Accepted: 01/03/2020] [Indexed: 12/12/2022] Open
Abstract
In a subset of psoriasis (PsO) and psoriatic arthritis (PsA) patients, the skin and/or joint lesions appear to generate biologically significant systemic inflammation. Red cell distribution width (RDW) and mean platelet volume (MPV) are readily available clinical tests that reflect responses of the bone marrow and/or plasma thrombogenicity (e.g., inflammation), and can be markers for major adverse cardiac events (MACE). We aimed to evaluate if RDW and MPV may be employed as inexpensive, routinely obtained biomarkers in predicting myocardial infarction (MI), atrial fibrillation (AF), and chronic heart failure (CHF) in psoriatic and psoriatic arthritis patients. The study was divided into two parts: (a) case control study employing big data (Explorys) to assess MPV and RDW in psoriasis, psoriatic arthritis and control cohorts; (b) a clinical observational study to validate the predictive value of RDW and to evaluate RDW response to anti-psoriatic therapies. We used Explorys, an aggregate electronic database, to identify psoriatic patients with available MPV and RDW data and compared them to gender and age matched controls. The incidence of myocardial infarction (MI), atrial fibrillation (AF), and chronic heart failure (CHF) was highest among patients with both elevated RDW and MPV, followed by patients with high RDW and normal MPV. RDW elevation among PsA patients was associated with an increased risk of MI, AF, and CHF. In a local clinical cohort, high RDWs were concentrated in a subset of patients who also had elevated circulating resistin levels. Among a small subset of participants who were treated with various systemic and biologic therapies, and observed over a year, and in whom RDW was elevated at baseline, a sustained response to therapy was associated with a decrease in RDW. RDW and MPV, tests commonly contained within routine complete blood count (CBC), may be a cost-effective manner to identify PsO and PsA patients at increased risk of MACE.
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128
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Beydoun MA, Hossain S, Beydoun HA, Shaked D, Weiss J, Evans MK, Zonderman AB. Red Cell Distribution Width Is Directly Associated with Poor Cognitive Performance among Nonanemic, Middle-Aged, Urban Adults. J Nutr 2020; 150:128-139. [PMID: 31912144 PMCID: PMC6946901 DOI: 10.1093/jn/nxz182] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2019] [Revised: 05/08/2019] [Accepted: 07/15/2019] [Indexed: 12/15/2022] Open
Abstract
BACKGROUND Epidemiological evidence suggests that both anemia and elevated red cell distribution width (RDW) are associated with cognitive impairment. However, the interplay between these 2 predictors has been understudied. OBJECTIVES We examined sex- and anemia-specific associations between RDW and cognitive performance among urban adults in the United States. METHODS Data from the Healthy Aging in Neighborhoods of Diversity Across the Life Span Study (Baltimore, MD; participants aged 30-65 y at baseline, ∼59% African-American, 45% men) were used. Participants were selected based on the completion of 11 cognitive tasks at baseline (2004-2009) and follow-up (2009-2013) visits (mean time between visits: 4.64 ± 0.93 y) and availability of exposure and covariate data, yielding a sample of between 1526 and 1646 adults out of the initial 3720 adults recruited at baseline. Multiple linear mixed-effects regression models were conducted with RDW as the main exposure of interest and anemia/sex as the key effect modifiers. RESULTS Overall, high RDWs were linked to poorer baseline performance on the California Verbal Learning Test (CVLT) List A (per 1 unit increase in RDW %, main effect: γ01 = -0.369 ± 0.114; P = 0.001) and to slower rates of decline on the CVLT Delayed Free Recall (per 1 unit increase in RDW %, RDW × time: γ11 = +0.036 ± 0.013; P = 0.007). Among nonanemic participants, RDWs were consistently associated with poorer baseline performance on the Trailmaking Test, Part A (γ01 = +3.11 ± 0.89; P < 0.001) and on the CVLT List A (γ01 = -0.560 ± 0.158; P < 0.001). Moreover, RDWs were associated with poorer baseline performance on the Brief Test of Attention in the total population (γ01 = -0.123 ± 0.039; P = 0.001) and among men (γ01 = -0.221 ± 0.068; P = 0.001). We did not detect an association between hemoglobin (Hb) and baseline cognitive performance or changes over time. CONCLUSIONS Elevated RDW had a consistent cross-sectional association with poor cognitive performance in the domains of verbal memory and attention among the nonanemic group in a sample of middle-aged, urban adults. Anemia and Hb concentrations were not associated with cognition. More longitudinal studies are needed to replicate our findings.
