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Baumer Y, Irei J, Boisvert WA. Cholesterol crystals in the pathogenesis of atherosclerosis. Nat Rev Cardiol 2025; 22:315-332. [PMID: 39558130 DOI: 10.1038/s41569-024-01100-3] [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] [Accepted: 10/23/2024] [Indexed: 11/20/2024]
Abstract
The presence of cholesterol crystals (CCs) in tissues was first described more than 100 years ago. CCs have a pathogenic role in various cardiovascular diseases, including myocardial infarction, aortic aneurysm and, most prominently, atherosclerosis. Although the underlying mechanisms and signalling pathways involved in CC formation are incompletely understood, numerous studies have highlighted the existence of CCs at various stages of atheroma progression. In this Review, we summarize the mechanisms underlying CC formation and the role of CCs in cardiovascular disease. In particular, we explore the established links between lipid metabolism across various cell types and the formation of CCs, with a focus on CC occurrence in the vasculature. We also discuss CC-induced inflammation as one of the pathogenic features of CCs in the atheroma. Finally, we summarize the therapeutic strategies aimed at reducing CC-mediated atherosclerotic burden, including approaches to inhibit CC formation in the vasculature or to mitigate the inflammatory response triggered by CCs. Addressing CC formation might emerge as a crucial component in our broader efforts to combat cardiovascular disease.
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Affiliation(s)
- Yvonne Baumer
- Social Determinants of Obesity and Cardiovascular Risk Laboratory, NIH, NHLBI, Bethesda, MD, USA
| | - Jason Irei
- Center for Cardiovascular Research, John A. Burns School of Medicine, University of Hawaii, Honolulu, HI, USA
| | - William A Boisvert
- Center for Cardiovascular Research, John A. Burns School of Medicine, University of Hawaii, Honolulu, HI, USA.
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Jordan A, Trkulja V, Jurin I, Marević S, Đerek L, Lukšić I, Manola Š, Lucijanić M. Accounting for Red Cell Distribution Width Improves Risk Stratification by Commonly Used Mortality/Deterioration Risk Scores in Adult Patients Hospitalized Due to COVID-19. Life (Basel) 2024; 14:1267. [PMID: 39459567 PMCID: PMC11509295 DOI: 10.3390/life14101267] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/17/2024] [Revised: 09/30/2024] [Accepted: 10/02/2024] [Indexed: 10/28/2024] Open
Abstract
Higher red blood cell distribution width (RDW) levels have gained attention in the prognostication of many chronic metabolic and malignant diseases, as well as coronavirus disease 2019 (COVID-19). We aimed to evaluate whether accounting for RDW might contribute to risk stratification when added to commonly used risk scoring systems in adult COVID-19 patients. We retrospectively analyzed a cohort of 3212 non-critical COVID-19 patients hospitalized in a tertiary-level institution from March 2020 to June 2021. Admission RDW values were considered normal if they were ≤14.5% in males or ≤16.1% in females. The Modified Early Warning Score (MEWS), International Severe Acute Respiratory and Emerging Infections Consortium Coronavirus Clinical Characterisation Consortium score (ISARIC 4C), and Veterans Health Administration COVID-19 (VACO) index were evaluated as prognostic scores. RDW exceeded the upper limit in 628 (19.6%) of the patients. When RDW was accounted for, risks of the predicted outcomes were considerably different within the same MEWS, 4C score, and VACO index levels. The same patterns applied equally to patients who started, and those who did not start, remdesivir before deterioration. RDW may be a useful tool for stratifying risk when considered on top of commonly used prognostic scores in non-critical COVID-19 patients.
