Red cell distribution width and high sensitivity C-reactive protein as risk markers in hypertension

IntroductionRed cell distribution width (RDW) is a parameter included in the complete blood count which informs about the size of the circulating red blood cell population and its distribution. In adults, an increase in RDW was shown to be associated both with obstructive sleep apnoea (OSA) and with an increase in cardiovascular mortality. The aim of this study was to determine whether RDW is a potential biomarker for screening children with moderate–severe OSA.MethodsAn observational study in snoring patients was performed. All patients underwent a sleep study and were classified either as simple snorers (apnoea–hypopnoea index (AHI) <1 event·h−1) or as patients with OSA (mild AHI ≥1 to <5 events·h−1; moderate–severe AHI ≥5 events·h−1). Blood analyses (complete blood count and C-reactive protein) were performed for every individual.ResultsA total of 175 individuals were recruited. The mean age was 8.3±3.6 years. Correlation studies between RDW and several sleep-related parameters showed negative significant associations with minimum oxygen saturation, and positive significant associations with oxygen desaturation index (≥3% and ≥4%), AHI and the arousal index. A predictive model for paediatric severe OSA (AHI ≥5 events·h−1) was found based on mean corpuscular haemoglobin concentration (MCHC) <34.9 g·dL−1 and RDW >13.1% values, adjusting for body mass index z-score and age (area under the curve 0.657; p=0.004). In addition, differences were found in eosinophil count and C-reactive protein concentrations among the three subgroups.ConclusionsIn children, RDW stands out as a biomarker associated with the severity of OSA. The use of RDW and MCHC could be a simple but useful tool for the severity prediction of paediatric OSA in snoring patients.

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Hubungan antara Nilai C−Reactive Protein, Immature To Total Neutrophil Ratio, dan Red Cell Distribution Width dengan Kejadian Sepsis Neonatorum Bayi Prematur

Sari Pediatri ◽

10.14238/sp21.4.2019.218-25 ◽

2020 ◽

Vol 21 (4) ◽

pp. 218

Author(s):

Fouad Hakiem ◽

Susi Susanah ◽

Tetty Yuniati

Keyword(s):

Red Cell Distribution Width ◽

Red Cell ◽

Cell Distribution ◽

C Reactive Protein ◽

Distribution Width ◽

Reactive Protein

Latar belakang. Bayi prematur rentan terhadap infeksi yang berisiko sepsis akibat sistem imun yang belum sempurna. Deteksi dini sepsis neonatorum dapat dilakukan dengan menggunakan sistem penilaian modifikasi Tollner yang berdasarkan penilaian klinis dan parameter laboratorium, seperti C-Reactive Protein (CRP), rasio Immature to Total Neutrophil (rasio I/T), dan Red Cell Distribution Width (RDW). Pemeriksaan RDW menunjukkan heterogenitas eritrosit akibat detruksi eritrosit oleh suatu proses infeksi.Tujuan. Mengetahui hubungan antara nilai CRP, rasio I/T, dan RDW dengan kejadian sepsis neonatorum bayi prematur. Metode. Studi kasus kontrol menggunakan data sekunder rekam medis dengan subjek penelitian bayi prematur usia gestasi 28-<37 minggu yang dirawat di ruang neonatus Rumah Sakit Hasan Sadikin (RSHS) periode Desember 2018−Mei 2019. Kelompok kasus adalah bayi prematur sepsis, sedangkan kelompok kontrol adalah bayi prematur sakit tidak sepsis yang dilakukan pemeriksaan CRP, rasio I/T, dan RDW. Data dianalisis secara bivariat dan multivariat dengan regresi logistik menggunakan program SPSS dan STATA.Hasil. Penelitian ini melibatkan 30 bayi prematur sepsis dan 30 bayi prematur tidak sakit (kontrol). Analisis bivariat menunjukkan nilai CRP dan rasio IT berhubungan bermakna terhadap kejadian sepsis dengan masing-masing p<0,001 dan p<0,011. Analisis multivariat dengan regresi logistik menunjukkan nilai CRP >0,64 mg/dL berisiko 32 kali terhadap kejadian sepsis (p<0,001) dibandingkan rasio I/T >0,119 dan RDW >18,7% yang masing-masing 3,2 kali (p=0,446) dan 0,9 kali (p=0,947) terhadap kejadian sepsis.Kesimpulan. Pemeriksaan CRP merupakan pemeriksaan yang lebih baik dalam membantu menegakkan diagnosis sepsis neonatorum bayi prematur dibandingkan pemeriksaan rasio I/T dan RDW.

