1
|
Mahmood A, Samad S, Haider H, Hassan W, Mushtaq R, Perwaiz A, Ali A, Azharuddin M. Association of Red Blood Cell and Platelet Parameters with Metabolic Syndrome: A Systematic Review and Meta-Analysis of 170,000 Patients. Horm Metab Res 2024; 56:517-525. [PMID: 38195797 DOI: 10.1055/a-2241-5361] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/11/2024]
Abstract
This systematic review and meta-analysis aim to establish associations between metabolic syndrome (MetS) and erythrocyte and platelet markers, contributing to improved diagnostic tests for identifying individuals at risk. Observational studies and Randomized Controlled Trials (RCTs) were included. The standardized mean difference (SMD) and 95% confidence intervals (CI) of erythrocyte and platelet markers between individuals with and without MetS were used as effect size (inverse variance model). Methodological quality assessment was conducted using the Newcastle-Ottawa scale (NOS) for observational studies and the Cochrane Risk of Bias tool 2.0 for RCTs. The analysis included 51 articles. Compared to controls, individuals with MetS exhibited significantly higher concentrations of mean red blood cell count [Standardized Mean Difference (95% CI): 0.15 (0.13-0.18); p<0.00001], hemoglobin [0.24 (0.18-0.31); p<0.00001], blood platelet count [5.49 (2.78-8.20); p<0.0001], and red blood cell distribution width [(0.55 (0.05-1.04); p=0.03]. Regarding mean platelet volume [0.16 (- 0.03 to 0.35); p=0.10] and platelet-to-lymphocyte ratio (PLR) [7.48 (-2.85-17.81); p=0.16], a non-significant difference was observed in patients with MetS. There was no statistically significant difference in hematocrit counts between the two groups [0.47 (-0.40 to -1.34); p=0.29]. Biomarkers such as mean red blood cell count, hemoglobin, blood platelet count, and RDW are associated with higher levels in patients in MetS, whereas mean platelet volume and PLR tend to be lower. These markers can potentially provide new avenues for early diagnosis of MetS.
Collapse
Affiliation(s)
- Aysal Mahmood
- Internal Medicine, Dow University of Health Sciences, Karachi, Pakistan
| | - Saba Samad
- Internal Medicine, Dow University of Health Sciences, Karachi, Pakistan
| | - Hoorain Haider
- Internal Medicine, Dow University of Health Sciences, Karachi, Pakistan
| | - Wardah Hassan
- Internal Medicine, Dow University of Health Sciences, Karachi, Pakistan
| | - Rabeea Mushtaq
- Internal Medicine, Dow University of Health Sciences, Karachi, Pakistan
| | - Aimen Perwaiz
- Internal Medicine, Dow University of Health Sciences, Karachi, Pakistan
| | - Abraish Ali
- Internal Medicine, Dow University of Health Sciences, Karachi, Pakistan
| | | |
Collapse
|
2
|
Liu Q, Zhai Y, Hui Y, Chen J, Mi Y, Wang J, Wei H. Identification of red blood cell distribution width as a prognostic factor in acute myeloid leukemia. Exp Hematol 2024; 133:104206. [PMID: 38508299 DOI: 10.1016/j.exphem.2024.104206] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/02/2024] [Revised: 02/27/2024] [Accepted: 02/29/2024] [Indexed: 03/22/2024]
Abstract
Many prognostic factors have been identified in acute myeloid leukemia (AML). In this study, we investigated novel prognostic biomarkers using machine learning and Cox regression models in a prospective cohort of 591 patients with AML and tried to identify potential therapeutic targets based on transcriptomic data. We found that elevated red blood cell distribution width (RDW) at diagnosis was an adverse prognostic factor for AML, independent of the 2022 European LeukemiaNet (ELN2022) genetic risk. As a continuous variable, higher RDW was associated with shorter overall survival (OS) (hazard ratio [HR] 1.087, 95% confidence interval [CI] 1.036-1.139, p < 0.001) and event-free survival (EFS) (HR 1.078, 95% CI 1.033-1.124, p < 0.001). Elevated RDW returned to normal after consolidation therapy, which indicated that leukemia cells resulted in abnormal RDW. We further investigated the relationship between RDW and transcriptome in another cohort of 191 patients with AML and public datasets using gene set enrichment analysis (GSEA) and cell-type identification by estimating relative subsets of RNA transcripts (CIBERSORT). We found that patients in the high-RDW group were significantly enriched in the positive regulation of erythroid differentiation and inflammation-related pathways. Finally, we identified the inflammation-associated gene IL12RB2 and verified its prognostic relevance with patients with AML in public databases, suggesting it as a potential therapy target.
Collapse
MESH Headings
- Humans
- Leukemia, Myeloid, Acute/blood
- Leukemia, Myeloid, Acute/genetics
- Leukemia, Myeloid, Acute/diagnosis
- Leukemia, Myeloid, Acute/mortality
- Erythrocyte Indices
- Female
- Male
- Middle Aged
- Prognosis
- Aged
- Adult
- Biomarkers, Tumor/blood
- Biomarkers, Tumor/genetics
- Transcriptome
- Prospective Studies
Collapse
Affiliation(s)
- Qiaoxue Liu
- State Key Laboratory of Experimental Hematology, National Clinical Research Center for Blood Diseases, Haihe Laboratory of Cell Ecosystem, Institute of Hematology & Blood Diseases Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Tianjin, China; Tianjin Institutes of Health Science, Tianjin, China
| | - Yujia Zhai
- State Key Laboratory of Experimental Hematology, National Clinical Research Center for Blood Diseases, Haihe Laboratory of Cell Ecosystem, Institute of Hematology & Blood Diseases Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Tianjin, China; Tianjin Institutes of Health Science, Tianjin, China
| | - Yan Hui
- State Key Laboratory of Experimental Hematology, National Clinical Research Center for Blood Diseases, Haihe Laboratory of Cell Ecosystem, Institute of Hematology & Blood Diseases Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Tianjin, China; Tianjin Institutes of Health Science, Tianjin, China
| | - Jiayuan Chen
- State Key Laboratory of Experimental Hematology, National Clinical Research Center for Blood Diseases, Haihe Laboratory of Cell Ecosystem, Institute of Hematology & Blood Diseases Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Tianjin, China; Tianjin Institutes of Health Science, Tianjin, China
| | - Yingchang Mi
- State Key Laboratory of Experimental Hematology, National Clinical Research Center for Blood Diseases, Haihe Laboratory of Cell Ecosystem, Institute of Hematology & Blood Diseases Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Tianjin, China; Tianjin Institutes of Health Science, Tianjin, China
| | - Jianxiang Wang
- State Key Laboratory of Experimental Hematology, National Clinical Research Center for Blood Diseases, Haihe Laboratory of Cell Ecosystem, Institute of Hematology & Blood Diseases Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Tianjin, China; Tianjin Institutes of Health Science, Tianjin, China.