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Affiliation(s)
- Ana Jordan
- Cardiology Department, University Hospital Dubrava, 10000 Zagreb, Croatia
| | | | - Ivana Jurin
- Cardiology Department, University Hospital Dubrava, 10000 Zagreb, Croatia
| | - Sanja Marević
- Clinical Department for Laboratory Diagnostics, University Hospital Dubrava, 10000 Zagreb, Croatia
| | - Lovorka Đerek
- Clinical Department for Laboratory Diagnostics, University Hospital Dubrava, 10000 Zagreb, Croatia
- School of Medicine, Catholic University of Croatia, 10000 Zagreb, Croatia
| | - Ivica Lukšić
- School of Medicine, University of Zagreb, 10000 Zagreb, Croatia
- Maxillofacial Surgery Department, University Hospital Dubrava, 10000 Zagreb, Croatia
| | - Šime Manola
- Cardiology Department, University Hospital Dubrava, 10000 Zagreb, Croatia
- School of Dental Medicine, University of Zagreb, 10000 Zagreb, Croatia
| | - Marko Lucijanić
- School of Medicine, University of Zagreb, 10000 Zagreb, Croatia
- Hematology Department, University Hospital Dubrava, 10000 Zagreb, Croatia
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Baluku JB, Nalwanga R, Kazibwe A, Olum R, Nuwagira E, Mugenyi N, Mulindwa F, Bongomin F. Association between biomarkers of inflammation and dyslipidemia in drug resistant tuberculosis in Uganda. Lipids Health Dis 2024; 23:65. [PMID: 38429714 PMCID: PMC10905847 DOI: 10.1186/s12944-024-02063-7] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2023] [Accepted: 02/27/2024] [Indexed: 03/03/2024] Open
Abstract
BACKGROUND Active tuberculosis (TB) significantly increases the risk of cardiovascular disease, but the underlying mechanisms remain unclear. This study aimed to investigate the association between inflammation biomarkers and dyslipidemia in patients with drug-resistant TB (DR-TB). METHODS This was a secondary analysis of data from a cross-sectional multi-center study in Uganda conducted 2021. Participants underwent anthropometric measurements and laboratory tests included a lipid profile, full haemogram and serology for HIV infection. Dyslipidemia was defined as total cholesterol > 5.0 mmol/l and/or low-density lipoprotein cholesterol > 4.14 mmol/l, and/or triglycerides (TG) ≥ 1.7 mmol/l, and/or high density lipoprotein cholesterol (HDL-c) < 1.03 mmol/l for men and < 1.29 mmol/l for women. Biomarkers of inflammation were leukocyte, neutrophil, lymphocyte, monocyte, and platelet counts, as well as neutrophil/lymphocyte (NLR), platelet/lymphocyte, and lymphocyte/monocyte (LMR) ratios, mean corpuscular volume (MCV), and the systemic immune inflammation index (SII) (neutrophil × platelet/lymphocyte). Modified Poisson Regression analysis was used for determining the association of the biomarkers and dyslipidemia. RESULTS Of 171 participants, 118 (69.0%) were co-infected with HIV. The prevalence of dyslipidemia was 70.2% (120/171) with low HDL-c (40.4%, 69/171) and hypertriglyceridemia (22.5%, 38/169) being the most common components. Patients with dyslipidemia had significantly higher lymphocyte (P = 0.008), monocyte (P < 0.001), and platelet counts (P = 0.014) in addition to a lower MCV (P < 0.001) than those without dyslipidemia. Further, patients with dyslipidemia had lower leucocyte (P < 0.001) and neutrophil (P = 0.001) counts, NLR (P = 0.008), LMR (P = 0.006), and SII (P = 0.049). The MCV was inversely associated with low HDL-C (adjusted prevalence ratio (aPR) = 0.97, 95% CI 0.94-0.99, P = 0.023) but was positively associated with hypertriglyceridemia (aPR = 1.04, 95% CI 1.00-1.08, P = 0.052). CONCLUSIONS Individuals with dyslipidemia exhibited elevated lymphocyte, monocyte, and platelet counts compared to those without. However, only MCV demonstrated an independent association with specific components of dyslipidemia. There is need for further scientific inquiry into the potential impact of dyslipidemia on red cell morphology and a pro-thrombotic state among patients with TB.
