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Chen J, Zhang D, Zhou D, Dai Z, Wang J. Association between red cell distribution width/serum albumin ratio and diabetic kidney disease. J Diabetes 2024; 16:e13575. [PMID: 38923843 PMCID: PMC11200132 DOI: 10.1111/1753-0407.13575] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/31/2024] [Revised: 04/25/2024] [Accepted: 05/06/2024] [Indexed: 06/28/2024] Open
Abstract
BACKGROUND Previous studies have shown that the red cell distribution width (RDW)/serum albumin ratio (RA) is an integrative and new inflammatory marker. RA is associated with clinical outcomes in a variety of diseases, but the clinical value of RDW/RA in the assessment of diabetic kidney disease (DKD) has not been elucidated. We examined the link between diabetic RA and DKD while controlling for a wide variety of possible confounders. METHODS Retrospective cohort analysis of the National Health and Nutrition Examination Survey (NHANES: 2009-2018) database from the Second Affiliated Hospital and Yuying Children's Hospital and the Wenzhou Medical University (WMU) database was conducted. Multivariate logistic regression analysis was used to assess the association between RA and DKD. RESULTS Overall, 4513 diabetic patients from the NHANES database (n = 2839) and the WMU (n = 1412) were included in this study; 974 patients were diagnosed with DKD in NHANES and 462 in WMU. In the NHANES cohort, diabetes mellitus (DM) patients with higher RA level had a higher risk of DKD (odds ratio = 1.461, 95% confidence interval: 1.250-1.707, p < 0.00001). After adjusting for confounders and propensity score-matched (PSM) analysis, both shown RA levels were independently linked to DKD (pAdjust = 0.00994, pPSM = 0.02889). Similar results were also observed in the WMU cohort (p < 0.00001). CONCLUSIONS The study observes that the RA was an independent predictor of DKD in DM patients. The RA, a biomarker that is cost-effective and easy-to-access, may have potential for risk stratification of DKD.
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Affiliation(s)
- Jiaqi Chen
- Department of EndocrinologySecond Affiliated Hospital and Yuying Children's Hospital of Wenzhou Medical UniversityWenzhouChina
| | - Daguan Zhang
- Department of GastroenterologyFirst Affiliated Hospital of Wenzhou Medical UniversityWenzhouChina
| | - Depu Zhou
- Department of EndocrinologyFirst Affiliated Hospital of Wenzhou Medical UniversityWenzhouChina
| | - Zhijuan Dai
- Department of EndocrinologySecond Affiliated Hospital and Yuying Children's Hospital of Wenzhou Medical UniversityWenzhouChina
| | - Jie Wang
- Department of EndocrinologySecond Affiliated Hospital and Yuying Children's Hospital of Wenzhou Medical UniversityWenzhouChina
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Shan X, Li Z, Jiang J, Li W, Zhan J, Dong L. Prognostic value of red blood cell distribution width to albumin ratio for predicting mortality in adult patients meeting sepsis-3 criteria in intensive care units. BMC Anesthesiol 2024; 24:208. [PMID: 38877408 PMCID: PMC11177566 DOI: 10.1186/s12871-024-02585-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2024] [Accepted: 05/29/2024] [Indexed: 06/16/2024] Open
Abstract
BACKGROUND Patients with sepsis with low albumin levels and high red blood cell distribution width levels have poor prognoses. Red blood cell distribution width to albumin ratio (RAR) has recently attracted attention as an innovative inflammation biomarker. We aimed to explore the association between RAR and the prognosis of patients with sepsis. METHODS This retrospective observational study included 402 patients meeting the sepsis-3 standards admitted to Yantai Yuhuangding Hospital's intensive care units (ICUs) between January 2020 and December 2022. The relationship between RAR and mortality in patients with sepsis was examined using regression analysis, Kaplan-Meier analyses, and a receiver operating characteristic curve. Subgroup and sensitivity analyses were conducted to assess the results' robustness. RESULTS RAR, when considered as a continuous variable, was a significant independent in-hospital mortality risk factor (adjusted odds ratio [OR]: 1.383; 95% confidence interval [CI]: 1.164-1.645; P < 0.001). When considering RAR as a categorical variable, the ORs (95% CIs) of hospital mortality for quartile 2 (Q2), Q3, and Q4 compared with Q1 were 1.027 (0.413-2.551), 3.632 (1.579-8.354), and 4.175 (1.625-10.729), respectively, P < 0.001. Similar outcomes were observed for 28- and 90-day mortalities. CONCLUSIONS RAR may indicate clinical prognosis for patients with sepsis in the ICU, potentially providing a low-cost, easily repeatable, and accessible biomarker for risk categorization for these patients.