| | - Hui Wei
- State Key Laboratory of Experimental Hematology, National Clinical Research Center for Blood Diseases, Haihe Laboratory of Cell Ecosystem, Institute of Hematology & Blood Diseases Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Tianjin, China; Tianjin Institutes of Health Science, Tianjin, China.
| |
Collapse
|
3
|
Gironella-Torrent M, Bergamaschi G, Sorkin R, Wuite GJL, Ritort F. Viscoelastic phenotyping of red blood cells. Biophys J 2024; 123:770-781. [PMID: 38268191 PMCID: PMC10995428 DOI: 10.1016/j.bpj.2024.01.019] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2023] [Revised: 12/21/2023] [Accepted: 01/18/2024] [Indexed: 01/26/2024] Open
Abstract
Red blood cells (RBCs) are the simplest cell types with complex dynamical and viscoelastic phenomenology. While the mechanical rigidity and the flickering noise of RBCs have been extensively investigated, an accurate determination of the constitutive equations of the relaxational kinetics is lacking. Here we measure the force relaxation of RBCs under different types of tensional and compressive extension-jump protocols by attaching an optically trapped bead to the RBC membrane. Relaxational kinetics follows linear response from 60 pN (tensional) to -20 pN (compressive) applied forces, exhibiting a triple exponential function with three well-separated timescales over four decades (0.01-100 s). While the fast timescale (τF∼0.02(1)s) corresponds to the relaxation of the membrane, the intermediate and slow timescales (τI=4(1)s; τS=70(8)s) likely arise from the cortex dynamics and the cytosol viscosity. Relaxation is highly heterogeneous across the RBC population, yet the three relaxation times are correlated, showing dynamical scaling. Finally, we find that glucose depletion and laser illumination of RBCs lead to faster triple exponential kinetics and RBC rigidification. Viscoelastic phenotyping is a promising dynamical biomarker applicable to other cell types and active systems.
Collapse
Affiliation(s)
- Marta Gironella-Torrent
- Small Biosystems Lab, Condensed Matter Physics Department, University of Barcelona, Barcelona, Spain; Department of Medical Biochemistry and Cell Biology, Institute of Biomedicine, The Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.
| | - Giulia Bergamaschi
- Department of Physics and Astronomy and LaserLab, Vrije Universiteit Amsterdam, Amsterdam, the Netherlands
| | - Raya Sorkin
- Raymond and Beverly Sackler Faculty of Exact Sciences, School of Chemistry, Tel Aviv University, Tel Aviv, Israel
| | - Gijs J L Wuite
- Department of Physics and Astronomy and LaserLab, Vrije Universiteit Amsterdam, Amsterdam, the Netherlands
| | - Felix Ritort
- Small Biosystems Lab, Condensed Matter Physics Department, University of Barcelona, Barcelona, Spain; Institut de Nanociència i Nanotecnologia (IN2UB), Universitat de Barcelona, Barcelona, Spain
| |
Collapse
|
4
|
Carlisi M, Presti RL, Plano F, Mancuso S, Siragusa S, Caimi G. Changes in RDW according to prognostic predictors in newly diagnosed multiple myeloma. Sci Rep 2024; 14:2832. [PMID: 38310176 PMCID: PMC10838310 DOI: 10.1038/s41598-024-53385-6] [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: 06/25/2023] [Accepted: 01/31/2024] [Indexed: 02/05/2024] Open
Abstract
RDW is an erythrocyte index that increase in multiple myeloma, in which it appears to have an important role in predicting outcome. For this reason, we performed a retrospective analysis to evaluate the relationships of RDW with some important prognostic predictors. Specifically, in a cohort of 190 newly diagnosed multiple myeloma patients, we have examined the behaviour of RDW and its trend in relation to the ISS stage and other prognostic factors, such as albumin, beta-2 microglobulin, LDH and bone marrow plasma cell infiltration. We performed the analysis in the entire cohort of patients and in the three different disease isotypes (Light chain, IgA, and IgG multiple myeloma). The evaluation of RDW in the different isotypes was made with the Kruskal-Wallis test, integrated by the Dunn test. The comparison between the subgroups allocated above and below the median value of each prognostic factor, was made with the Mann-Whitney test. From our analysis, we observed that RDW is higher in the IgA multiple myeloma, and it increases significantly from ISS I to III. Moreover, RDW increases in the presence of lower albumin values, higher levels of beta2-microglobulin and LDH and in the presence of a greater bone marrow plasma cell infiltrate.
Collapse
Affiliation(s)
- Melania Carlisi
- Department of Health Promotion, Mother and Child Care, Internal Medicine and Medical Specialties, University of Palermo, Via del Vespro 129, 90127, Palermo, Italy.
| | - R Lo Presti
- Department of Psychology, Educational Science and Human Movement, University of Palermo, Palermo, Italy
| | - F Plano
- Department of Health Promotion, Mother and Child Care, Internal Medicine and Medical Specialties, University of Palermo, Via del Vespro 129, 90127, Palermo, Italy
| | - S Mancuso
- Department of Health Promotion, Mother and Child Care, Internal Medicine and Medical Specialties, University of Palermo, Via del Vespro 129, 90127, Palermo, Italy
| | - S Siragusa
- Department of Health Promotion, Mother and Child Care, Internal Medicine and Medical Specialties, University of Palermo, Via del Vespro 129, 90127, Palermo, Italy
| | - G Caimi
- Department of Health Promotion, Mother and Child Care, Internal Medicine and Medical Specialties, University of Palermo, Via del Vespro 129, 90127, Palermo, Italy
| |
Collapse
|
5
|
Huang B, Yan J, Li C, Jin F, Ma R, Cao G, Chen Y, Liu K, Ning X. Red blood cell distribution width is a risk factor for multiple organ dysfunction syndrome in elderly patients with infection: a case control study. Aging Clin Exp Res 2023:10.1007/s40520-023-02431-w. [PMID: 37233902 DOI: 10.1007/s40520-023-02431-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2023] [Accepted: 04/30/2023] [Indexed: 05/27/2023]
Abstract
BACKGROUND Infection is the leading cause of multiple organ dysfunction syndrome (MODS) in the elderly. Red blood cell distribution width (RDW) was considered to be associated with many diseases. We aimed to explore whether RDW was associated with MODS in elderly infected patients. METHODS We retrospectively collected data from elderly patients (≥ 65 years old) with infection. In this study, we conducted a 1:3 case-control match based on age and gender and utilized binary Logistic regression to investigate the impact of variables such as RDW on MODS. RESULTS A total of 576 eligible patients were included in this study. RDW in the case group was significantly higher than that in control group (p < 0.001). Multivariate analysis found that RDW was an independent risk factor for MODS in elderly infected patients (OR = 1.397, 95% CI: 1.166-1.674, p < 0.001). CONCLUSIONS RDW was an independent risk factor for MODS in elderly patients with infection.