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Affiliation(s)
- May A Beydoun
- Laboratory of Epidemiology and Population Sciences, National Institute on Aging, NIH, Intramural Research Program, Baltimore, MD, USA
| | - Sharmin Hossain
- Laboratory of Epidemiology and Population Sciences, National Institute on Aging, NIH, Intramural Research Program, Baltimore, MD, USA
| | - Hind A Beydoun
- Department of Research Programs, Fort Belvoir Community Hospital, Fort Belvoir, VA, USA
| | - Danielle Shaked
- Laboratory of Epidemiology and Population Sciences, National Institute on Aging, NIH, Intramural Research Program, Baltimore, MD, USA
| | - Jordan Weiss
- Population Studies Center and Leonard Davis Institute of Health Economics, University of Pennsylvania, Philadelphia, PA, USA
| | - Michele K Evans
- Laboratory of Epidemiology and Population Sciences, National Institute on Aging, NIH, Intramural Research Program, Baltimore, MD, USA
| | - Alan B Zonderman
- Laboratory of Epidemiology and Population Sciences, National Institute on Aging, NIH, Intramural Research Program, Baltimore, MD, USA
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Yousefi B, Sanaie S, Ghamari AA, Soleimanpour H, Karimian A, Mahmoodpoor A. Red Cell Distribution Width as a Novel Prognostic Marker in Multiple Clinical Studies. Indian J Crit Care Med 2020; 24:49-54. [PMID: 32148349 PMCID: PMC7050177 DOI: 10.5005/jp-journals-10071-23328] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022] Open
Abstract
Red cell distribution width (RDW), which is a quantitative method applied for the measurement of anisocytosis, is the most reliable and inexpensive method for differentiation of iron deficiency anemia and thalassemia trait. An increase in its rate reflects a great heterogeneity in the size of red blood cells (RBCs). Recent studies have shown a significant relationship between RDW and the risk of morbidity and mortality in patients with multiple diseases. A strong association is established between changes in RDW and the risk of adverse outcome in patients with heart failure in multiple studies. In this review, we try to focus on the association and correlation between the increase in RDW and different outcomes of common diseases that may be related to RDW and based on the results of various studies, we are trying to introduce RDW as a diagnostic indicator for these diseases.
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Affiliation(s)
- Bahman Yousefi
- Department of Clinical Biochemistry, Faculty of Medicine, Tabriz University of Medical Sciences, Tabriz, Islamic Republic of Iran
| | - Sarvin Sanaie
- Department of Anesthesiology, Tabriz University of Medical Sciences, Tabriz, Islamic Republic of Iran
| | - Ali A Ghamari
- Department of Anesthesiology, Tabriz University of Medical Sciences, Tabriz, Islamic Republic of Iran
| | - Hassan Soleimanpour
- Department of Anesthesiology, Tabriz University of Medical Sciences, Tabriz, Islamic Republic of Iran
| | - Ansar Karimian
- Department of Clinical Biochemistry, Faculty of Medicine, Tabriz University of Medical Sciences, Tabriz, Islamic Republic of Iran
| | - Ata Mahmoodpoor
- Department of Anesthesiology, Tabriz University of Medical Sciences, Tabriz, Islamic Republic of Iran
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130
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Jayasuriya NA, Kjaergaard AD, Pedersen KM, Sørensen AL, Bak M, Larsen MK, Nordestgaard BG, Bojesen SE, Çolak Y, Skov V, Kjaer L, Tolstrup JS, Hasselbalch HC, Ellervik C. Smoking, blood cells and myeloproliferative neoplasms: meta-analysis and Mendelian randomization of 2·3 million people. Br J Haematol 2019; 189:323-334. [PMID: 31875952 DOI: 10.1111/bjh.16321] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/14/2019] [Accepted: 09/19/2019] [Indexed: 12/19/2022]
Abstract
Meta-analyses and Mendelian randomization (MR) may clarify the associations of smoking, blood cells and myeloproliferative neoplasms (MPN). We investigated the association of smoking with blood cells in the Danish General Suburban Population Study (GESUS, n = 11 083), by meta-analyses (including GESUS) of 92 studies (n = 531 741) and MR of smoking variant CHRNA3 (rs1051730[A]) in UK Biobank, and with MPN in a meta-analysis of six studies (n (total/cases):1 425 529/2187), totalling 2 307 745 participants. In the meta-analysis the random-effects standardized mean difference (SMD) in current smokers versus non-smokers was 0·82 (0·75-0·89, P = 2·0 * 10-108 ) for leukocytes, 0·09 (-0·02 to 0·21, P = 0·12) for erythrocytes, 0·53 (0·42-0·64, P = 8·0 * 10-22 ) for haematocrit, 0·42 (0·34-0·51, P = 7·1 * 10-21 ) for haemoglobin, 0·19 (0·08-0·31, P = 1·2 * 10-3 ) for mean corpuscular haemoglobin (MCH), 0·29 (0·19-0·39, P = 1·6 * 10-8 ) for mean corpuscular volume (MCV), and 0·04 (-0·04 to 0·13, P = 0·34) for platelets with trends for ever/ex-/current smokers, light/heavy smokers and female/male smokers. Analyses presented high heterogeneity but low publication bias. Per allele in CHRNA3, cigarettes per day in current smokers was associated with increased blood cell counts (leukocytes, neutrophils), MCH, red cell distribution width (RDW) and MCV. The pooled fixed-effects odds ratio for MPN was 1·44 [95% confidence interval (CI): 1·33-1·56; P = 1·8 * 10-19 ; I2 = 0%] in current smokers, 1·29 (1·15-1·44; P = 8·0 * 10-6 ; I2 = 0%) in ex-smokers, 1·49 (1·26-1·77; P = 4·4 * 10-6 ; I2 = 0%) in light smokers and 2·04 (1·74-2·39, P = 2·3 * 10-18 ; I2 = 51%) in heavy smokers compared with non-smokers. Smoking is observationally and genetically associated with increased leukocyte counts and red blood cell indices (MCH, MCV, RDW) and observationally with risk of MPN in current and ex-smokers versus non/never-smokers.