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Affiliation(s)
- Xiaoxi Shan
- Department of Respiratory and Critical Care Medicine, Tianjin Medical University General Hospital, Tianjin, China
- Department of Pulmonary and Critical Care Medicine, Yantai Yuhuangding Hospital, Yantai, Shandong, China
| | - Zhishu Li
- Department of Respiratory and Critical Care Medicine, Tianjin Medical University General Hospital, Tianjin, China
| | - Jing Jiang
- Department of Pulmonary and Critical Care Medicine, Yantai Yuhuangding Hospital, Yantai, Shandong, China
| | - Wei Li
- Department of Pulmonary and Critical Care Medicine, Yantai Yuhuangding Hospital, Yantai, Shandong, China
| | - Jingyan Zhan
- Department of Training, Yantai Yuhuangding Hospital, Yantai, Shandong, China
| | - Lixia Dong
- Department of Respiratory and Critical Care Medicine, Tianjin Medical University General Hospital, Tianjin, China.
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He Y, Xiao F, Luo Q, Liao J, Huang H, He Y, Gao M, Liao Y, Xiong Z. Red cell distribution width to albumin ratio predicts treatment failure in peritoneal dialysis-associated peritonitis. Ther Apher Dial 2024; 28:399-408. [PMID: 38112028 DOI: 10.1111/1744-9987.14098] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2023] [Revised: 11/24/2023] [Accepted: 11/30/2023] [Indexed: 12/20/2023]
Abstract
BACKGROUND This study aims to investigate the potential correlation between baseline red cell distribution width (RDW) to albumin ratio (RAR) levels and treatment failure in peritoneal dialysis-associated peritonitis (PDAP) patients. METHODS A retrospective single-center study was conducted on 286 PDAP patients. Logistic regression and generalized estimation equation (GEE) analyses were employed to assess the relationship between RAR and treatment failure. RESULTS RAR emerged as a robust predictor of treatment failure in PDAP patients. Elevated RAR levels were associated with an increased risk of treatment failure, exhibiting a linear relationship. Even after adjusting for demographic and clinical variables, this association remained statistically significant. ROC analysis revealed that RAR outperformed RDW and albumin individually in predicting PDAP prognosis. CONCLUSION This study highlights RAR as a superior prognostic marker for treatment failure in PDAP patients, offering new insights into risk assessment and management strategies for this challenging condition.