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Affiliation(s)
- Joseph Baruch Baluku
- Kiruddu National Referral Hospital, Kampala, Uganda
- Faculty of Medicine, Mbarara University of Science and Technology, Mbarara, Uganda
- Makerere University Lung Institute, Kampala, Uganda
| | | | | | - Ronald Olum
- School of Public Health, Makerere University College of Health Sciences, Kampala, Uganda
| | - Edwin Nuwagira
- Faculty of Medicine, Mbarara University of Science and Technology, Mbarara, Uganda
| | - Nathan Mugenyi
- Faculty of Medicine, Mbarara University of Science and Technology, Mbarara, Uganda
| | | | - Felix Bongomin
- Department of Medical Microbiology and Immunology, Faculty of Medicine, Gulu University, Gulu, Uganda
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Huang S, Zhang H, Zhuang Z, Guo N, Zhou Q, Duan X, Ge L. Propensity score analysis of red cell distribution width to serum calcium ratio in acute myocardial infarction as a predictor of in-hospital mortality. Front Cardiovasc Med 2023; 10:1292153. [PMID: 38169646 PMCID: PMC10758436 DOI: 10.3389/fcvm.2023.1292153] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2023] [Accepted: 12/07/2023] [Indexed: 01/05/2024] Open
Abstract
Objective Red cell distribution width (RDW) and serum calcium (Ca) levels are predictors of in-hospital mortality in acute myocardial infarction (AMI) patients. However, their sensitivity and specificity are limited. Therefore, this study aimed to determine whether the RDW to Ca ratio (RCR) acquired on admission can be used to predict the in-hospital mortality of AMI patients. Methods This retrospective cohort study extracted clinical information from the Medical Information Market for Intensive IV (MIMIC-IV) database on 2,910 AMI patients enrolled via propensity score matching (PSM). Prognostic values were assessed using a multivariate logistic model and three PSM approaches. Analysis was performed based on stratified variables and interactions among sex, age, ethnicity, anemia, renal disease, percutaneous transluminal coronary intervention (PCI), coronary artery bypass grafting (CABG), atrial fibrillation, congestive heart failure, dementia, diabetes, paraplegia, hypertension, cerebrovascular disease, and Sequential Organ Failure Assessment (SOFA) score. Results A total of 4,105 ICU-admitted AMI patients were analyzed. The optimal cut-off value of the RCR for in-hospital mortality was 1.685. The PSM was performed to identify 1,455 pairs (2,910) of score-matched patients, with balanced differences exhibited for nearly all variables.The patients' median age was 72 years (range, 63-82 years) and 60.9% were male. The risk of in-hospital mortality incidence increased with increasing RCR levels. After adjusting for confounders, the risk ratio for the incidence of in-hospital mortality for high RCR was 1.75 [95% confidence interval (CI): 1.60-1.94, P = 0.0113] compared to that associated with low RCR in the PSM cohort. High RCR was also substantially implicated in in-hospital mortality incidence in the weighted cohorts [odds ratio (OR) = 1.76, 95% CI: 1.62-1.94, P = 0.0129]. Assessment of RCR in three groups showed that patients with high RCR also had a higher risk of in-hospital mortality (OR = 3.04; 95% CI, 2.22-4.16; P < 0.0001) than in patients with RCR in the adjusted model. In the sensitivity analysis, both the original and weighted groups showed similar results. Conclusion The RCR at admission may be useful for predicting in-hospital mortality in ICU-admitted AMI patients.