Collapse
Affiliation(s)
- Boyong Huang
- Department of Geriatrics, Xijing Hospital, Fourth Military Medical University, Xi'an, 710032, China
- Special Service Department, No. 989 Hospital of the PLA Joint Logistic Support Force, Pingdingshan, 467000, China
| | - Jipeng Yan
- Department of Nephrology, Xijing Hospital, Fourth Military Medical University, Xi'an, 710032, China
| | - Cui Li
- Department of Geriatrics, Xijing Hospital, Fourth Military Medical University, Xi'an, 710032, China
| | - Fengzhong Jin
- Department of Geriatrics, Xijing Hospital, Fourth Military Medical University, Xi'an, 710032, China
| | - Rui Ma
- Department of Geriatrics, Xijing Hospital, Fourth Military Medical University, Xi'an, 710032, China
| | - Guihua Cao
- Department of Geriatrics, Xijing Hospital, Fourth Military Medical University, Xi'an, 710032, China
| | - Yang Chen
- Department of Geriatrics, Xijing Hospital, Fourth Military Medical University, Xi'an, 710032, China
| | - Kun Liu
- Department of Epidemiology, School of Public Health, Fourth Military Medical University, Xi'an, 710032, China.
| | - Xiaoxuan Ning
- Department of Geriatrics, Xijing Hospital, Fourth Military Medical University, Xi'an, 710032, China.
| |
Collapse
|
6
|
Sinan M, Yalcin O, Karakas Z, Goksel E, Ertan NZ. Zinc improved erythrocyte deformability and aggregation in patients with beta-thalassemia: An in vitro study. Clin Hemorheol Microcirc 2023; 85:1-12. [PMID: 37482986 DOI: 10.3233/ch-221452] [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] [Indexed: 07/25/2023]
Abstract
BACKGROUND Thalassemia patients have reduced red cell deformability and decreased plasma zinc levels in their blood. OBJECTIVE This study aimed to evaluate the effects of zinc (Zn) on the hemorheological parameters and antioxidant enzyme activities in β-thalassemia major (TM) and healthy volunteers (HV). METHODS Hemorheological parameters were measured using LORCA (laser-assisted optical rotational cell analyzer) after adjusting the hematocrit to 40%. Zinc sulfate (ZnSO4.7H2O) was used for Zn incubation with a concentration of 0.5μg/dl. Oxidative stress and antioxidant status were determined using commercial kits. RESULTS Data showed that after Zn incubation, EImax, the area under the EI-osmolarity curve (Area), and Omax decreased in TM. However, no significant difference was observed in the osmotic deformability parameters of HV. The increased elongation index was obtained at different shear stresses for TM and HV, and SS1/2 decreased in both groups. The AMP and aggregation index (AI) decreased in TM, and the required time for half of the maximum aggregation (t1/2) increased in HV. However, Zn did not affect oxidative parameters in both groups. CONCLUSIONS This study showed that Zn incubation increased deformability and decreased aggregation in thalassemic erythrocytes. It means that Zn supplementation will contribute to microcirculation in thalassemia patients.
Collapse
Affiliation(s)
- Mukaddes Sinan
- Department of Physiology, Istanbul University, Istanbul Faculty of Medicine, Capa, Istanbul, Turkey
- Istanbul University, Institute of Graduate Studies of Health Sciences, Istanbul, Turkey
- Department of Physiology, Istanbul Aydin University, Faculty of Medicine, Besyol, Kucukcekmece, Istanbul, Turkey
| | - Ozlem Yalcin
- Department of Physiology, Koc University, Faculty of Medicine, Sariyer, Istanbul, Turkey
- Research Center for Translational Medicine (KUTTAM), Koç University, Istanbul, Turkey
| | - Zeynep Karakas
- Department of Pediatrics, Istanbul University, Istanbul Faculty of Medicine, Division of Hematology/Oncology, Capa, Istanbul, Turkey
| | - Evrim Goksel
- Department of Physiology, Koc University, Faculty of Medicine, Sariyer, Istanbul, Turkey
- Research Center for Translational Medicine (KUTTAM), Koç University, Istanbul, Turkey
| | - Nesrin Zeynep Ertan
- Department of Physiology, Istanbul University, Istanbul Faculty of Medicine, Capa, Istanbul, Turkey
- Department of Physiology, Istanbul Aydin University, Faculty of Medicine, Besyol, Kucukcekmece, Istanbul, Turkey
| |
Collapse
|
7
|
Martins TDO, Ramos RC, Possidonio G, Bosculo MRM, Oliveira PL, Costa LR, Zamboni VAG, Marques MG, de Almeida BFM. Feline obesity causes hematological and biochemical changes and oxidative stress - a pilot study. Vet Res Commun 2023; 47:167-177. [PMID: 35778642 DOI: 10.1007/s11259-022-09940-5] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2022] [Accepted: 05/17/2022] [Indexed: 01/27/2023]
Abstract
Obesity, an extremely important factor in feline clinical practice, is estimated to affect up to one third of the feline population. Moreover, it can trigger chronic inflammation, which could predispose to oxidative stress by increasing reactive oxygen species, thereby generating potentially irreversible cellular damage. This study analyzed hematological, biochemical and oxidative stress profiles at various degrees of feline obesity. Forty-five cats were selected and divided into three groups: control (n = 17), overweight (n = 13) and obese (n = 15), after clinical and laboratory evaluation and body condition score. Biochemical and oxidative stress analyses were performed using a photocolorimeter and hematological analyses were performed in a veterinary cell counter. Obese cats showed increased mean corpuscular volume (MCV), red cell distribution width (RDW), HDL cholesterol and triglycerides and decreased activity of gamma-glutamyl transferase (GGT) than control cats, although within the reference ranges for the species. As for oxidative stress, obese cats showed higher total antioxidant capacity (TAC), by the inhibition of 2,2'-Azino-Bis-3-Ethylbenzthiazoline-6-Sulfonic Acid (ABTS), inhibition of ABTS associated with horseradish peroxidase (ABTS + HRP), cupric ion reducing antioxidant capacity (CUPRAC) and ferric reducing antioxidant power (FRAP) methods, while overweight cats had a higher TAC-ABTS + HRP and TAC-FRAP than control cats. We conclude that the conditions of natural obesity and overweight in the feline species alter its hematological, biochemical and oxidative stress parameters.