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Affiliation(s)
- Yujian He
- Renal Division, Peking University Shenzhen Hospital (PKU-Shenzhen Clinical Institute of Shantou University Medical College, PKU-Shenzhen Clinical Institute of Shenzhen University Medical College), Shenzhen, China
| | - Fei Xiao
- Renal Division, Peking University Shenzhen Hospital (PKU-Shenzhen Clinical Institute of Shantou University Medical College, PKU-Shenzhen Clinical Institute of Shenzhen University Medical College), Shenzhen, China
| | - Qingyun Luo
- Renal Division, Peking University Shenzhen Hospital (PKU-Shenzhen Clinical Institute of Shantou University Medical College, PKU-Shenzhen Clinical Institute of Shenzhen University Medical College), Shenzhen, China
| | - Jinlan Liao
- Renal Division, Peking University Shenzhen Hospital (PKU-Shenzhen Clinical Institute of Shantou University Medical College, PKU-Shenzhen Clinical Institute of Shenzhen University Medical College), Shenzhen, China
| | - Huie Huang
- Renal Division, Peking University Shenzhen Hospital (PKU-Shenzhen Clinical Institute of Shantou University Medical College, PKU-Shenzhen Clinical Institute of Shenzhen University Medical College), Shenzhen, China
| | - Yan He
- Renal Division, Peking University Shenzhen Hospital (PKU-Shenzhen Clinical Institute of Shantou University Medical College, PKU-Shenzhen Clinical Institute of Shenzhen University Medical College), Shenzhen, China
| | - Min Gao
- Renal Division, Peking University Shenzhen Hospital (PKU-Shenzhen Clinical Institute of Shantou University Medical College, PKU-Shenzhen Clinical Institute of Shenzhen University Medical College), Shenzhen, China
| | - Yumei Liao
- Renal Division, Peking University Shenzhen Hospital (PKU-Shenzhen Clinical Institute of Shantou University Medical College, PKU-Shenzhen Clinical Institute of Shenzhen University Medical College), Shenzhen, China
| | - Zibo Xiong
- Renal Division, Peking University Shenzhen Hospital (PKU-Shenzhen Clinical Institute of Shantou University Medical College, PKU-Shenzhen Clinical Institute of Shenzhen University Medical College), Shenzhen, China
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Wei S, Xiaqin W, Liwei L, Fasu Z, Ying P, Pingping T, Furong Y. Analysis of Risk Factors for Death in the Coronavirus Disease 2019 (COVID-19) Population: Data Analysis from a Large General Hospital in Anhui, China. Cureus 2024; 16:e60069. [PMID: 38741698 PMCID: PMC11089484 DOI: 10.7759/cureus.60069] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/10/2024] [Indexed: 05/16/2024] Open
Abstract
During the coronavirus disease 2019 (COVID-19) pandemic, clinical prevention, early diagnosis, and hematological monitoring were challenging areas. This study aims to compare risk factors and hematological and biochemical data in non-survivor group patients with COVID-19 versus survivor group patients. A total of 204 patients with COVID-19 were selected as research subjects from December 2022 to January 2023. We analyzed the age, sex, time from onset to admission, and laboratory test indicators upon admission. The differences between surviving and deceased patients and mortality-related risk factors were examined. Among the 204 patients, 168 survived, whereas 36 died during hospitalization. Significant differences were observed between the two groups with COVID-19 across various factors, including age (p < 0.0001), WBC count (p < 0.0001), RBC count (p < 0.05), neutrophils (p < 0.0001), lymphocytes (p < 0.05), mean corpuscular hemoglobin concentration (MCHC) (p < 0.0001), RBC distribution width-standard deviation (RDW-SD) (p < 0.0001), RBC distribution width coefficient of variation (RDW-CV) (p < 0.0001), aspartate aminotransferase (AST) (p < 0.05), albumin (ALB) (p < 0.0001), creatinine (CR) (p < 0.0001), uric acid (UA) (p < 0.0001), blood urea nitrogen (BUN) (p < 0.0001), plasma thrombin time (TT) (p < 0.05), prothrombin time (PT) (p < 0.0001), and D-dimer (p < 0.0001). Multivariate logistic analysis revealed that older age, CR, UA, and ALB were independent factors associated with death (p < 0.05). Elderly patients with underlying diseases, abnormal routine blood test indices, and abnormal renal function and coagulation indices are at an increased worse prognosis and should be identified early. Age, UA, CR, and ALB can be used as predictors to assess the worse prognosis in the hospital.
