Relation Between Red Blood Cell Distribution Width and Inflammatory Biomarkers in a Large Cohort of Unselected Outpatients

作者：Giuseppe Lippi, Giovanni Targher, Martina Montagnana, Gian Luca Salvagno, Giacomo Zoppini, Gian Cesare Guidi · 发表于：Archives of Pathology & Laboratory Medicine · 年份：2009 · DOI：10.5858/133.4.628 · 被引用次数：996 · 研究领域：Inflammatory Biomarkers in Disease Prognosis、Blood properties and coagulation、Adipokines, Inflammation, and Metabolic Diseases

Abstract Context. —A strong independent association has been recently observed between elevated red blood cell distribution width (RDW) and increased incidence of cardiovascular events. Objective. —To assess whether RDW is associated with plasma 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-sensitivity C-reactive protein (hsCRP), and erythrocyte sedimentation rate (ESR) in a large cohort of unselected adult outpatients who were consecutively referred by general practitioners for routine medical check-up. Results. —Cumulative results of RDW and other factors were retrieved from the database of our laboratory information system for 3845 adult outpatients during a 3-year period. When participants were grouped according to RDW quartiles, there were strong, graded increases of ESR and hsCRP ( P < .001), both parameters being up to 3-fold higher 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 40 mm/h (from 8% to 40%; P < .001) increased steadily across 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 demonstrates for the first time a strong, graded association of RDW with hsCR...