Collapse
Affiliation(s)
- Tainara de Oliveira Martins
- Roque Quagliato Veterinary Hospital, University Center of the Integrated Faculties of Ourinhos (Unifio), Rodovia BR 153, km 338, Bairro Água do Cateto, 19909-100, Ourinhos, SP, Brazil
| | - Rebecca Cápera Ramos
- Roque Quagliato Veterinary Hospital, University Center of the Integrated Faculties of Ourinhos (Unifio), Rodovia BR 153, km 338, Bairro Água do Cateto, 19909-100, Ourinhos, SP, Brazil
| | - Geovana Possidonio
- Roque Quagliato Veterinary Hospital, University Center of the Integrated Faculties of Ourinhos (Unifio), Rodovia BR 153, km 338, Bairro Água do Cateto, 19909-100, Ourinhos, SP, Brazil
| | - Maria Rachel Melo Bosculo
- Roque Quagliato Veterinary Hospital, University Center of the Integrated Faculties of Ourinhos (Unifio), Rodovia BR 153, km 338, Bairro Água do Cateto, 19909-100, Ourinhos, SP, Brazil
| | - Paula Lima Oliveira
- Faculty of Veterinary Medicine of Araçatuba, São Paulo State University (FMVA-Unesp), Araçatuba, SP, Brazil
| | - Leticia Ramos Costa
- Roque Quagliato Veterinary Hospital, University Center of the Integrated Faculties of Ourinhos (Unifio), Rodovia BR 153, km 338, Bairro Água do Cateto, 19909-100, Ourinhos, SP, Brazil
| | - Vinicius Aquiles Gomes Zamboni
- Roque Quagliato Veterinary Hospital, University Center of the Integrated Faculties of Ourinhos (Unifio), Rodovia BR 153, km 338, Bairro Água do Cateto, 19909-100, Ourinhos, SP, Brazil
| | - Marcel Gambin Marques
- Roque Quagliato Veterinary Hospital, University Center of the Integrated Faculties of Ourinhos (Unifio), Rodovia BR 153, km 338, Bairro Água do Cateto, 19909-100, Ourinhos, SP, Brazil
| | - Breno Fernando Martins de Almeida
- Roque Quagliato Veterinary Hospital, University Center of the Integrated Faculties of Ourinhos (Unifio), Rodovia BR 153, km 338, Bairro Água do Cateto, 19909-100, Ourinhos, SP, Brazil. .,Faculty of Veterinary Medicine of Araçatuba, São Paulo State University (FMVA-Unesp), Araçatuba, SP, Brazil.
| |
Collapse
|
8
|
Xiong K, Xu C, Shou X, Dong M. Relation of Red Cell Distribution Width to Glucose Metabolism and Adverse Long-Term Prognosis in Patients with Acute Coronary Syndrome. Diabetes Metab Syndr Obes 2023; 16:61-70. [PMID: 36760586 PMCID: PMC9843474 DOI: 10.2147/dmso.s395923] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/02/2022] [Accepted: 12/31/2022] [Indexed: 01/18/2023] Open
Abstract
INTRODUCTION Red cell distribution width (RDW) reflects the heterogeneity of red blood cell size. However, few studies examined whether RDW is related to glucose metabolism indices, such as fasting blood glucose (FBG) and hemoglobin A1c (HbA1c), diabetic mellitus (DM) state or long-term outcomes of acute coronary syndrome (ACS) patients. METHODS AND RESULTS A total of 448 consecutive patients with ACS were enrolled in this study. All patients were followed up for major cardiovascular adverse events (MACEs), and the mean follow-up was 952 days. Linear regression analysis showed that RDW inversely correlated with FBG but not HbA1c or DM. Kaplan-Meier survival curve analysis demonstrated that higher RDW levels were significantly positively associated with MACEs in the whole study population and the ACS patients with high FBG but not the low FBG group. Cox multivariate regression analysis revealed the independent function of RDW on MACEs in all ACS patients and ACS patients with high FBG. The receiver operating characteristic (ROC) curve demonstrated the optimal cutoff value of RDW for MACEs. CONCLUSION We first reported that higher RDW was associated with decreased FBG but not HbA1c or DM and an increased risk of MACEs in patients with ACS. This relationship was also found in ACS patients with higher FBG levels but not in ACS patients with lower FBG.