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Affiliation(s)
- Shi Wei
- Medical Laboratory Science, Anhui Medical College, Hefei, CHN
| | - Wu Xiaqin
- Medical Laboratory, Anqing Center, Anhui Medical University, Anqing, CHN
| | - Liu Liwei
- Immunology, Anhui Medical College, Hefei, CHN
| | - Zhang Fasu
- Medical Laboratory Science, Anhui Medical College, Hefei, CHN
| | - Pan Ying
- Medical Laboratory Science, Anhui Medical College, Hefei, CHN
| | - Tian Pingping
- Medical Laboratory Science, Anhui Medical College, Hefei, CHN
| | - Yu Furong
- Medical Laboratory Science, Anhui Medical College, Hefei, CHN
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Eyiol A, Ertekin B. Association of red blood cell distribution width to albumin ratio with prognosis in stroke patients. Biomark Med 2024; 18:311-320. [PMID: 38648096 PMCID: PMC11218802 DOI: 10.2217/bmm-2023-0460] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2023] [Accepted: 03/05/2024] [Indexed: 04/25/2024] Open
Abstract
Aim: The authors investigated the association of red blood cell distribution width to albumin ratio (RAR) with prognosis and severity in acute ischemic stroke (AIS). Methods: One hundred twenty-seven patients with AIS were prospectively analyzed. The NIH Stroke Scale was used to determine stroke severity. RAR was compared between severe and nonsevere patients. Results: RAR was significantly higher in severe compared with nonsevere patients (p < 0.001). According to receiver operating characteristic analysis, RAR alone predicted mortality better than red blood cell distribution width and albumin (area under the curve: 0.933, 0.911, 0.870, respectively). Additionally, RAR was significantly correlated with NIH Stroke Scale score (p < 0.001). Conclusion: High RAR measured at presentation is a feasible index for prognosis and severity stratification in AIS.
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Affiliation(s)
- Azmi Eyiol
- Department of Cardiology, University of Health Sciences, Beyhekim Training & Research Hospital, Konya, Turkey
| | - Birsen Ertekin
- Department of Emergency, University of Health Sciences, Beyhekim Training & Research Hospital, Konya, Turkey
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Li D, Long J, Zhang J, He M, Zeng Q, He Q, Zhan W, Chi Y, Zou M. Association between red cell distribution width-and-albumin ratio and the risk of peripheral artery disease in patients with diabetes. Front Endocrinol (Lausanne) 2024; 15:1272573. [PMID: 38405142 PMCID: PMC10884210 DOI: 10.3389/fendo.2024.1272573] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/04/2023] [Accepted: 01/22/2024] [Indexed: 02/27/2024] Open
Abstract
Aim The aim of this study is to explore the association between red blood cell distribution width-to-albumin ratio (RAR) and the risk of peripheral artery disease (PAD) in patients with diabetes. Methods This cross-sectional study extracted the data of 1,125 participants with diabetes from the National Health and Nutrition Examination Survey database. A weighted univariable logistic regression model was used to explore variables associated with PAD. With PAD as the outcome variable, a weighted logistic regression model was established. The odds ratio (OR) and 95% confidence interval (CI) were effect size. Results After adjusting for covariates, the risk of PAD in patients with diabetes was observed in those with higher RAR (OR = 1.83; 95% CI: 1.06-3.15). In addition, RAR ≥3.25 was related to increased risk of PAD in patients with diabetes (OR = 2.04; 95% CI: 1.05-3.95). In people with diabetes aged ≥65, RAR was a risk factor for PAD with an OR value of 2.67 (95% CI: 1.30-5.46). RAR ≥3.25 was associated with increased risk of PAD (OR = 3.06; 95% CI: 1.15-8.11) relative to RAR <2.80. In people with diabetes who smoked, the risk of PAD was elevated in those with RAR ≥3.25 (OR = 2.85; 95% CI: 1.28-6.32). As for patients with cardiovascular disease, the risk of PAD was elevated as the increase of RAR (OR = 2.31; 95% CI: 1.05-5.10). RAR ≥3.25 was correlated with increased risk of PAD (OR = 3.75; 95% CI: 1.42-9.87). The area under the curve of RAR for the risk of PAD in patients with diabetes was 0.631 (95% CI: 0.588-0.675). Conclusion A higher RAR was related to increased risk of PAD in patients with diabetes. The findings might offer a reference for the management of PAD in patients with diabetes.