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Affiliation(s)
- Nimesh A Jayasuriya
- Department of Laboratory Medicine, Boston Children's Hospital, Boston, MA, USA.,School of Medicine, University of Glasgow, Glasgow, UK
| | - Alisa D Kjaergaard
- Department of Laboratory Medicine, Boston Children's Hospital, Boston, MA, USA.,Department of Clinical Epidemiology, Aarhus University Hospital and Aarhus University, Aarhus, Denmark
| | - Kasper M Pedersen
- Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark.,Department of Hematology, Zealand University Hospital, Roskilde, Denmark.,Department of Clinical Biochemistry, Copenhagen University Hospital, Herlev and Gentofte Hospital, Herlev, Denmark
| | - Anders L Sørensen
- Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark.,Department of Hematology, Zealand University Hospital, Roskilde, Denmark
| | - Marie Bak
- Department of Hematology, Zealand University Hospital, Roskilde, Denmark
| | - Morten K Larsen
- Department of Hematology, Zealand University Hospital, Roskilde, Denmark.,Department of Science and Environment, Roskilde University, Roskilde, Denmark
| | - Børge G Nordestgaard
- Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark.,Department of Clinical Biochemistry and the Copenhagen General Population Study, Copenhagen University Hospital, Herlev and Gentofte Hospital, Herlev, Denmark
| | - Stig E Bojesen
- Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark.,Department of Clinical Biochemistry and the Copenhagen General Population Study, Copenhagen University Hospital, Herlev and Gentofte Hospital, Herlev, Denmark
| | - Yunus Çolak
- Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark.,Department of Clinical Biochemistry and the Copenhagen General Population Study, Copenhagen University Hospital, Herlev and Gentofte Hospital, Herlev, Denmark
| | - Vibe Skov
- Department of Hematology, Zealand University Hospital, Roskilde, Denmark
| | - Lasse Kjaer
- Department of Hematology, Zealand University Hospital, Roskilde, Denmark
| | - Janne S Tolstrup
- Faculty of Health and Medical Sciences, University of Southern Denmark, Odense, Denmark.,National Institute of Public Health, University of Southern Denmark, Odense, Denmark
| | - Hans C Hasselbalch
- Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark.,Department of Hematology, Zealand University Hospital, Roskilde, Denmark
| | - Christina Ellervik
- Department of Laboratory Medicine, Boston Children's Hospital, Boston, MA, USA.,Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark.,Department of Production, Research, and Innovation; Region Zealand, Sorø, Denmark.,Division of Pathology, Faculty of Medicine, Harvard Medical School, Boston, USA
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131
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The impact of smoke from grilled fish on the hematological parameters of Indonesian grilled fish sellers. JOURNAL OF HEALTH RESEARCH 2019. [DOI: 10.1108/jhr-12-2018-0177] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
Purpose
Fish processing by grilling can produce emissions that contain toxic compounds that can have short- and long-term effects on human health. Another study reported that exposure to air pollutants is hematotoxic. The purpose of this paper is to determine the effect of smoke exposure on fish grill results on hematological parameters.
Design/methodology/approach
The subjects of this study were 90 grilled fish sellers, with 32 processed food sellers who did not sell grill food as a control. The hematological analysis was performed using the Hematology Analyzers KX300 instrument.
Findings
The results showed that the mean value of hematological parameters in the test group was higher than the control group except for the number of lymphocytes and mixed cell parameters.
Originality/value
The content of harmful compounds contained in fish grill smoke can increase hematological value in the blood of exposed individuals, which has the potential for health problems and disease progression.
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Korur A, Yanardag Acik D, Solmaz S, Gereklioglu C, Asma S, Ozdogu H. A Novel Parameter for Predicting Therapeutic Response in Iron Deficiency Anemia: Red Blood Cell Distribution Width. EURASIAN JOURNAL OF FAMILY MEDICINE 2019. [DOI: 10.33880/ejfm.2019080303] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
Aim: Anemia is a public health problem worldwide. Cost effectiveness and efficient use of resources are vitally important. Red blood cell distribution width, which can be obtained from a standard complete blood count, is a measure of the variability in size of circulating erythrocytes. The present study was performed to investigate whether red blood cell distribution width can be used to predict response to iron therapy. Methods: This study was conducted in 50 patients admitted to hematology and family medicine clinics. Complete blood count and reticulocyte count were determined on day 5; complete blood count was examined 1 month after commencement of therapy. Results: Statistically significant differences were detected between hemoglobin levels and red blood cell distribution width values at the time of diagnosis and on day 5 and after 1 month of therapy. A significant positive correlation was found between the increase in red blood cell distribution width and the increase in hemoglobin. Conclusion: Red blood cell distribution width may be used in place of reticulocyte count to predict response to iron therapy. Red blood cell distribution width is the best biomarker for this purpose as a component of complete blood count, and therefore it may be accepted as superior to reticulocyte count.
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Affiliation(s)
- Aslı Korur
- Department of Family Medicine, Baskent University Faculty of Medicine
| | | | - Soner Solmaz
- Department of Hematology, Baskent University Faculty of Medicine
| | | | - Suheyl Asma
- Department of Family Medicine, Baskent University Faculty of Medicine
| | - Hakan Ozdogu
- Department of Hematology, Baskent University Faculty of Medicine
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Raspante Cerqueira Teixeira K, de Medeiros LA, Mendes JA, Vaz ER, Cunha TM, de Oliveira EP, Penha-Silva N, Crispim CA. The erythrocyte membrane stability is associated with sleep time and social jetlag in shift workers. PLoS One 2019; 14:e0222698. [PMID: 31545844 PMCID: PMC6756543 DOI: 10.1371/journal.pone.0222698] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2018] [Accepted: 09/05/2019] [Indexed: 11/19/2022] Open
Abstract
The osmotic stability of the erythrocyte membrane (OSEM) has been associated with changes in lipid profile, blood glucose and blood pressure. Changes in these parameters are very frequent in shift workers, possibly because of the lack of synchronization of biological rhythms, which results in the social jetlag. However, the existence of association between OSEM and circadian misalignment has not been investigated in this population. Therefore, this study investigated whether shift work, sleep time and social jetlag (SJL) are associated with biochemical and hematological variables. A population consisting of 79 men working at night (n = 37) or during the day (n = 42), aged between 21 and 65 years and with a mean BMI of 27.56 ± 4.0 kg/m2, was investigated cross-sectionally in relation to sleep time, SJL, anthropometric (height, weight and waist circumference) and blood variables, with emphasis on the OSEM. SJL was calculated by the absolute difference between the midpoint of sleep on work and rest days. The Generalized Linear Model (GzLM) was used to investigate the existence of associations between SJL and average sleep time in relation to the analyzed variables. Workers without SJL presented lower baseline lysis values of erythrocytes in isotonic medium in relation to workers with SJL. In addition, workers who slept on average less than 6 hours had higher OSEM, and higher total and LDL-cholesterol in relation to those who slept more than 6 hours, regardless of the shift. It is possible that the association of sleep deprivation and SJL with erythrocyte membrane stability is mediated through changes in the lipid profile.