Collapse
Affiliation(s)
- Ke Xiong
- Department of Cardiovascular Medicine, Shaanxi Provincial People’s Hospital, Xi’an, 710068, People’s Republic of China
| | - Chenbo Xu
- Department of Cardiovascular Medicine, First Affiliated Hospital of Medical College, Xi’an Jiaotong University, Xi’an, 710061, People’s Republic of China
| | - Xiling Shou
- Department of Cardiovascular Medicine, Shaanxi Provincial People’s Hospital, Xi’an, 710068, People’s Republic of China
| | - Mengya Dong
- Department of Cardiovascular Medicine, Shaanxi Provincial People’s Hospital, Xi’an, 710068, People’s Republic of China
- Correspondence: Mengya Dong, Department of Cardiovascular Medicine, Shaanxi Provincial People’s Hospital, 256 West Youyi Road, Xi’an, Shaanxi, 710068, People’s Republic of China, Tel +86–15802943974, Email
| |
Collapse
|
9
|
Jiang Y, Ren C, Alimujiang A, Wu Y, Huang D, Yang W. The difference in red blood cell distribution width from before to after thrombolysis as a prognostic factor in acute ischemic stroke patients: A 2-year follow-up. Front Neurol 2022; 13:1011946. [PMID: 36313517 PMCID: PMC9606336 DOI: 10.3389/fneur.2022.1011946] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2022] [Accepted: 09/20/2022] [Indexed: 11/16/2022] Open
Abstract
Purpose The aim of our study was to determine whether delta red blood cell distribution (ΔRDW) improves neurological outcomes in acute ischemic stroke (AIS) patients 2 years after intravenous thrombolysis (IVT) therapy. Methods AIS patients who received IVT between January 2013 and December 2019 were retrospectively analyzed. In accordance with their mRS scores, the patients were divided into two groups. A binary logistic regression analysis was conducted to determine the influencing factors of adverse functional outcomes. It was decided to evaluate the variables' the predictive ability by using the area under the receiver operating characteristic. For the poor neurological recovery risk model, features were selected using the LASSO regression model. We also developed a predictive model based on logistic regression analysis, which combined the features selected in the minimum absolute contraction and selection operator regression models. An evaluation of the discrimination, calibration, and clinical applicability of the predictive model was conducted using the C index, calibration chart, and decision curve analysis. Internal validation was evaluated via bootstrapping. Results Binary logistic regression analysis showed that ΔRDW was an independent influencing factor for poor neurofunctional outcomes. The most appropriate ΔRDW cut-off value for predicting the recovery of poor neurological outcomes was 18.9% (sensitivity: 89.9%, specificity: 78.6%, p < 0.001). The predictive factors included in the nomogram were age, the occurrence of CHD, stroke, AF, ΔRDW, NIHSS score at onset, interval time from onset to IVT, and whether there were indwelling urine catheters and gastric tubes. The model has not only a good discrimination ability, which was indicated by an overall C index of 0.891 (95% confidence interval: 0.829–0.953), but also a considerable calibration ability. Decision curve analysis showed that the nomogram of adverse neurological outcomes recovery was useful in the clinical practice when intervention was implemented above the threshold of 1% possibility of adverse neurological outcomes recovery. Conclusion In patients with AIS after thrombolysis, the ΔRDW is a potential influencing factor that can be readily used to predict the likelihood of poor neurological function recovery.
Collapse
Affiliation(s)
- Yanyan Jiang
- Department of Neurology, Shanghai East Hospital, Tongji University School of Medicine, Shanghai, China
- Department of Neurology, Shanghai General Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Chuancheng Ren
- Department of Neurology, Shanghai East Hospital, Tongji University School of Medicine, Shanghai, China
| | - Aydos Alimujiang
- Department of Neurology, Shanghai East Hospital, Tongji University School of Medicine, Shanghai, China
| | - Yuncheng Wu
- Department of Neurology, Shanghai General Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
- *Correspondence: Yuncheng Wu
| | - Dongya Huang
- Department of Neurology, Shanghai East Hospital, Tongji University School of Medicine, Shanghai, China
- Dongya Huang
| | - Weiting Yang
- Department of Neurology, Shanghai East Hospital, Tongji University School of Medicine, Shanghai, China
- Weiting Yang
| |
Collapse
|
10
|
Red Cell Distribution Width as a Novel Predictor of Mortality and Complications After Primary Shoulder Arthroplasty. J Am Acad Orthop Surg 2020; 28:802-807. [PMID: 31842062 DOI: 10.5435/jaaos-d-19-00499] [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: 02/01/2023] Open
Abstract
INTRODUCTION Variability in red blood cell volume can occur in disease states and is quantified using a simple equation, yielding the relative distribution of width (RDW). Recent literature has correlated RDW with outcomes in many cardiac disease states, hip fractures, and even revision hip arthroplasty. The association with outcomes in total shoulder arthroplasty (TSA) is yet to be delineated. The purpose of this study was to investigate the possible relationship between preoperative RDW levels and mortality and other adverse outcomes after primary TSA. METHODS Patients who underwent primary TSA and had RDW values on record were identified in a national database. Patients were then grouped by RDW, and the incidence of complications was calculated for each group, including mortality within 1 year, periprosthetic infection within 1 year, acute venous thromboembolism within 30 days, and readmission to a hospital within 30 days. A threshold value of RDW for increased complications was established using receiver operator characteristic (ROC) curves. RESULTS Five thousand two hundred forty-five patients who underwent TSA with a recorded RDW were included in the study. An RDW cutoff of 16% was found to be significantly associated with mortality at 1 year (P < 0.0001), readmission (P < 0.0001), and infection (P = 0.013) on ROC analysis. When controlling for demographic and comorbidity values, a high RDW was markedly associated with a higher mortality rate (odds ratio 2.0, 95% confidence interval 18 to 2.2) and readmission rate (odds ratio 1.5, 95% confidence interval 1.3 to 1.8). A high RDW was not markedly associated with increased infection or venous thromboembolism rate in the multivariate analysis. DISCUSSION Increasing preoperative RDW is associated with increasing complication rates after TSA. This value can be used as an indirect, real-time preoperative predictor of adverse outcomes and most importantly one-year mortality and hospital readmission. LEVEL OF EVIDENCE III retrospective cohort study.