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Affiliation(s)
- Dongling Li
- Department of Endocrinology and Metabolism, Nanfang Hospital, Southern Medical University, Guangzhou, China
| | - Juan Long
- Department of Endocrinology and Metabolism, Nanfang Hospital, Southern Medical University, Guangzhou, China
| | - Jialu Zhang
- Department of Endocrinology and Metabolism, Nanfang Hospital, Southern Medical University, Guangzhou, China
| | - Meinan He
- Department of Endocrinology and Metabolism, Nanfang Hospital, Southern Medical University, Guangzhou, China
| | - Qingxiang Zeng
- Department of Endocrinology and Metabolism, Nanfang Hospital, Southern Medical University, Guangzhou, China
| | - Qiaoling He
- Department of Endocrinology, Central Hospital of Zengcheng District, Guangzhou, China
| | - Wanhua Zhan
- Department of Endocrinology, Central Hospital of Zengcheng District, Guangzhou, China
| | - Yongqian Chi
- Department of Endocrinology, Central Hospital of Zengcheng District, Guangzhou, China
| | - Mengchen Zou
- Department of Endocrinology and Metabolism, Nanfang Hospital, Southern Medical University, Guangzhou, China
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Fu W, Hu F, Xu C. Association between red blood cell distribution width/albumin ratio and all-cause mortality or cardiovascular diseases mortality in patients with diabetic retinopathy: A cohort study. PLoS One 2023; 18:e0296019. [PMID: 38128055 PMCID: PMC10735013 DOI: 10.1371/journal.pone.0296019] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2023] [Accepted: 12/04/2023] [Indexed: 12/23/2023] Open
Abstract
BACKGROUND Red blood cell distribution width/albumin ratio (RAR) has been reported as an independent risk factor for diabetic retinopathy (DR), while its association and predictive value in the prognosis of DR patients has not been reported. This study aims to explore the association and predictive value of RAR in the prognosis of DR patients. METHODS This was a retrospective cohort study based on the National Health and Nutrition Examination Survey (NHANES). The independent variable was RAR, and dependent variables were all-cause mortality and cardiovascular diseases (CVD) mortality. The association between RAR and the risk of all-cause mortality and CVD mortality was assessed using univariate and multivariate cox regression models. The results were shown as HR (hazard ratio) with 95% confidence intervals (CIs). Subgroup analysis based on age or hyperlipidemia was performed. The discrimination of the prediction model was assessed using concordance index (C-index). RESULTS A total of 725 eligible patients were finally included in this study. The increase of RAR was associated with increased risk of all-cause mortality (HR: 1.15, 95%CI: 1.01-1.31) and CVD mortality (HR: 1.35, 95%CI: 1.12-1.63) after adjusting the covariates. We also found the significant association between higher RAR and higher risk of CVD mortality in DR patients with age < 65 years (HR: 1.35, 95%CI: 1.09-1.67) and with hyperlipidemia (HR: 1.34, 95%CI: 1.10-1.64). C-index of RAR for all-cause mortality and CVD mortality was 0.63 (95%CI: 0.59-0.67) and 0.65 (95%CI: 0.59-0.71), respectively. CONCLUSIONS Higher RAR was associated with the higher risk of all-cause mortality and CVD mortality in DR patients, and RAR may be a useful predictor for the prognosis of DR patients.