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Affiliation(s)
| | | | | | - Emília Rezende Vaz
- Institute of Biotechnology, Federal University of Uberlândia, Uberlândia, MG, Brazil
| | | | | | - Nilson Penha-Silva
- Institute of Biotechnology, Federal University of Uberlândia, Uberlândia, MG, Brazil
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134
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Wang B, Aihemaiti G, Cheng B, Li X. Red Blood Cell Distribution Width Is Associated with All-Cause Mortality in Critically Ill Patients with Cardiogenic Shock. Med Sci Monit 2019; 25:7005-7015. [PMID: 31530796 PMCID: PMC6765343 DOI: 10.12659/msm.917436] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2019] [Accepted: 06/03/2019] [Indexed: 12/19/2022] Open
Abstract
BACKGROUND There is no previously published epidemiological study exploring the association between red blood cell distribution width (RDW) and mortality in patients with cardiogenic shock (CS). The aim of this study was to examine the association between RDW and the risk of all-cause mortality in these patients. MATERIAL AND METHODS We analyzed clinical data from the MIMIC-III V1.4 database. We collected data on each patient's demographic parameters, vital signs, laboratory parameters, vital signs, comorbidities, and scoring systems on ICU admission. Cox proportional hazards models were used to assess the association between RDW levels and the 30-day, 90-day, and 365-day mortality in patients with CS. RESULTS There were 1131 patients meeting inclusion criteria in our study. In multivariate analysis, following adjustment for age, sex, and ethnicity, higher RDW in tertiles and quintiles were all associated with increased risk of 30-day, 90-day, and 365-day all-cause mortality. Furthermore, after adjusting for more relevant confounders, RDW remained a significant predictor of risk of 30-day, 90-day, and 365-day mortality (tertile 3 versus tertile 1: HR, 95% CI: 1.66, 1.19-2.31; 1.73, 1.28-2.33; 1.80, 1.38-2.34). Similarly significant robust associations were found in RDW levels stratified by quintiles. CONCLUSIONS Higher RDW is associated with increased risk of all-cause mortality in critically ill patients with CS.
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Affiliation(s)
- Benji Wang
- Department of Cardiology, The First Affiliated Hospital of Xinjiang Medical University, Urumqi, Xinjiang, P.R. China
| | - Gulandanmu Aihemaiti
- Department of Cardiology, The First Affiliated Hospital of Xinjiang Medical University, Urumqi, Xinjiang, P.R. China
| | - Bihuan Cheng
- Department of Anesthesiology, Critical Care and Pain Medicine, The Second Affiliated Hospital and Yuying Children’s Hospital of Wenzhou Medical University, Wenzhou, Zhejiang, P.R. China
| | - Xiaomei Li
- Department of Cardiology, The First Affiliated Hospital of Xinjiang Medical University, Urumqi, Xinjiang, P.R. China
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135
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Martinez C, Mooney CT, Shiel RE, Tang PK, Mooney L, O'Neill EJ. Evaluation of red blood cell distribution width in dogs with various illnesses. THE CANADIAN VETERINARY JOURNAL = LA REVUE VETERINAIRE CANADIENNE 2019; 60:964-971. [PMID: 31523082 PMCID: PMC6697020] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/10/2023]
Abstract
In humans, increased red blood cell distribution width (RDW) values are associated with higher morbidity and mortality in a variety of pathological processes. The main objective of this study was to evaluate RDW in dogs with a diverse range of pathologies. Clinical data from 276 dogs were retrospectively evaluated. Significantly higher RDW values were found in dogs with primary immune-mediated hemolytic anemia (P < 0.0001), immune-mediated thrombocytopenia (P < 0.0004), hyperadrenocorticism (P < 0.0001), hypothyroidism (P = 0.0220), hepatic vascular anomaly (P < 0.0001), pneumonia (P < 0.0001), chronic kidney disease (P = 0.0005), multi-centric lymphoma (P = 0.0002), and myxomatous mitral valve degeneration (P = 0.0032). However, there was extensive overlap with the values from healthy dogs, limiting the diagnostic value of RDW in this setting. Although RDW may have a role as a potential prognostic indicator, further studies would be necessary to address this.