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Elevated Plasma Levels of B-Type Natriuretic Peptide but Not C-Reactive Protein Are Associated With Higher Red Cell Distribution Width in Patients With Coronary Artery Disease

International Heart Journal ◽

10.1536/ihj.50.301 ◽

2009 ◽

Vol 50 (3) ◽

pp. 301-312 ◽

Cited By ~ 59

Author(s):

Hidekatsu Fukuta ◽

Nobuyuki Ohte ◽

Seiji Mukai ◽

Tomoaki Saeki ◽

Kaoru Asada ◽

...

Keyword(s):

Coronary Artery Disease ◽

Coronary Artery ◽

Plasma Levels ◽

Red Cell ◽

Cell Distribution ◽

Elevated Plasma ◽

C Reactive Protein ◽

Distribution Width ◽

Reactive Protein ◽

Artery Disease

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Abstract 14819: The Red Cell Distribution Width Predicts Mortality among Patients Free from Systemic Inflammation

Circulation ◽

10.1161/circ.130.suppl_2.14819 ◽

2014 ◽

Vol 130 (suppl_2) ◽

Author(s):

Benjamin D Horne ◽

Joseph B Muhlestein ◽

Sterling T Bennett ◽

Jeffrey L Anderson

Keyword(s):

Complete Blood Count ◽

Collaborative Study ◽

High Sensitivity ◽

Red Cell Distribution Width ◽

Causal Mechanism ◽

Red Cell ◽

Cell Distribution ◽

Distribution Width ◽

Mortality And Morbidity ◽

Markers Of Inflammation

Background: The causal mechanism is unknown for why the red cell distribution width (RDW) predicts mortality and morbidity outcomes. One explanation is an inflammatory process: statistically significant, weak magnitude correlations (r<0.30) have been found between RDW and markers of inflammation. This study evaluated the association of RDW with mortality in patients with normal levels of inflammation, as indicated by normal high-sensitivity C-reactive protein (hsCRP) and white blood cell count (WBC). Methods: Intermountain Heart Collaborative Study patients undergoing coronary angiography (N=650) from 1994-2000 were evaluated if they never smoked, were free of acute myocardial infarction (MI), and had baseline hsCRP≤3 mg/L, WBC>4 K/μL, and WBC≤10.6 K/μL. RDW and WBC were tested clinically at index hospitalization via the complete blood count; hsCRP testing used stored research samples. Subjects were followed until December, 2013, and all-cause mortality was determined from hospital records, Utah death certificates, and US Social Security data. Results: Age averaged 66.7±11.6 years, 31.1% were female, and 62.9% died during a mean follow-up of 15.2±1.6 years (range:12.6-19.6 years). Continuous RDW predicted mortality after adjustment for demographics, risk factors, comorbidities, and baseline treatments (hazard ratio [HR]=1.15 per +1%, 95% CI=1.06, 1.26; p=0.002). In quartiles, this was significant for Q4 vs. Q1 (survival 23.6% vs. 43.4%, HR=1.56, CI=1.17, 2.08; p=0.003), but not Q2 (HR=1.18, p=0.29) or Q3 (HR=1.08, p=0.60) vs.Q1. In subjects with hsCRP<1 mg/L (n=259), RDW (adj. HR=1.13 per +1%, CI=0.99, 1.29, p=0.08) and RDW quartiles [Q2: adj. HR=1.70 (p=0.036), Q3: HR=1.88 (p=0.020), Q4: HR=1.97 (p=0.013) vs. Q1] predicted mortality. Among subjects free from heart failure (LVEF≥40%), diabetes, prior or current coronary disease, prior MI, stroke, renal failure, COPD, and depression (n=66), RDW had adjusted HR=1.70 per +1% (CI=1.06, 2.75; p=0.029). Conclusions: RDW predicted mortality in patients with normal hsCRP and WBC. This suggests that RDW marks the risk of a breadth of health concerns, likely including but not limited to inflammation. Further investigation is required to explain the causes of RDW elevation.

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