Collapse
|
11
|
Valadão Cardoso A. An experimental erythrocyte rigidity index (Ri) and its correlations with Transcranial Doppler velocities (TAMMV), Gosling Pulsatility Index PI, hematocrit, hemoglobin concentration and red cell distribution width (RDW). PLoS One 2020; 15:e0229105. [PMID: 32084188 PMCID: PMC7034921 DOI: 10.1371/journal.pone.0229105] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2019] [Accepted: 01/29/2020] [Indexed: 12/17/2022] Open
Abstract
Brain artery velocities (Time-Averaged Maximum Mean Velocity, TAMMV) by Transcranial Doppler (TCD), hematocrit, hemoglobin, Red blood cell (RBC) Distribution Width (RDW) and RBC rigidity index (Ri), when reported together with their correlations, provide a accurate and useful diagnostic picture than blood viscosity measurements alone. Additionally, our study included a sixth parameter provided by TCD, the Gosling Pulsatility Index PI, which is an indicator of CBF (Cerebral Blood Flow) resistance. All these parameters are routine in Hematology except for values of Ri. The rigidity (Ri) of the RBC is the main rheological characteristic of the blood of Sickle Cell Anemia (SCA) patients and several pathologies. However, its quantification depends on many commercial and experimental techniques, none disseminated and predominant around the World. The difference in absorbance values of the blood, during the process of sedimentation in a microwell of a Microplate Reader, is a straightforward way of semi-quantifying the RBC rigidity Ri, since the fraction of irreversibly sickled red blood cells does not form rouleaux. Erythrocyte Rigidity Index (Ri) was calculated using initial absorbance Ainitial (6 s) and final Afinal (540 s), Ri = 1 / (Ai-Af). The Ri of 119 patients (2–17 y / o, M & F) SCA, SCC (Sickle Cell/hemoglobin C), SCD (Sickle Cell/hemoglobin D), Sβ0thal (Sickle Cell/hemoglobin Beta Zero Thalassemia) and 71 blood donors (20–65 y / o, M & F) were measured in our laboratory while the five parameters (TAMMV and PI by TCD, Hct, Hb and RDW) were obtained from medical records. The in vitro addition of hydroxyurea (HU, 50mg /dl, n = 51 patients, and n = 8 healthy donors) in the samples decreased the rouleaux adhesion strength of both donor and patients’ blood samples, leading to extraordinarily high Ri values. The correlation between the studied parameters was especially significant for the direct relationships between Ri, TAMMV, and PI.
Collapse
Affiliation(s)
- Antonio Valadão Cardoso
- Rheology Laboratory, Materials Engineering Post-Graduation Program REDEMAT-UEMG/DESP-ED, State University of Minas Gerais, Belo Horizonte, Minas Gerais, Brasil
- * E-mail:
| |
Collapse
|
12
|
Yan Z, Fan Y, Meng Z, Huang C, Liu M, Zhang Q, Song K, Jia Q. The relationship between red blood cell distribution width and metabolic syndrome in elderly Chinese: a cross-sectional study. Lipids Health Dis 2019; 18:34. [PMID: 30704536 PMCID: PMC6357446 DOI: 10.1186/s12944-019-0978-7] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2018] [Accepted: 01/17/2019] [Indexed: 01/10/2023] Open
Abstract
OBJECTIVE Metabolic syndrome (MS) is a group of risk factors which includes hypertension, hyperglycemia, abnormal cholesterol levels, and obesity. Red blood cell distribution width (RDW) is a parameter that reflects the heterogeneity of erythrocyte volume. But the relationship between MS and RDW is intricate and remains poorly understood. We hypothesized that high RDW was associated with MS via inflammation. Our study aimed to investigate the association between RDW and MS in Chinese elderly large cohort. If RDW had a strong correlation with MS, RDW could become a predictor of MS? METHODS We recruited 10,887 ostensibly healthy participants aged from 60 to 93 (5795 male, 5092 female). Associations between RDW and other variables were assessed by Pearson correlation. Crude and adjusted odds ratio for MS with 95% confidence intervals was calculated by binary logistic regression models. RESULTS In elderly Chinese, RDW was significantly higher in males than in females. The prevalence of both men and women decreased with the rise of RDW. For both sexes, RDW demonstrated positive correlations with age, systolic blood pressure (0.070 in males,0.058 in females), high density lipoprotein(0.027in males,0.064 in females), negative correlations with triglycerides (- 0.120 in males,-0.074 in females) and fasting glucose (- 0.048 in males,-0.016 in females). Notably, we detected the associated reduced risks at the the third and fourth quartile of RDW in males. In women, there was no statistical significance. CONCLUSION We found the adjusted odds ratios of MS was lower at the third and fourth quartile of RDW in males.
Collapse
Affiliation(s)
- Ziyu Yan
- Department of Nuclear Medicine, Tianjin Medical University General Hospital, Anshan Road No. 154, Heping District, 300052, Tianjin, People's Republic of China
| | - Yaguang Fan
- Department of Nuclear Medicine, Tianjin Medical University General Hospital, Anshan Road No. 154, Heping District, 300052, Tianjin, People's Republic of China
| | - Zhaowei Meng
- Department of Nuclear Medicine, Tianjin Medical University General Hospital, Anshan Road No. 154, Heping District, 300052, Tianjin, People's Republic of China.
| | - Chao Huang
- University of Hull, Allam Medical Building, Cottingham Road, Hull, HU6 7RX, UK
| | - Ming Liu
- Department of Endocrinology and Metabolism, Tianjin Medical University General Hospital, Tianjin, People's Republic of China
| | - Qing Zhang
- Department of Health Management, Tianjin Medical University General Hospital, Tianjin, People's Republic of China
| | - Kun Song
- Department of Health Management, Tianjin Medical University General Hospital, Tianjin, People's Republic of China
| | - Qiyu Jia
- Department of Health Management, Tianjin Medical University General Hospital, Tianjin, People's Republic of China
| |
Collapse
|
13
|
Zhang Z, Chew GM, Shikuma CM, Gangcuangco LMA, Souza SA, Shiramizu B, Nakamoto BK, Gong T, Mannem SR, Mitchell BI, Kallianpur KJ, Ndhlovu LC, Chow DC. Red blood cell distribution width as an easily measurable biomarker of persistent inflammation and T cell dysregulation in antiretrovirally treated HIV-infected adults. HIV CLINICAL TRIALS 2018; 19:172-176. [PMID: 30422099 DOI: 10.1080/15284336.2018.1514821] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
BACKGROUND Chronic inflammation and immune dysfunction occur in human immunodeficiency virus (HIV)-infection despite stable antiretroviral therapy (ART). Red blood cell distribution width (RDW) has been shown to correlate with markers of inflammation in non-HIV conditions. The study objective was to determine associations between RDW with cellular markers of immune activation and immune dysfunction including soluble inflammatory mediators in ART treated HIV infection. METHODS We performed a cross-sectional analysis of the Hawaii Aging with HIV-Cardiovascular study. RDW was defined as one standard deviation of RBC size divided by mean corpuscular volume multiplied by 100%. Correlations were analyzed between RDW, soluble inflammatory biomarkers and T cell activation (CD38 + HLA-DR+), senescence (CD28-CD57+), and immune exhaustion (PD-1, TIGIT, TIM-3 expression). RESULTS Of 158 participants analyzed, median age was 50 years, duration of ART 12.6 years, virally suppressed 84.4%, and CD4 count 503 cells/mm3. Significant positive correlations were identified between RDW and soluble biomarkers including sICAM, IL-8, IL-6, SAA, TNF-α, sE-selection, fibrinogen, D-dimer, CRP, CD4/CD8 ratio, and frequency of multiple CD8 T-cell populations such as CD38 + HLA-DR + T-cells, single TIGIT+, and dual expressing of TIGIT + PD1+, TIGIT + TIM3+, and TIM3 + PD1+ CD8+ T-cell subsets (p < .05). Frequencies of CD38 + HLA-DR + CD8+ T-cells and TIGIT + CD8+ T-cells remained significant adjusting for baseline variables (p < .01). CONCLUSION Our study revealed correlations between RDW with systemic inflammatory biomarkers and CD8+ T-cell populations related to immune activation and exhaustion in HIV-infected individuals on ART. Further studies are warranted to determine the utility of RDW as a marker of immune dysregulation in HIV.