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Affiliation(s)
- Sulan Huang
- The First Affiliated Hospital, Jinan University, Guangzhou, China
- Department of Cardiovascular Medicine, The First People's Hospital of Changde City, Changde City, Hunan Province, China
| | - Huijia Zhang
- Department of Rheumatology and Immunology, The First People's Hospital of Changde City, Changde City, Hunan Province, China
| | - Zhijie Zhuang
- Department of Gastroenterology, The First People's Hospital of Changde City, Changde City, Hunan Province, China
| | - Ning Guo
- Department of Cardiovascular Medicine, The First People's Hospital of Changde City, Changde City, Hunan Province, China
| | - Quan Zhou
- Department of Science and Education Section, The First People's Hospital of Changde City, Changde City, Hunan Province, China
| | - Xiangjie Duan
- Department of Infectious Disease, The First People's Hospital of Changde, Changde City, Hunan Province, China
| | - Liangqing Ge
- The First Affiliated Hospital, Jinan University, Guangzhou, China
- Department of Cardiovascular Medicine, The First People's Hospital of Changde City, Changde City, Hunan Province, China
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Yang A, Yang YT, Zhao XM. An augmented Mendelian randomization approach provides causality of brain imaging features on complex traits in a single biobank-scale dataset. PLoS Genet 2023; 19:e1011112. [PMID: 38150468 PMCID: PMC10775988 DOI: 10.1371/journal.pgen.1011112] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2023] [Revised: 01/09/2024] [Accepted: 12/12/2023] [Indexed: 12/29/2023] Open
Abstract
Mendelian randomization (MR) is an effective approach for revealing causal risk factors that underpin complex traits and diseases. While MR has been more widely applied under two-sample settings, it is more promising to be used in one single large cohort given the rise of biobank-scale datasets that simultaneously contain genotype data, brain imaging data, and matched complex traits from the same individual. However, most existing multivariable MR methods have been developed for two-sample setting or a small number of exposures. In this study, we introduce a one-sample multivariable MR method based on partial least squares and Lasso regression (MR-PL). MR-PL is capable of considering the correlation among exposures (e.g., brain imaging features) when the number of exposures is extremely upscaled, while also correcting for winner's curse bias. We performed extensive and systematic simulations, and demonstrated the robustness and reliability of our method. Comprehensive simulations confirmed that MR-PL can generate more precise causal estimates with lower false positive rates than alternative approaches. Finally, we applied MR-PL to the datasets from UK Biobank to reveal the causal effects of 36 white matter tracts on 180 complex traits, and showed putative white matter tracts that are implicated in smoking, blood vascular function-related traits, and eating behaviors.
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Affiliation(s)
- Anyi Yang
- Department of Neurology, Zhongshan Hospital and Institute of Science and Technology for Brain-Inspired Intelligence, Fudan University, Shanghai, People’s Republic of China
- MOE Key Laboratory of Computational Neuroscience and Brain-Inspired Intelligence, and MOE Frontiers Center for Brain Science, Fudan University, Shanghai, People’s Republic of China
| | - Yucheng T. Yang
- Department of Neurology, Zhongshan Hospital and Institute of Science and Technology for Brain-Inspired Intelligence, Fudan University, Shanghai, People’s Republic of China
- MOE Key Laboratory of Computational Neuroscience and Brain-Inspired Intelligence, and MOE Frontiers Center for Brain Science, Fudan University, Shanghai, People’s Republic of China
| | - Xing-Ming Zhao
- Department of Neurology, Zhongshan Hospital and Institute of Science and Technology for Brain-Inspired Intelligence, Fudan University, Shanghai, People’s Republic of China
- MOE Key Laboratory of Computational Neuroscience and Brain-Inspired Intelligence, and MOE Frontiers Center for Brain Science, Fudan University, Shanghai, People’s Republic of China
- State Key Laboratory of Medical Neurobiology, Institutes of Brain Science, Fudan University, Shanghai, People’s Republic of China
- International Human Phenome Institutes (Shanghai), Shanghai, People’s Republic of China
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Suprasanna K, HB S, Ravikiran SR, Jain I, Holla V. Hematological indices as predictors of intracerebral hematoma expansion detected on serial computed tomography. BRAIN HEMORRHAGES 2023. [DOI: 10.1016/j.hest.2023.02.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/19/2023] Open
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Huang X, Yuan S, Ling Y, Tan S, Huang T, Cheng H, Lyu J. The Hemoglobin-to-Red Cell Distribution Width Ratio to Predict All-Cause Mortality in Patients with Sepsis-Associated Encephalopathy in the MIMIC-IV Database. Int J Clin Pract 2022; 2022:7141216. [PMID: 36683597 PMCID: PMC9825232 DOI: 10.1155/2022/7141216] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/13/2022] [Revised: 12/23/2022] [Accepted: 12/26/2022] [Indexed: 01/02/2023] Open
Abstract