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Affiliation(s)
- Carlos Martinez
- School of Veterinary Medicine, University College Dublin Veterinary Hospital, Belfield, Co. Dublin, Ireland
| | - Carmel T Mooney
- School of Veterinary Medicine, University College Dublin Veterinary Hospital, Belfield, Co. Dublin, Ireland
| | - Robert E Shiel
- School of Veterinary Medicine, University College Dublin Veterinary Hospital, Belfield, Co. Dublin, Ireland
| | - Pak Kan Tang
- School of Veterinary Medicine, University College Dublin Veterinary Hospital, Belfield, Co. Dublin, Ireland
| | - Louise Mooney
- School of Veterinary Medicine, University College Dublin Veterinary Hospital, Belfield, Co. Dublin, Ireland
| | - Emma J O'Neill
- School of Veterinary Medicine, University College Dublin Veterinary Hospital, Belfield, Co. Dublin, Ireland
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136
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A cross-sectional comparison between cardiorespiratory fitness, level of lesion and red blood cell distribution width in adults with chronic spinal cord injury. J Sci Med Sport 2019; 23:106-111. [PMID: 31558360 DOI: 10.1016/j.jsams.2019.08.015] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2019] [Revised: 08/13/2019] [Accepted: 08/16/2019] [Indexed: 11/20/2022]
Abstract
OBJECTIVES To assess; (1) differences in red blood cell distribution width between individuals with chronic (>1year), motor-complete cervical (n=21), upper-thoracic (n=27) and thoracolumbar (n=15) spinal cord injury and, (2) associations between red blood cell distribution width and cardiorespiratory fitness. DESIGN Prospective multi-center, cross-sectional study. METHODS Peak oxygen uptake was determined using an upper-body arm-crank exercise test to volitional exhaustion and red blood cell distribution width was measured using an automated hematology system. RESULTS There were significant (p<0.009) differences between groups classified by level of injury in absolute and relative peak oxygen uptake, peak power output and red blood cell distribution width. A significant (p<0.001) large negative association (r = -0.524) was found between relative peak oxygen uptake and red blood cell distribution width. Unbiased recursive partitioning, while revealing study site specific differences in red blood cell distribution width, identified homogenous subgroups based specifically on cardiorespiratory fitness irrespective of additional demographic and injury characteristics. CONCLUSION The strong negative association between cardiorespiratory fitness and red blood cell distribution width in individuals with paraplegia parallel those previously observed in non-disabled individuals. Higher red blood cell distribution width values are an independent risk factor for increased cardiovascular mortality, heart failure, and coronary heart disease and may reflect several underlying exacerbated metabolic responses such as oxidative stress and systemic inflammation. These data emphasize the importance of maintaining a high aerobic capacity following spinal cord injury.
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137
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Nakashima K, Ohgami E, Kato K, Yoshitomi S, Maruyama T, Harada M. Prognostic significance of red cell distribution width in hospitalized older patients with heart failure or infection. Geriatr Gerontol Int 2019; 19:988-992. [PMID: 31397034 DOI: 10.1111/ggi.13755] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2019] [Revised: 07/02/2019] [Accepted: 07/19/2019] [Indexed: 12/29/2022]
Abstract
AIM Red cell distribution width (RDW) is a simple, sensitive and cost-effective parameter, and is associated with pathophysiology of many common diseases. The aim of the present study was to investigate the prognostic role of RDW in older adults hospitalized for the treatment of heart failure (HF) or infection, because both diseases are fatal, especially in the geriatric population. METHODS This observational study consecutively enrolled 196 Japanese older (aged ≥75 years) patients hospitalized for the treatment of HF (group A, n = 102) or non-cardiovascular bacterial infection (group B, n = 94). Baseline and clinical data were extracted from medical records. The observational period was that of hospitalization. The primary end-point was classified in the order of discharge to the patients' home, discharge to other facilities and in-hospital death. RESULTS Longer hospital stay (P < 0.01) and worse prognosis (P < 0.01), including higher in-hospital mortality, were found in patients showing RDW ≥15% relative to those with RDW <15% in both groups. RDW showed no in-hospital variation despite successful treatment of acutely decompensated HF in selected patients of group A (n = 64). CONCLUSIONS The present study showed the role of RDW in predicting the prognostic outcome of older adults hospitalized for the treatment of HF or infection, indicating that RDW is a stable and reliable parameter in these common diseases. Geriatr Gerontol Int 2019; 19: 988-992.
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Affiliation(s)
- Keitaro Nakashima
- Department of Medicine, Karatsu Higashimatsuura Medical Center, Karatsu, Japan
| | - Eiichi Ohgami
- Department of Medicine, Karatsu Higashimatsuura Medical Center, Karatsu, Japan
| | - Kazuhiko Kato
- Department of Medicine, Karatsu Higashimatsuura Medical Center, Karatsu, Japan
| | - Souichi Yoshitomi
- Department of Medicine, Karatsu Higashimatsuura Medical Center, Karatsu, Japan
| | - Toru Maruyama
- Department of Medicine and Biosystemic Sciences, Kyushu University School of Medicine, Fukuoka, Japan
| | - Mine Harada
- Department of Medicine, Karatsu Higashimatsuura Medical Center, Karatsu, Japan
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138
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Satılmış S, Karabulut A. Correlation Between Red Cell Distribution Width and Peripheral Vascular Disease Severity and Complexity. Med Sci (Basel) 2019; 7:medsci7070077. [PMID: 31324033 PMCID: PMC6681184 DOI: 10.3390/medsci7070077] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/21/2019] [Revised: 07/02/2019] [Accepted: 07/08/2019] [Indexed: 02/03/2023] Open
Abstract
A traditional hematological marker, red cell distribution width (RDW), is accepted as a novel marker of atherosclerotic vascular diseases. Clinical importance of the RDW as a prognostic biomarker in peripheral vascular disease (PVD) has been reported in a few studies. Herein, we aimed to show the correlation between RDW and PVD severity and its complexity in terms of angiographic evaluation. A total of 118 patients who underwent peripheral lower extremity angiography were subsequently evaluated retrospectively. Upon admission, RDW level was measured with automated complete blood count. Severity and complexity of the PVD was evaluated according to Trans-Atlantic Inter-Society Consensus (TASC II) classification. A TASC II A-B lesion was defined as simple PVD, and a TASC II C-D lesion was defined as prevalent and complex PVD. Then, both groups were compared statistically according to clinical, laboratory, and demographic features, including RDW levels. In 49.6% of the patients, TASC II C-D lesions were observed. Advanced age, male gender, and body mass index (BMI) were associated with TASC II groups. Red cell distribution width levels were correlated with presence of PVD, as well as TASC II grades (p:0.02). The fourth quartile (75th percentile) of the RDW levels was 14.1, and patients with RDW levels ≥14.1 had a more significant correlation with the presence and severity of PVD (p:0.001). In the multivariate regression analysis, elevated RDW was found to be an independent predictor of the presence of PVD and also TASC II C-D lesions (OR:2.26, with a 95% confidence interval (CI) 0.051-0.774; p:0.02). Elevated RDW levels was associated with TASC II C-D lesions, which indicated more prevalent and complex PVD.
