Increased Red Blood Cell Distribution Width in the First Year after Diagnosis Predicts Worsening of Systemic Sclerosis-Associated Interstitial Lung Disease at 5 Years: A Pilot Study

The course of systemic sclerosis-associated interstitial lung disease (SSc-ILD) varies among individuals. Red blood cell distribution width (RDW) has been reported to be a predictor of idiopathic pulmonary fibrosis. However, there are no studies on the relationship between RDW and SSc-ILD. We conducted a retrospective study of 28 patients who were diagnosed with SSc-ILD on their first visit to our hospital and were followed-up for 5 years. The correlation between the changes in RDW, KL-6, and SP-D (ΔRDW, ΔKL-6, ΔSP-D) and the changes in percent-predicted forced lung volume and % carbon monoxide diffusion (Δ%FVC, Δ%DLco) was investigated. ΔRDW at 1 year after diagnosis was significantly inversely correlated with Δ%FVC at 5 years after diagnosis (r = −0.51, p < 0.001) and Δ%DLco at 5 years after diagnosis (r = −0.47, p < 0.001), whereas ΔKL-6 and ΔSP-D at 1 year were not correlated with Δ%FVC or Δ%DLco at 5 years. In the group of SSc-ILD patients with RDW increase in the first year after diagnosis, %FVC and %DLco were significantly lower than baseline at 3-, 4-, and 5-year assessments. In the group of patients without RDW increase in the first year, %FVC and %DLco did not decrease during the follow-up period. In conclusion, the changes in RDW in the first year after diagnosis may be useful surrogate markers to predict the long-term course of SSc-ILD.

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Study on the Red Blood Cell Distribution Width in Connective Tissue Disease Associated with Interstitial Lung Disease

BioMed Research International ◽

10.1155/2020/8130213 ◽

2020 ◽

Vol 2020 ◽

pp. 1-5

Author(s):

Chuanmei Liu ◽

Jie Yang ◽

Zhiwei Lu

Keyword(s):

Interstitial Lung Disease ◽

Connective Tissue ◽

Blood Cell ◽

Lung Disease ◽

Connective Tissue Disease ◽

Red Blood Cell ◽

Multivariate Logistic Regression Analysis ◽

Cell Distribution ◽

Distribution Width ◽

Red Blood Cell Distribution

Background. Connective tissue disease (CTD) associated with interstitial lung disease (ILD) affects the lungs and can lead to considerable morbidity and shortened survival. Red blood cell distribution width (RDW) is a readily available parameter that is routinely reported with complete blood cell count (CBC) This study aimed to investigate the predictive value of RDW in CTD-ILD. Methods. A retrospective analysis was performed on 180 patients with CTD-ILD and 202 patients with CTD but without ILD between April 2016 and December 2018. Baseline demographics, laboratory results, imaging examinations, and results of ultrasound scans were analysed. Results. In comparison with patients without ILD, patients with CTD-ILD displayed a larger RDW (14.65 ± 2.08 vs. 14.17 ± 1.63, P=0.002), and RDW shared positive relationships with pulmonary artery systolic pressure (r = 0.349; P<0.001), length of hospital confinement (r = 0.172; P=0.022), and hospitalisation expenses (r = 0.158; P=0.037). Multivariate logistic regression analysis showed that RDW (odds ratio (OR): 1.232, 95% confidence interval (CI): 1.053–1.422, P=0.009), IgG (OR: 1.103, 95% CI: 1.051–1.159, P<0.001), and age (OR: 1.032, 95% CI: 1.010–1.054, P=0.004) are independent predictors of CTD-ILD risk. The optimal cut-off value of RDW for predicting CTD-ILD was 14.85%, with a sensitivity and a specificity value of 41.2% and 75.2%, respectively. Conclusions. RDW was significantly increased in patients with CTD-ILD under various CTD backgrounds and may be a promising biomarker that may help physicians predict CTD-ILD risk.

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Association of Red Blood Cell Distribution Width Levels with Connective Tissue Disease-Associated Interstitial Lung Disease (CTD-ILD)

Disease Markers ◽

10.1155/2021/5536360 ◽

2021 ◽

Vol 2021 ◽

pp. 1-7

Author(s):

Shenyun Shi ◽

Ling Chen ◽

Xianhua Gui ◽

Lulu Chen ◽

Xiaohua Qiu ◽

...

Keyword(s):

Interstitial Lung Disease ◽

Connective Tissue ◽

Blood Cell ◽

Lung Disease ◽

Connective Tissue Disease ◽

Red Blood Cell ◽

Cell Distribution ◽

Distribution Width ◽

Cutoff Value ◽

Red Blood Cell Distribution

Objective. The aim of this study was to evaluate the diagnostic and prognostic value of red blood cell distribution width (RDW) in patients with connective tissue disease-associated interstitial lung disease (CTD-ILD). Methods. We retrospectively reviewed 213 CTD-ILD patients and 97 CTD patients without ILD from February 2017 to February 2020. Hospital and office records were used as data sources. CTD-ILD patients were followed up. Results. Patients with CTD-ILD had significantly higher RDW than those with CTD without ILD ( p < 0.001 ). The area under the receiver operating characteristic curve (AUROC) of RDW for discriminating CTD-ILD from CTD without ILD was 0.64 (95% CI: 0.57-0.70, p < 0.001 ). The cutoff value of RDW for discriminating CTD-ILD from CTD without ILD was 13.95% with their corresponding specificity (55.9%) and sensitivity (70.1%). Correlation analyses showed that the increased RDW was significantly correlated with decreased DLCO%predicted ( r = − 0.211 , p = 0.002 ). Cox multiple regression analysis indicated that RDW ( HR = 1.495 , p < 0.001 ) was an independent factor in the survival of CTD-ILD. The best cutoff value of RDW to predict the survival of patients with CTD-ILD was 14.05% ( AUC = 0.78 , 95% CI: 0.72-0.84, p < 0.001 ). The log-rank test showed a significant difference in survival between the two groups ( RDW > 14.05 % and RDW < 14.05 % ). Conclusion. RDW was higher in CTD-ILD patients and had a negative correlation with DLCO%predicted. RDW may be an important serum biomarker for severity and prognosis of patients with CTD-ILD.

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