OBJECTIVE The hemoglobin-to-red cell distribution width ratio (HRR) is associated with the prognosis of sepsis-associated encephalopathy (SAE). This study aimed to determine the relationship between HRR and SAE and to clarify the possible mechanism of HRR as a prognostic factor for SAE. METHODS A multivariate Cox proportional-hazards regression model was used to assess the correlation between HRR and all-cause mortality. Piecewise linear regression and smooth-curve Cox proportional-hazards regression models were used to observe whether there was a nonlinear relationship between HRR and all-cause mortality in SAE. RESULTS This study included 8853 patients with SAE. A nonlinear relationship between HRR and SAE was observed through a two-segment regression model. The left inflection point for the HRR threshold was calculated to be 15.54, which was negatively correlated with all-cause mortality (HR = 0.83, 95% CI = 0.76-0.91, p < 0.001). Subgroup analyses revealed significant interactions between white blood cell count, glucose, and patients who received dialysis and HRR. The inverse correlation between HRR and SAE was more pronounced in patients who did not receive vasopressin (HR = 0.91, 95% CI = 0.87-0.96, p < 0.001) than in those who did receive vasopressin (HR = 0.94, 95% CI = 0.88-1.02, p=0.152) and was significantly more pronounced in patients without myocardial infarction (HR = 0.91, 95% CI = 0.88-0.96, p < 0.001) than in those with myocardial infarction (HR = 0.94, 95% CI = 0.87-1.02, p < 0.114). CONCLUSION This large retrospective study found a nonlinear relationship between all-cause mortality and HRR in patients with SAE in intensive care units, with low HRR being inversely associated with increased all-cause mortality in patients with SAE.
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Affiliation(s)
- Xiaxuan Huang
- Department of Neurology, The First Affiliated Hospital of Jinan University, Guangzhou 510630, China
| | - Shiqi Yuan
- Department of Neurology, The First Affiliated Hospital of Jinan University, Guangzhou 510630, China
| | - Yitong Ling
- Department of Neurology, The First Affiliated Hospital of Jinan University, Guangzhou 510630, China
| | - Shanyuan Tan
- Department of Neurology, The First Affiliated Hospital of Jinan University, Guangzhou 510630, China
| | - Tao Huang
- Department of Clinical Research, The First Affiliated Hospital of Jinan University, Guangzhou 510630, China
| | - Hongtao Cheng
- School of Nursing, Jinan University, Guangzhou 510630, China
| | - Jun Lyu
- Department of Clinical Research, The First Affiliated Hospital of Jinan University, Guangzhou 510630, China
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RDW-to-ALB Ratio Is an Independent Predictor for 30-Day All-Cause Mortality in Patients with Acute Ischemic Stroke: A Retrospective Analysis from the MIMIC-IV Database. Behav Neurol 2022; 2022:3979213. [PMID: 36567762 PMCID: PMC9780005 DOI: 10.1155/2022/3979213] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2022] [Revised: 07/21/2022] [Accepted: 09/10/2022] [Indexed: 12/23/2022] Open
Abstract
Purpose Previous studies have shown that the peripheral red blood cell distribution width (RDW) and human serum albumin (ALB) were both predictors of the risk and mortality of cerebrovascular diseases, and the ratio of RDW to ALB (RAR) was a combined new index that can predict the prognosis of the cardiovascular and respiration systemic diseases, but its role in cerebrovascular diseases had not been effectively evaluated. This study is aimed at exploring whether RAR can effectively predict the 30-day all-cause mortality of acute ischemic stroke (AIS) patients. Methods This retrospective cohort study was conducted on AIS patients (age > 18 years) in the intensive care database MIMIC-IV. The RAR was measured based on the red blood cell distribution width and albumin. The main result was 30-day all-cause mortality, and the secondary results were ICU mortality and hospital mortality. Obtain the odds ratio (OR) estimate from the logistic regression model of log-transformed RAR values and mortality. We had used another database for external validation. Results A total of 1412 patients were enrolled, with an average age of 68.8 ± 15.9, including 708 (50.1%) males. When log-transformed RAR values were used as a continuous variable, as the values increases, the risk of death increases (30-day all-cause mortality OR = 4.02 (2.21, 7.32) P < 0.0001, ICU mortality OR = 3.81 (1.92, 7.54) P = 0.0001, and hospital mortality OR = 3.31 (1.83, 6.00) P < 0.0001), when the values were used as three-category variables and as a trend variable was also positively correlated with each mortality rate. Especially as the categorical variables, a dose-response relationship was clearly observed, that was, as the category of RAR increased (Q1 to Q3), the HR value of the risk of death gradually steadily increased. Such a relationship can also be observed in the external validation database. In the subgroup analysis, we observed an increased risk of death in the patient with hyperlipidemia and low HAS-BLED scores; however, no significant interaction was found in other subgroup analyses (including the diagnostic sequence of AIS). Conclusion RAR was a predictor of mortality in AIS patients. However, more in-depth research is needed to further analyze and confirm the role of RAR in AIS patients.