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Affiliation(s)
- Seçkin Satılmış
- Department of Cardiology, Acibadem Atakent Hospital, Istanbul 34303, Turkey
| | - Ahmet Karabulut
- Department of Cardiology, Acibadem Atakent Hospital, Istanbul 34303, Turkey.
- Department of Cardiology, Acibadem Mehmet Ali Aydınlar University School of Medicine, Istanbul 34752, Turkey.
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Bobeff EJ, Fortuniak J, Bryszewski B, Wiśniewski K, Bryl M, Kwiecień K, Stawiski K, Jaskólski DJ. Mortality After Traumatic Brain Injury in Elderly Patients: A New Scoring System. World Neurosurg 2019; 128:e129-e147. [PMID: 30981800 DOI: 10.1016/j.wneu.2019.04.060] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2019] [Revised: 04/05/2019] [Accepted: 04/06/2019] [Indexed: 12/29/2022]
Abstract
BACKGROUND Traumatic brain injury (TBI) remains a life-threatening condition characterized by growing incidence worldwide, particularly in the aging population, in which the primary goal of treatment appears to be avoidance of chronic institutionalization. METHODS To identify independent predictors of 30-day mortality or vegetative state in a geriatric population and calculate an intuitive scoring system, we screened 480 patients after TBI treated at a single department of neurosurgery over a 2-year period. We analyzed data of 214 consecutive patients aged ≥65 years, including demographics, medical history, cause and time of injury, neurologic state, radiologic reports, and laboratory results. A predictive model was developed using logistic regression modeling with a backward stepwise feature selection. RESULTS The median Glasgow Coma Scale (GCS) score on admission was 14 (interquartile range, 12-15), whereas the 30-day mortality or vegetative state rate amounted to 23.4%. Starting with 20 predefined features, the final prediction model highlighted the importance of GCS motor score (odds ratio [OR], 0.17; 95% confidence interval [CI], 0.09-0.32); presence of comorbid cardiac, pulmonary, or renal dysfunction or malignancy (OR, 2.86; 9 5% CI, 1.08-7.61); platelets ≤100 × 109 cells/L (OR, 13.60; 95% CI, 3.33-55.49); and red blood cell distribution width coefficient of variation ≥14.5% (OR, 2.91; 95% CI, 1.09-7.78). The discovered coefficients were used for nomogram development. It was further simplified to facilitate clinical use. The proposed scoring system, Elderly Traumatic Brain Injury Score (eTBI Score), yielded similar performance metrics. CONCLUSIONS The eTBI Score is the first scoring system designed specifically for older adults. It could constitute a framework for clinical decision-making and serve as an outcome predictor. Its capability to stratify risk provides reliable criteria for assessing efficacy of TBI management.
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Affiliation(s)
- Ernest J Bobeff
- Department of Neurosurgery and Neuro-oncology, Medical University of Lodz, Barlicki University Hospital, Lodz, Poland
| | - Jan Fortuniak
- Department of Neurosurgery and Neuro-oncology, Medical University of Lodz, Barlicki University Hospital, Lodz, Poland.
