Context.—A strong independent association has been recentlyobserved between elevated red blood cell distributionwidth (RDW) and increased incidence of cardiovascularevents.Objective.—To assess whether RDW is associated withplasma markers of inflammation since the mechanism(s)underlying this association remain unknown.Design.—We retrospectively analyzed results of RDW,hemoglobin, mean corpuscular volume, ferritin, high-sensitivityC-reactive protein (hsCRP), and erythrocyte sedimentationrate (ESR) in a large cohort of unselected adultoutpatients who were consecutively referred by generalpractitioners for routine medical check-up.Results.—Cumulative results of RDW and other factorswere retrieved from the database of our laboratory informationsystem for 3845 adult outpatients during a 3-yearperiod. When participants were grouped according toRDW quartiles, there were strong, graded increases of ESRand hsCRP (P .001), both parameters being up to 3-foldhigher in the fourth versus the first quartile. Accordingly,the percentages of those with hsCRP greater than 3 mg/L(from 28% to 63%; P .001) and ESR greater than 40mm/h (from 8% to 40%; P .001) increased steadilyacross RDW quartiles. In multivariable regression analysis,ESR and hsCRP predicted RDW independently of age, sex,mean corpuscular volume, hemoglobin, and ferritin.Conclusions.—To our knowledge, our study demonstratesfor the first time a strong, graded association ofRDW with hsCRP and ESR independent of numerous confoundingfactors. If confirmed in future follow-up studies,this association might provide a rationale to introduce theeasy, inexpensive RDW in algorithms for cardiovascularrisk prediction.
Relation between red blood cell distribution width and inflammatory biomarkers in a large cohort of unselected outpatients
LIPPI, Giuseppe;TARGHER, Giovanni;MONTAGNANA, Martina;SALVAGNO, GIAN LUCA;ZOPPINI, Giacomo;GUIDI, Giancesare
2009-01-01
Abstract
Context.—A strong independent association has been recentlyobserved between elevated red blood cell distributionwidth (RDW) and increased incidence of cardiovascularevents.Objective.—To assess whether RDW is associated withplasma markers of inflammation since the mechanism(s)underlying this association remain unknown.Design.—We retrospectively analyzed results of RDW,hemoglobin, mean corpuscular volume, ferritin, high-sensitivityC-reactive protein (hsCRP), and erythrocyte sedimentationrate (ESR) in a large cohort of unselected adultoutpatients who were consecutively referred by generalpractitioners for routine medical check-up.Results.—Cumulative results of RDW and other factorswere retrieved from the database of our laboratory informationsystem for 3845 adult outpatients during a 3-yearperiod. When participants were grouped according toRDW quartiles, there were strong, graded increases of ESRand hsCRP (P .001), both parameters being up to 3-foldhigher in the fourth versus the first quartile. Accordingly,the percentages of those with hsCRP greater than 3 mg/L(from 28% to 63%; P .001) and ESR greater than 40mm/h (from 8% to 40%; P .001) increased steadilyacross RDW quartiles. In multivariable regression analysis,ESR and hsCRP predicted RDW independently of age, sex,mean corpuscular volume, hemoglobin, and ferritin.Conclusions.—To our knowledge, our study demonstratesfor the first time a strong, graded association ofRDW with hsCRP and ESR independent of numerous confoundingfactors. If confirmed in future follow-up studies,this association might provide a rationale to introduce theeasy, inexpensive RDW in algorithms for cardiovascularrisk prediction.
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