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Affiliation(s)
- Weina Fu
- Department of Ophthalmology, Ningbo Medical Center Lihuili Hospital, Ningbo University, Ningbo, P.R. China
| | - Feng Hu
- Department of Ophthalmology, Ningbo Medical Center Lihuili Hospital, Ningbo University, Ningbo, P.R. China
| | - Caiyun Xu
- The Archive Room, Ningbo Medical Center Lihuili Hospital, Ningbo University, Ningbo, P.R. China
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Meng L, Yang H, Xin S, Chang C, Liu L, Gu G. Association of red blood cell distribution width-to-albumin ratio with mortality in patients undergoing transcatheter aortic valve replacement. PLoS One 2023; 18:e0286561. [PMID: 37276211 DOI: 10.1371/journal.pone.0286561] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2023] [Accepted: 05/18/2023] [Indexed: 06/07/2023] Open
Abstract
BACKGROUND Frailty is associated with poor prognosis in patients undergoing transcatheter aortic valve replacement (TAVR). The red blood cell distribution width (RDW)-to-albumin ratio (RAR) reflects key components of frailty. This study aimed to evaluate the relationship between RAR and all-cause mortality in patients undergoing TAVR. METHODS The data were extracted from the Medical Information Mart for Intensive Care IV database. The RAR was computed by dividing the RDW by the albumin. The primary outcome was all-cause mortality within 1-year following TAVR. The association between RAR and the primary outcome was evaluated using the Kaplan-Meier survival curves, restricted cubic spline (RCS), and Cox proportional hazard regression models. RESULTS A total of 760 patients (52.9% male) with a median age of 84.0 years were assessed. The Kaplan-Meier survival curves showed that patients with higher RAR had higher mortality (log-rank P < 0.001). After adjustment for potential confounders, we found that a 1 unit increase in RAR was associated with a 46% increase in 1-year mortality (HR = 1.46, 95% CI:1.22-1.75, P < 0.001). According to the RAR tertiles, high RAR (RAR > 4.0) compared with the low RAR group (RAR < 3.5) significantly increased the risk of 1-year mortality (HR = 2.21, 95% CI: 1.23-3.95, P = 0.008). The RCS regression model revealed a continuous linear relationship between RAR and all-cause mortality. No significant interaction was observed in the subgroup analysis. CONCLUSION The RAR is independently associated with all-cause mortality in patients treated with TAVR. The higher the RAR, the higher the mortality. This simple indicator may be helpful for risk stratification of TAVR patients.
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Affiliation(s)
- Limin Meng
- Department of Cardiology, The Second Hospital of Hebei Medical University, Shijiazhuang, Hebei, China
- Department of Cardiology, Handan First Hospital, Handan, Hebei, China
| | - Hua Yang
- Department of Cardiology, The Second Hospital of Hebei Medical University, Shijiazhuang, Hebei, China
- Department of Cardiology, Handan First Hospital, Handan, Hebei, China
| | - Shuanli Xin
- Department of Cardiology, Handan First Hospital, Handan, Hebei, China
| | - Chao Chang
- Department of Cardiology, Handan First Hospital, Handan, Hebei, China
| | - Lijun Liu
- Department of Cardiology, Handan First Hospital, Handan, Hebei, China
| | - Guoqiang Gu
- Department of Cardiology, The Second Hospital of Hebei Medical University, Shijiazhuang, Hebei, China
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Rafaqat S, Rafaqat S. Role of hematological parameters in pathogenesis of diabetes mellitus: A review of the literature. World J Hematol 2023; 10:25-41. [DOI: 10.5315/wjh.v10.i3.25] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/07/2022] [Revised: 01/03/2023] [Accepted: 03/09/2023] [Indexed: 03/22/2023] Open
Abstract
Diabetes mellitus (DM) is characterized by hyperglycemia and abnormalities in insulin secretion and activity. There are numerous hematological parameters; however, this review article only focuses on red blood cells, hemoglobin, hematocrit, red blood cell indices, platelet count, white blood cells, lymphocytes, neutrophils, monocytes, eosinophils, neutrophil-to-lymphocyte ratio, platelet-to-lymphocyte ratio, and monocyte-to-lymphocyte ratio, which play an essential role in the pathogenesis of DM. Also, this review article aims to report the relationship between these hematological parameters and the development of DM. In con-clusion, this article shows that increased levels of platelets, red blood cells, hematocrit, lymphocytes, eosinophils, neutrophils, neutrophil-to-lymphocyte ratio, platelet-to-lymphocyte ratio, and monocyte-to-lymphocyte ratio and decreased levels of hemoglobin are involved in the pathogenesis of DM. However, the role of basophils in DM is unknown yet.