| | - Bartosz Bryszewski
- Department of Neurosurgery and Neuro-oncology, Medical University of Lodz, Barlicki University Hospital, Lodz, Poland
| | - Karol Wiśniewski
- Department of Neurosurgery and Neuro-oncology, Medical University of Lodz, Barlicki University Hospital, Lodz, Poland
| | - Maciej Bryl
- Department of Neurosurgery and Neuro-oncology, Medical University of Lodz, Barlicki University Hospital, Lodz, Poland
| | - Katarzyna Kwiecień
- Department of Neurosurgery and Neuro-oncology, Medical University of Lodz, Barlicki University Hospital, Lodz, Poland
| | - Konrad Stawiski
- Department of Biostatistics and Translational Medicine, Medical University of Lodz, Lodz, Poland
| | - Dariusz J Jaskólski
- Department of Neurosurgery and Neuro-oncology, Medical University of Lodz, Barlicki University Hospital, Lodz, Poland
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Usefulness of Red Cell Width Distribution (RDW) in the Assessment of Children with Pulmonary Arterial Hypertension (PAH). Pediatr Cardiol 2019; 40:820-826. [PMID: 30830279 PMCID: PMC6451723 DOI: 10.1007/s00246-019-02077-4] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/10/2018] [Accepted: 02/23/2019] [Indexed: 11/24/2022]
Abstract
Red cell width distribution (RDW) is known to be a prognostic marker in adults with pulmonary hypertension. The value of this test in the pulmonary arterial hypertension (PAH) pediatric population was not yet established. The aim of the study was to evaluate the prognostic value of RDW in children with PAH and utility of this parameter in the management. Data were collected retrospectively in 61 patients with PAH confirmed by right heart catheterization. RDW was measured at diagnosis, 3 and 12 months after initial therapy, during and after deterioration if occurred. Results were compared with NTproBNP, WHO-FC and oxygen blood saturation. Mean RDW at baseline was 15.3 ± 2.4% (12.1-24.4, median 14.7%) and was elevated in 29 patients (47%). There were no significant difference in clinical status, NTproBNP and hemodynamic parameters among patient with normal and elevated RDW at diagnosis. Poor negative correlation with SaO2 and SvO2 was shown. After 3 and 12 months of treatment no significant change of RDW level was found despite of statistically significant improvement of WHO-FC and decrease of NTproBNP level (NS). Episodes of clinical deterioration weren't connected with change of RDW level (16 vs. 15.6% NS). Kaplan-Meier analysis did not show differences in prognosis between patients with normal and elevated RDW. Elevation of RDW was not associated with any measured parameters. Prognostic value of RDW in the pediatric PAH population was not confirmed. Usefulness of RDW in management in PAH pediatric population is limited and required further studies.
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141
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Red Cell Distribution Width: An Unacknowledged Predictor of Mortality and Adverse Outcomes Following Revision Arthroplasty. J Arthroplasty 2018; 33:3514-3519. [PMID: 30072185 DOI: 10.1016/j.arth.2018.06.035] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/20/2018] [Revised: 06/18/2018] [Accepted: 06/25/2018] [Indexed: 02/07/2023] Open
Abstract
BACKGROUND Revision total joint arthroplasties (TJAs) have been empirically associated with significant postoperative morbidity and mortality. Red blood cell distribution width (RDW), a frequently measured hematological parameter, has been shown to predict mortality in hip fracture patients. However, its utility in risk-stratifying patients before revision TJA remains unknown. The aim of this study was to investigate the possible relationship between preoperative RDW levels and outcome of revision arthroplasty in terms of mortality, adverse outcomes, and length of hospital stay. METHODS A single-institution retrospective study was conducted on 4633 patients who underwent revision TJA (3289 hips and 1344 knees) between 2000 and September 2016. Of those, 656 (14.1%) surgeries were performed due to periprosthetic joint infection, and 3977 (85.9%) were aseptic revisions. The association between preoperative RDW and various outcomes, including 1-year mortality, in-hospital medical complications, length of hospital stay, and 90-day all-cause readmission, was examined. RESULTS The average age of patients in the cohort was 65.4 ± 12.9 years. The average Charlson comorbidity index was 0.6 (standard deviation = 1.0), with 691 patients (14.9%) having 2 or more comorbidities. Mean preoperative RDW level was 14.4% (standard deviation = 1.8). After adjusting for covariates, higher RDW levels were statistically significantly associated with mortality (adjusted odds ratio [OR], 1.25; 95% confidence interval [CI], 1.13-1.39; P < .001), any in-hospital medical complications (adjusted OR, 1.12; 95% CI, 1.07-1.18; P < .001), and readmission (adjusted OR, 1.07; 95% CI, 1.02-1.13; P < .001). CONCLUSION Higher levels of preoperative RDW appeared to be associated with less optimal outcomes after revision TJA. Adult reconstruction orthopedic surgeons should be aware of this predictive factor and exercise caution with TJA revision patients with high values of preoperative RDW. RDW could be included in the routine perioperative workup and used to counsel patients on their postoperative risk.
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Poz D, De Falco E, Pisano C, Madonna R, Ferdinandy P, Balistreri CR. Diagnostic and Prognostic Relevance of Red Blood Cell Distribution Width for Vascular Aging and Cardiovascular Diseases. Rejuvenation Res 2018; 22:146-162. [PMID: 30132390 DOI: 10.1089/rej.2018.2094] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022] Open
Abstract
Evidence suggests association of red blood cell distribution width (RDW) with cardiovascular diseases (CVDs). On the contrary, we underline that the sole RDW values cannot represent a valid CVD biomarker. High RDW values are expression of biological effects of a lot of both endogenous and exogenous factors (i.e., age, sex, genetic background, inflammation, hormones, drugs, diet, exercise, hematological analyzers, and ranges of values), modulating the biology and physiology of erythrocytes. Thus, the singular monitoring of RDW cannot be used to predict cardiovascular disorders. Accordingly, we have reviewed the evidence for potential relationship of RDW values with alterations in the cardiovascular system (i.e., regenerative capacity, endothelial turnover, and senescence of cardiovascular cells), associated with vascular aging and disease. In addition, we highlight the inevitable impact of biases in clinical application of RDW related to CVDs. Based on our thorough review of literature, we suggest a combined evaluation of RDW with other emerging biomarkers related to vascular aging and the diagnosis and prognosis of CVDs, including telomere length of leukocytes, circulating nucleated red blood cells (nRBCs) and endothelial progenitor cells (EPCs) in future large scale studies.