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Chen C, Gu Y, Xiao Z, Wang H, He X, Jiang Z, Kong Y, Liu C, Xue L, Vargas J, Wang S. Automatic whole blood cell analysis from blood smear using label-free multi-modal imaging with deep neural networks. Anal Chim Acta 2022; 1229:340401. [PMID: 36156229 DOI: 10.1016/j.aca.2022.340401] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/18/2022] [Revised: 08/27/2022] [Accepted: 09/11/2022] [Indexed: 11/01/2022]
Abstract
Whole blood cell analysis is widely used in medical applications since its results are indicators for diagnosing a series of diseases. In this work, we report automatic whole blood cell analysis from blood smear using label-free multi-modal imaging with deep neural networks. First, a commercial microscope equipped with our developed Phase Real-time Microscope Camera (PhaseRMiC) obtains both bright-field and quantitative phase images. Then, these images are automatically processed by our designed blood smear recognition networks (BSRNet) that recognize erythrocytes, leukocytes and platelets. Finally, blood cell parameters such as counts, shapes and volumes can be extracted according to both quantitative phase images and automatic recognition results. The proposed whole blood cell analysis technique provides high-quality blood cell images and supports accurate blood cell recognition and analysis. Moreover, this approach requires rather simple and cost-effective setups as well as easy and rapid sample preparations. Therefore, this proposed method has great potential application in blood testing aiming at disease diagnostics.
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Affiliation(s)
- Chao Chen
- Computational Optics Laboratory, School of Science, Jiangnan University, Wuxi, Jiangsu, 214122, China
| | - Yuanjie Gu
- Computational Optics Laboratory, School of Science, Jiangnan University, Wuxi, Jiangsu, 214122, China
| | - Zhibo Xiao
- Computational Optics Laboratory, School of Science, Jiangnan University, Wuxi, Jiangsu, 214122, China
| | - Hailun Wang
- Computational Optics Laboratory, School of Science, Jiangnan University, Wuxi, Jiangsu, 214122, China
| | - Xiaoliang He
- Computational Optics Laboratory, School of Science, Jiangnan University, Wuxi, Jiangsu, 214122, China
| | - Zhilong Jiang
- Computational Optics Laboratory, School of Science, Jiangnan University, Wuxi, Jiangsu, 214122, China
| | - Yan Kong
- Computational Optics Laboratory, School of Science, Jiangnan University, Wuxi, Jiangsu, 214122, China
| | - Cheng Liu
- Computational Optics Laboratory, School of Science, Jiangnan University, Wuxi, Jiangsu, 214122, China; Shanghai Institute of Optics and Fine Mechanics, Chinese Academy of Sciences, Shanghai, 201800, China
| | - Liang Xue
- College of Electronics and Information Engineering, Shanghai University of Electric Power, Shanghai, 200090, China.
| | - Javier Vargas
- Applied Optics Complutense Group, Optics Department, Universidad Complutense de Madrid, Facultad de CC. Físicas, Plaza de Ciencias, 1, 28040, Madrid, Spain
| | - Shouyu Wang
- Computational Optics Laboratory, School of Science, Jiangnan University, Wuxi, Jiangsu, 214122, China; OptiX+ Laboratory, Wuxi, Jiangsu, China.