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Affiliation(s)
- Sana Rafaqat
- Department of Biotechnology, Lahore College for Women University, Lahore 5400, Pakistan
| | - Saira Rafaqat
- Department of Zoology, Lahore College for Women University, Lahore 5400, Pakistan
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Ertekin B, Acar T. The Relationship Between Prognosis and Red Cell Distribution Width (RDW) and RDW-Albumin Ratio (RAR) in Patients with Severe COVID-19 Disease. Int J Gen Med 2022; 15:8637-8645. [PMID: 36561230 PMCID: PMC9767021 DOI: 10.2147/ijgm.s392453] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2022] [Accepted: 11/30/2022] [Indexed: 12/23/2022] Open
Abstract
Purpose The present study aimed to investigate the relationship between prognosis and the red cell distribution width (RDW) and the RDW-albumin ratio (RAR) in patients with coronavirus diseases 2019 (COVID-19), since serum albumin and RDW levels may reflect inflammatory conditions. Patients and Methods A total of 289 patients who had been diagnosed with severe COVID-19 in the emergency department were retrospectively analyzed. The RAR levels were calculated by dividing RDW-CV by albumin. Patient groups (survivors, dying patients, those who received mechanical ventilation (MV) support or not, and those who needed vasopressors or not) were compared with regard to RDW-SD, RDW-CV and the RAR levels. Results RDW-SD, RDW-CV and the RAR levels were found to be statistically significantly higher in patients who died, and who received MV and vasopressor support, compared to those who survived and did not receive support (p<0.001 for all). In addition, while the cut-off value of RAR was >5.43, the sensitivity was 91.6%, the specificity was 93.7%, NPV was 93.1% and the AUC was 0.965 in predicting mortality (p<0.001). Logistic regression analysis showed that RDW-SD and RAR were independent risk factors for mortality in patients with severe COVID-19. Conclusion Elevated RDW and RAR levels at the time of admission may independently predict mortality and the need for vasopressor or MV support.
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Affiliation(s)
- Birsen Ertekin
- Department of Emergency, University of Health Sciences, Beyhekim Training and Research Hospital, Konya, Turkey,Correspondence: Birsen Ertekin, Tel +903322243524 – 3145, Email
| | - Tarık Acar
- Department of Emergency, University of Health Sciences, Beyhekim Training and Research Hospital, Konya, Turkey
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Xu W, Huo J, Chen G, Yang K, Huang Z, Peng L, Xu J, Jiang J. Association between red blood cell distribution width to albumin ratio and prognosis of patients with sepsis: A retrospective cohort study. Front Nutr 2022; 9:1019502. [PMID: 36211519 PMCID: PMC9539557 DOI: 10.3389/fnut.2022.1019502] [Citation(s) in RCA: 14] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/15/2022] [Accepted: 09/05/2022] [Indexed: 11/13/2022] Open
Abstract
Background Red blood cell distribution width (RDW) to albumin ratio (RAR) is associated with poor prognosis in diabetic comorbidities and cancer. However, the association between RAR and prognosis in patients with sepsis remains unclear, which was investigated in this study. Methods We conducted a retrospective cohort study based on the Medical Information Mart for Intensive Care (MIMIC) IV version 2.0 database. The primary outcome of this study was 28-day mortality. Secondary outcomes included 90-day mortality, in-hospital mortality, length of hospital stay, and length of intensive care unit (ICU) stay. Multivariate regression analysis and subgroup analysis were performed to investigate the association between RAR and prognosis in patients with sepsis. Results A total of 14,639 participants were included in this study. The mean age of the participants was 65.2 ± 16.3 years and the mean RAR was 5.5 ± 1.9 % /g/dl. For 28-day mortality, after adjusting for covariates, HRs [95% confidence intervals (CIs)] for tertiles 2 (4.4–5.8) and 3 (RAR > 5.8) were 1.33 (1.20, 1.46) and 1.98 (1.79, 2.19), respectively. Similar results were observed for 90-day mortality and in-hospital mortality. According to Kaplan-Meier curve analysis, the higher RAR group had higher 28-day mortality and 90-day mortality. Conclusion Our study shows that RAR is significantly associated with poor clinical prognosis in sepsis. The higher the RAR, the higher the 28-day, 90-day, and in-hospital mortality.