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Affiliation(s)
- Donatella Poz
- 1 Department of Laboratory Medicine, Institute of Clinical Pathology, Azienda Sanitaria Universitaria Integrata (ASUI) di Udine, Udine, Italy
| | - Elena De Falco
- 2 Department of Medical-Surgical Sciences and Biotechnologies, "Sapienza" University of Rome, Latina, Italy
| | - Calogera Pisano
- 3 Cardiac Surgery, Tor Vergata University, Cardiochirurgia Policlinico Tor Vergata, Rome, Italy
| | - Rosalinda Madonna
- 4 Heart Failure Research, Texas Heart Institute, St. Luke's Episcopal Hospital, Houston, Texas.,5 Department of Internal Medicine, Cardiology, The University of Texas Health Science Center at Houston, Houston, Texas.,6 Department of Neurosciences, Center of Aging Sciences and Translational Medicine, CESI-Met and Institute of Cardiology, Imaging and Clinical Sciences "G. D'Annunzio" University, Chieti, Italy
| | - Peter Ferdinandy
- 7 Department of Pharmacology and Pharmacotherapy, Semmelweis University, Budapest, Hungary.,8 Pharmahungary Group, Szeged, Hungary
| | - Carmela Rita Balistreri
- 9 Department of Pathobiology and Medical and Forensic Biotechnologies, University of Palermo, Palermo, Italy
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Lai Z, Yang Y, Yan Y, Li T, Li Y, Wang Z, Shen Z, Ye Y, Jiang K, Wang S. Analysis of co-expression networks for circular RNAs and mRNAs reveals that circular RNAs hsa_circ_0047905, hsa_circ_0138960 and has-circRNA7690-15 are candidate oncogenes in gastric cancer. Cell Cycle 2017; 16:2301-2311. [PMID: 28980874 DOI: 10.1080/15384101.2017.1380135] [Citation(s) in RCA: 42] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022] Open
Abstract
Accumulating evidence has suggested that circular RNAs (circRNAs) play important roles in oncogenesis and tumor progression. However, our knowledge of circRNAs in gastric cancer (GC) remains limited. To investigate circRNAs involved in GC oncogenesis, we examined differentially-expressed circRNAs and mRNAs in GC tissues and paired noncancerous mucosa tissues using circRNA and mRNA microarrays. Next, we built gene co-expression networks according to the degree of correlation to predict the critical circRNAs in GC. Through bioinformatics analysis, we observed three newly identified circRNAs that are substantially upregulated in GC: hsa_circ_0047905, hsa_circ_0138960 and has-circRNA7690-15. Additionally, hsa_circ_0047905 and hsa_circ_0138960 positively correlated with their parental gene mRNA. Knockdown of hsa_circ_0047905, hsa_circ_0138960 and has-circRNA7690-15 in GC cells, resulted in downregulation of parental gene expression. Functional assays suggested that inhibition of these three circular RNAs suppresses GC cell proliferation and invasion in vitro. Those findings suggest that hsa_circ_0047905, hsa_circ_0138960 and has-circRNA7690-15 might act as tumor promoters in the pathogenesis of gastric cancer.
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Affiliation(s)
- Zhiyong Lai
- a Department of Gastroenterological Surgery , Laboratory of Surgical Oncology , Beijing Key Laboratory of Colorectal Cancer Diagnosis and Treatment Research , Peking University People's Hospital , No.11 Xizhimen South Street, Xicheng District, Beijing , People's Republic of China
| | - Yang Yang
- b Department of Breast Center , Peking University People's Hospital , No.11 Xizhimen South Street, Xicheng District, Beijing , People's Republic of China
| | - Yichao Yan
- c Department of Gastroenterological Surgery , Peking University International Hospital , No.1 Life Park Road, Life Science Park of Zhong Guancun, Changping District, Beijing , People's Republic of China
| | - Tao Li
- a Department of Gastroenterological Surgery , Laboratory of Surgical Oncology , Beijing Key Laboratory of Colorectal Cancer Diagnosis and Treatment Research , Peking University People's Hospital , No.11 Xizhimen South Street, Xicheng District, Beijing , People's Republic of China
| | - Yansen Li
- a Department of Gastroenterological Surgery , Laboratory of Surgical Oncology , Beijing Key Laboratory of Colorectal Cancer Diagnosis and Treatment Research , Peking University People's Hospital , No.11 Xizhimen South Street, Xicheng District, Beijing , People's Republic of China
| | - Zhu Wang
- a Department of Gastroenterological Surgery , Laboratory of Surgical Oncology , Beijing Key Laboratory of Colorectal Cancer Diagnosis and Treatment Research , Peking University People's Hospital , No.11 Xizhimen South Street, Xicheng District, Beijing , People's Republic of China
| | - Zhanlong Shen
- a Department of Gastroenterological Surgery , Laboratory of Surgical Oncology , Beijing Key Laboratory of Colorectal Cancer Diagnosis and Treatment Research , Peking University People's Hospital , No.11 Xizhimen South Street, Xicheng District, Beijing , People's Republic of China
| | - Yingjiang Ye
- a Department of Gastroenterological Surgery , Laboratory of Surgical Oncology , Beijing Key Laboratory of Colorectal Cancer Diagnosis and Treatment Research , Peking University People's Hospital , No.11 Xizhimen South Street, Xicheng District, Beijing , People's Republic of China
| | - Kewei Jiang
- a Department of Gastroenterological Surgery , Laboratory of Surgical Oncology , Beijing Key Laboratory of Colorectal Cancer Diagnosis and Treatment Research , Peking University People's Hospital , No.11 Xizhimen South Street, Xicheng District, Beijing , People's Republic of China
| | - Shan Wang
- a Department of Gastroenterological Surgery , Laboratory of Surgical Oncology , Beijing Key Laboratory of Colorectal Cancer Diagnosis and Treatment Research , Peking University People's Hospital , No.11 Xizhimen South Street, Xicheng District, Beijing , People's Republic of China
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