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Arkew M, Gemechu K, Haile K, Asmerom H. Red Blood Cell Distribution Width as Novel Biomarker in Cardiovascular Diseases: A Literature Review. J Blood Med 2022; 13:413-424. [PMID: 35942475 PMCID: PMC9356613 DOI: 10.2147/jbm.s367660] [Citation(s) in RCA: 32] [Impact Index Per Article: 10.7] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2022] [Accepted: 07/26/2022] [Indexed: 11/23/2022] Open
Abstract
Red blood cell distribution width (RDW) is a measure of the change in size of red blood cells and it is used in combination with other hematological parameters for the differential diagnosis of anemias. Recent evidence suggested that the change in RDW level may be a predictive biomarker of morbidity and mortality in cardiovascular diseases (CVDs). Cardiovascular diseases are the most common cause of death globally as compared to cancer and communicable diseases. Early diagnosis and prompt intervention of these diseases are very important to minimize their complications. Nowadays, the diagnosis of most cardiovascular diseases majorly depends on clinical judgment, electrocardiography and biochemical parameters. Red blood cell distribution width as a new predictive biomarker may play a pivotal role in assessing the severity and progression of CVDs. However, the underlying mechanisms for the association between RDW and CVDs are not clear. A deeper understanding of their association could help the physicians in more careful identification, early prevention, intervention, and treatment to prevent adverse cardiovascular events. This review aims to elaborate on the recent knowledge on the association between RDW and cardiovascular diseases and some possible pathophysiological mechanisms.
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Affiliation(s)
- Mesay Arkew
- School of Medical Laboratory Sciences, College of Health and Medical Sciences, Haramaya University, Harar, Ethiopia
| | - Kabtamu Gemechu
- School of Medical Laboratory Sciences, College of Health and Medical Sciences, Haramaya University, Harar, Ethiopia
| | - Kassahun Haile
- Department of Medical Laboratory Science, College of Medicine and Health Sciences, Wolkite University, Wolkite, Ethiopia
| | - Haftu Asmerom
- School of Medical Laboratory Sciences, College of Health and Medical Sciences, Haramaya University, Harar, Ethiopia
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11
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Deng X, Gao B, Wang F, Zhao MH, Wang J, Zhang L. Red Blood Cell Distribution Width Is Associated With Adverse Kidney Outcomes in Patients With Chronic Kidney Disease. Front Med (Lausanne) 2022; 9:877220. [PMID: 35755057 PMCID: PMC9218182 DOI: 10.3389/fmed.2022.877220] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2022] [Accepted: 05/09/2022] [Indexed: 12/08/2022] Open
Abstract
Background Chronic kidney disease (CKD) is a global public health issue. Red blood cell distribution width (RDW) is a recently recognized potential inflammatory marker, which mirrors the variability in erythrocyte volume. Studies indicate that elevated RDW is associated with increased risk of mortality in CKD patients, while evidence regarding the impact of RDW on kidney outcome is limited. Methods Altogether 523 patients with CKD stage 1-4 from a single center were enrolled. We identified the cutoff point for RDW level using maximally selected log-rank statistics. The time-averaged estimated glomerular filtration rate (eGFR) slope was determined using linear mixed effects models. Rapid CKD progression was defined by an eGFR decline >5 ml/min/1.73 m2/year. The composite endpoints were defined as doubling of serum creatinine, a 30% decline in initial eGFR or incidence of eGFR < 15 ml/min/1.73 m2, whichever occurred first. Multivariable logistic regression or Cox proportional hazards regression was performed, as appropriate. Results During a median follow-up of 26 [interquartile range (IQR): 12, 36] months, 65 (12.43%) patients suffered a rapid CKD progression and 172 (32.89%) composite kidney events occurred at a rate of 32.3/100 patient-years in the high RDW group, compared with 14.7/100 patient-years of the remainder. The annual eGFR change was clearly steeper in high RDW group {-3.48 [95% confidence interval (CI): -4.84, -2.12] ml/min/1.73 m2/year vs. -1.86 [95% CI: -2.27, -1.45] ml/min/1.73 m2/year among those with RDW of >14.5% and ≤14.5%, respectively, P for between-group difference <0.05}. So was the risk of rapid renal function loss (odds ratio = 6.79, 95% CI: 3.08-14.97) and composite kidney outcomes (hazards ratio = 1.51, 95% CI: 1.02-2.23). The significant association remained consistent in the sensitivity analysis. Conclusion Increased RDW value is independently associated with accelerated CKD deterioration. Findings of this study suggest RDW be a potential indicator for risk of CKD progression.