Collapse
Affiliation(s)
- Zao Zhang
- a Hawaii Center for AIDS, University of Hawaii John A. Burns School of Medicine , Honolulu , HI , USA.,b The Queen's Medical Center , Honolulu , HI , USA
| | - Glen M Chew
- c Department of Tropical Medicine , Medical Microbiology & Pharmacology, University of Hawaii John A. Burns School of Medicine , Honolulu , HI , USA
| | - Cecilia M Shikuma
- a Hawaii Center for AIDS, University of Hawaii John A. Burns School of Medicine , Honolulu , HI , USA
| | - Louie Mar A Gangcuangco
- c Department of Tropical Medicine , Medical Microbiology & Pharmacology, University of Hawaii John A. Burns School of Medicine , Honolulu , HI , USA
| | - Scott A Souza
- a Hawaii Center for AIDS, University of Hawaii John A. Burns School of Medicine , Honolulu , HI , USA
| | - Bruce Shiramizu
- a Hawaii Center for AIDS, University of Hawaii John A. Burns School of Medicine , Honolulu , HI , USA.,c Department of Tropical Medicine , Medical Microbiology & Pharmacology, University of Hawaii John A. Burns School of Medicine , Honolulu , HI , USA
| | - Beau K Nakamoto
- a Hawaii Center for AIDS, University of Hawaii John A. Burns School of Medicine , Honolulu , HI , USA.,d Straub Medical Center, Hawaii Pacific Health , Honolulu , HI , USA
| | - Ting Gong
- c Department of Tropical Medicine , Medical Microbiology & Pharmacology, University of Hawaii John A. Burns School of Medicine , Honolulu , HI , USA
| | | | - Brooks I Mitchell
- c Department of Tropical Medicine , Medical Microbiology & Pharmacology, University of Hawaii John A. Burns School of Medicine , Honolulu , HI , USA
| | - Kalpana J Kallianpur
- a Hawaii Center for AIDS, University of Hawaii John A. Burns School of Medicine , Honolulu , HI , USA.,c Department of Tropical Medicine , Medical Microbiology & Pharmacology, University of Hawaii John A. Burns School of Medicine , Honolulu , HI , USA
| | - Lishomwa C Ndhlovu
- a Hawaii Center for AIDS, University of Hawaii John A. Burns School of Medicine , Honolulu , HI , USA.,c Department of Tropical Medicine , Medical Microbiology & Pharmacology, University of Hawaii John A. Burns School of Medicine , Honolulu , HI , USA
| | - Dominic C Chow
- a Hawaii Center for AIDS, University of Hawaii John A. Burns School of Medicine , Honolulu , HI , USA
| |
Collapse
|
14
|
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.
Collapse
|
15
|
Medical significance of simultaneous application of red blood cell distribution width (RDW) and neopterin as diagnostic/prognostic biomarkers in clinical practice. Pteridines 2017. [DOI: 10.1515/pterid-2017-0021] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/12/2023] Open
Abstract
Abstract
In our individual and collaborative studies, we have played a part in pioneering investigations on the usefulness of biomarkers – red blood cell distribution width (RDW) and neopterin. This mini review includes historical data on the topic and is related to the first contributions in this field, as well as to the possibilities for further improvement and simultaneous application of RDW and neopterin measurements in the prevention, prognosis and treatment of a great number of socially important disease conditions (arterial, cardiovascular, brain vascular, peripheral artery diseases, inflammations, autoimmune states, cancers and leukemias, addictions, etc.). When comparing the results obtained with the immunobiochemical biomarker neopterin with RDW, they are reported to be very similar as independent predictors of the same pathological states in the human body although their biomedical origins are very different. Both the parameters were until now successfully, but only separately used in medical practice. The combined use of these two biomarkers can shed some more light on their interrelationships and provide some clues as to how the interaction between immune system activation and red blood cells biology are intertwined.
Collapse
|
16
|
Sargento L, Simões AV, Longo S, Lousada N, Palma Dos Reis R. Red blood cell distribution width is a survival predictor beyond anemia and Nt-ProBNP in stable optimally medicated heart failure with reduced ejection fraction outpatients. Clin Hemorheol Microcirc 2017; 65:185-194. [PMID: 27716652 DOI: 10.3233/ch-16155] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/29/2023]
Abstract
BACKGROUND RDW is an automatic value obtained with the blood count, and represents the erythrocytes dimension variation. OBJECTIVE To evaluate in optimally medicated outpatients with heart failure with reduced ejection fraction (HFrEF) the RDW prognostic value regarding survival in a multivariable model including anemia and Nt-ProBNP. METHODS 233 consecutive outpatients, LVEF <40%, clinically stable were followed-up for 3-years in an HF Unit. End-point was all-cause death. The RDW categorized according to the tertiles (T1 = <13.9; T2 14-15.2; T3> = 15.3). Anemia classified according to the WHO criteria. Cox survival model adjusted for clinical profile, optimal therapeutic, renal function, Nt-ProBNP, etiology, atrial fibrillation, and anemia. RESULTS (1) The 3-years death rate was 33.5%, and increased with the RDW tertiles (17.3%; 25%; 61.1%; p < 0.001). (2) The ROC curve for death associated with RDW (AUC 0.73; p < 0.001); (3) The adjusted death risk increased with the tertiles (Hazard-ratio '[HR] = 1.61; IC 95% 1.09-2.39; p = 0.017). RDW> = 15.3 had greater adjusted death risk than T1 (HR = 2.18; 95% CI 0.99-4.8; p = 0.05) and T1+T2 (HR = 1.54; 95% CI 1.13-2.09; p = 0.006). CONCLUSION RDW determined in optimally medicated outpatients with HFrEF, during dry-state, is a strong, cheap, and independent predictor of long-term survival.