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Affiliation(s)
- Weigan Xu
- Department of Emergency, First People's Hospital of Foshan, Foshan, China
- The Poison Treatment Centre of Foshan, First People's Hospital of Foshan, Foshan, China
| | - Jianyang Huo
- Department of Emergency, First People's Hospital of Foshan, Foshan, China
- The Poison Treatment Centre of Foshan, First People's Hospital of Foshan, Foshan, China
| | - Guojun Chen
- Department of Emergency, First People's Hospital of Foshan, Foshan, China
- The Poison Treatment Centre of Foshan, First People's Hospital of Foshan, Foshan, China
| | - Kangyi Yang
- Department of Emergency, First People's Hospital of Foshan, Foshan, China
- The Poison Treatment Centre of Foshan, First People's Hospital of Foshan, Foshan, China
| | - Zuhua Huang
- Department of Emergency, First People's Hospital of Foshan, Foshan, China
- The Poison Treatment Centre of Foshan, First People's Hospital of Foshan, Foshan, China
| | - Lina Peng
- Department of Emergency, First People's Hospital of Foshan, Foshan, China
- The Poison Treatment Centre of Foshan, First People's Hospital of Foshan, Foshan, China
| | - Jingtao Xu
- Department of Emergency, First People's Hospital of Foshan, Foshan, China
- The Poison Treatment Centre of Foshan, First People's Hospital of Foshan, Foshan, China
| | - Jun Jiang
- The Poison Treatment Centre of Foshan, First People's Hospital of Foshan, Foshan, China
- *Correspondence: Jun Jiang
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Weng Y, Peng Y, Xu Y, Wang L, Wu B, Xiang H, Ji K, Guan X. The Ratio of Red Blood Cell Distribution Width to Albumin Is Correlated With All-Cause Mortality of Patients After Percutaneous Coronary Intervention – A Retrospective Cohort Study. Front Cardiovasc Med 2022; 9:869816. [PMID: 35686040 PMCID: PMC9170887 DOI: 10.3389/fcvm.2022.869816] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2022] [Accepted: 04/14/2022] [Indexed: 12/14/2022] Open
Abstract
Objectives The purpose of this study was to investigate the independent effect of the ratio of red blood cell distribution width (RDW) to albumin (RA) on all-cause mortality in patients after percutaneous coronary intervention (PCI). Methods Clinical data were obtained from the Multiparameter Intelligent Monitoring in Intensive Care-III (MIMIC-III) database version 1.4 and the database of Second Affiliated Hospital and Yuying Children’s Hospital of Wenzhou Medical University. We used the MIMIC-III database for model training, and data collected from the Second Affiliated Hospital of Wenzhou Medical University for validation. The primary outcome of our study was 90-day mortality. Cox proportional hazards regression model was used to estimate hazard ratio (HR) for the association between RA and all-cause mortality in patients after PCI. Pearson correlation analysis was conducted to assess the relationship between RA and Gensini score or cardiac troponin I (cTnI). Results A total of 707 patients were eligible in MIMIC-III database, including 432 males, with a mean age of 70.29 years. For 90-day all-cause mortality, in the adjusted multivariable model, the adjusted HRs [95% confidence intervals (CIs)] for the second (RA: 3.7–4.5 ml/g) and third (RA >4.5 ml/g) tertiles were 2.27 (1.11, 4.64) and 3.67 (1.82, 7.40), respectively, compared to the reference group (RA <3.7 ml/g) (p < 0.05). A similar relationship was also observed for 30-day all-cause mortality and 1-year all-cause mortality. No significant interaction was observed in subgroup analysis. Receiver operating characteristic (ROC) curve analysis proved that the ability of RA to predict the 90-day mortality was better than that of RDW or albumin alone. The correlation coefficient between Gensini score and RA was 0.254, and that between cTnI and RA was 0.323. Conclusion RA is an independent risk factor for all-cause mortality in patients after PCI. The higher the RA, the higher the mortality. RA has a good predictive ability for all-cause mortality in patients after PCI, which is better than RDW or albumin alone. RA may be positively correlated with the severity of coronary artery disease (CAD) in patients with CAD.
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