Collapse
|
17
|
Yazıcı S, Kırış T, Sadık Ceylan U, Terzi S, Uzun AO, Emre A, Yeşilçimen K. Relation between dynamic change of red cell distribution width and 30-day mortality in patients with acute pulmonary embolism. CLINICAL RESPIRATORY JOURNAL 2017; 12:953-960. [PMID: 28063201 DOI: 10.1111/crj.12611] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/23/2016] [Revised: 12/19/2016] [Accepted: 12/29/2016] [Indexed: 12/21/2022]
Abstract
INTRODUCTION AND OBJECTIVES Recent studies suggest that an increase in red cell distribution width (RDW) levels have a better prognostic value than a single measurement. In the current study, we investigated the predictive value of increasing RDW levels for mortality in acute pulmonary emboli (APE) patients. MATERIALS AND METHODS For the study, 199 APE patients who were hospitalized were enrolled. Patients were divided into three groups according to their admission and 24th hour RDW values. Patients for whom both RDW values normal were put in group 1 (normal); patients with admission RDW > 14.5% and decreased 24th hour RDW values were in group 2 (decreased); patients whose 24th hour RDW levels were >14.5% and increased compared to their baseline RDW measurement were in group 3 (increased). Clinical and laboratory findings and 30-day mortality of these groups were compared. RESULTS Mean patient age was 68 ± 16, and 48% of the patients were male. There were 98 patients (49%) in group 1, 59 patients (30%) in group 2, and 42 patients (21%) in group 3. Patients in group 3 were older, had lower eGFR and hemoglobin values, and had higher brain type natriuretic peptide values. Mortality rate was higher in group 3 (0%, 3.4%, 19%, respectively, P < .0001). Increase in RDW was independently related to mortality [HR: 4.9, (95%CI: 1.2-18, P = .02)]. CONCLUSION APE patients with increasing RDW levels have higher mortality rates. Serial measurements of RDW may help us determine patients with high risk for mortality.
Collapse
Affiliation(s)
- Selçuk Yazıcı
- Dr.Siyami Ersek Thoracic and Cardiovascular Surgery Center, Department of Cardiology, İstanbul, Turkey
| | - Tuncay Kırış
- Katip Celebi University, Atatürk Training and Research Hospital, Department of Cardiology, İzmir, Turkey
| | - Ufuk Sadık Ceylan
- Dr.Siyami Ersek Thoracic and Cardiovascular Surgery Center, Department of Cardiology, İstanbul, Turkey
| | - Sait Terzi
- Dr.Siyami Ersek Thoracic and Cardiovascular Surgery Center, Department of Cardiology, İstanbul, Turkey
| | - Ahmet Okan Uzun
- Dr.Siyami Ersek Thoracic and Cardiovascular Surgery Center, Department of Cardiology, İstanbul, Turkey
| | - Ayşe Emre
- Dr.Siyami Ersek Thoracic and Cardiovascular Surgery Center, Department of Cardiology, İstanbul, Turkey
| | - Kemal Yeşilçimen
- Dr.Siyami Ersek Thoracic and Cardiovascular Surgery Center, Department of Cardiology, İstanbul, Turkey
| |
Collapse
|
18
|
Uslu AU, Yonem O, Aydin B, Uncu T, Seven D, Balta S, Cicekli E. Red cell distribution width is associated with albuminuria in adults with familial Mediterranean fever. Kaohsiung J Med Sci 2016; 32:216-20. [PMID: 27185605 DOI: 10.1016/j.kjms.2016.03.009] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2016] [Revised: 03/26/2016] [Accepted: 03/30/2016] [Indexed: 11/28/2022] Open
Abstract
Systematic inflammation, enhanced oxidative stress, and endothelial dysfunction are important for evolution and progression of renal damage, and they cause an increase in red cell distribution width (RDW). Familial Mediterranean fever (FMF) patients who are in the attack-free period and its relation with albuminuria and performance on assessment of microalbuminuria. One hundred and seventy-seven patients who had been diagnosed in accordance with Tel-hoshmer criteria and were in the attack-free period, and 143 age- and sex-matched healthy individuals were enrolled in our study. RDW values of FMF patients were higher compared with those of the controls (13.85 ± 1.07 and 13.15 ± 0.91, respectively; p < 0.0001). RDW values of FMF patients with microalbuminuria were higher compared with those of FMF patients with normoalbuminuria and the control group (p = 0.002 and p < 0.0001, respectively). RDW values of FMF patients with normoalbuminuria were higher compared with those of the control group (p < 0.0001). We have showed RDW levels are positively correlated with albuminuria (r = 0.185, p = 0.014). When assessing microalbuminuria with RDW in the patients, a cutoff value of 13.85 with sensitivity of 60%, specificity of 62%, and p = 0.002 (area under curve: 0.651, 95% confidence interval 0.563-0.738), was observed according to receiver-operating characteristic curve analysis. Among the various variables associated with albuminuria in multivariate logistic regression analyses, RDW remained an independent predictor of albuminuria (95% confidence interval 0.479-0.942, p = 0.021). RDW may be associated with albuminuria in FMF patients and it can be a predictor of microalbuminuria.
Collapse
Affiliation(s)
- Ali Ugur Uslu
- Department of Internal Medicine, Eskisehir Military Hospital, Eskisehir, Turkey.
| | - Ozlem Yonem
- Department of Gastroenterology, Cumhuriyet University Faculty of Medicine, Sivas, Turkey
| | - Bahattin Aydin
- Department of Internal Medicine, Etimesgut Military Hospital, Ankara, Turkey
| | - Tunahan Uncu
- Department of Internal Medicine, Cumhuriyet University Faculty of Medicine, Sivas, Turkey
| | - Dogan Seven
- Department of Internal Medicine, Cumhuriyet University Faculty of Medicine, Sivas, Turkey
| | - Sevket Balta
- Department of Cardiology, Gulhane Medical Academy Ankara, Turkey
| | - Emre Cicekli
- Department of Internal Medicine, Cumhuriyet University Faculty of Medicine, Sivas, Turkey
| |
Collapse
|