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Affiliation(s)
- Xinwei Deng
- Renal Division, Department of Medicine, Peking University First Hospital, Beijing, China.,Institute of Nephrology, Peking University, Beijing, China.,Research Units of Diagnosis and Treatment of Immune-Mediated Kidney Diseases, Chinese Academy of Medical Sciences, Beijing, China
| | - Bixia Gao
- Renal Division, Department of Medicine, Peking University First Hospital, Beijing, China.,Institute of Nephrology, Peking University, Beijing, China.,Research Units of Diagnosis and Treatment of Immune-Mediated Kidney Diseases, Chinese Academy of Medical Sciences, Beijing, China.,Key Laboratory of Renal Disease, Ministry of Health of China, Beijing, China.,Key Laboratory of Chronic Kidney Disease Prevention and Treatment, Ministry of Education of China, Beijing, China
| | - Fang Wang
- Renal Division, Department of Medicine, Peking University First Hospital, Beijing, China.,Institute of Nephrology, Peking University, Beijing, China.,Research Units of Diagnosis and Treatment of Immune-Mediated Kidney Diseases, Chinese Academy of Medical Sciences, Beijing, China.,Key Laboratory of Renal Disease, Ministry of Health of China, Beijing, China.,Key Laboratory of Chronic Kidney Disease Prevention and Treatment, Ministry of Education of China, Beijing, China
| | - Ming-Hui Zhao
- Renal Division, Department of Medicine, Peking University First Hospital, Beijing, China.,Institute of Nephrology, Peking University, Beijing, China.,Research Units of Diagnosis and Treatment of Immune-Mediated Kidney Diseases, Chinese Academy of Medical Sciences, Beijing, China.,Key Laboratory of Renal Disease, Ministry of Health of China, Beijing, China.,Key Laboratory of Chronic Kidney Disease Prevention and Treatment, Ministry of Education of China, Beijing, China.,Peking-Tsinghua Center for Life Sciences, Academy for Advanced Interdisciplinary Studies, Peking University, Beijing, China
| | - Jinwei Wang
- Renal Division, Department of Medicine, Peking University First Hospital, Beijing, China.,Institute of Nephrology, Peking University, Beijing, China.,Research Units of Diagnosis and Treatment of Immune-Mediated Kidney Diseases, Chinese Academy of Medical Sciences, Beijing, China.,Key Laboratory of Renal Disease, Ministry of Health of China, Beijing, China.,Key Laboratory of Chronic Kidney Disease Prevention and Treatment, Ministry of Education of China, Beijing, China
| | - Luxia Zhang
- Renal Division, Department of Medicine, Peking University First Hospital, Beijing, China.,Institute of Nephrology, Peking University, Beijing, China.,Research Units of Diagnosis and Treatment of Immune-Mediated Kidney Diseases, Chinese Academy of Medical Sciences, Beijing, China.,Key Laboratory of Renal Disease, Ministry of Health of China, Beijing, China.,Key Laboratory of Chronic Kidney Disease Prevention and Treatment, Ministry of Education of China, Beijing, China.,National Institute of Health Data Science, Peking University, Beijing, China
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12
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Raza H, Noor T, Umer S, Fatima M, Imran A, Malik N. Relationship Between High-Density Lipoprotein-Cholesterol and Red Cell Distribution Width in Patients With Coronary Artery Disease. Cureus 2022; 14:e23132. [PMID: 35425675 PMCID: PMC9005557 DOI: 10.7759/cureus.23132] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/13/2022] [Indexed: 11/28/2022] Open
Abstract
Background A high red cell distribution width (RDW), which indicates ongoing inflammation, and low levels of high-density lipoprotein-cholesterol (HDL-C) are associated with increased mortality and morbidity in patients with coronary artery disease (CAD). Recent studies have suggested that HDL-C possesses anti-inflammatory and antioxidant effects, which may explain its anti-atherogenic properties. This study aims to determine the relationship between HDL-C levels and RDW in patients with CAD. Materials and methods This cross-sectional study was performed on 120 patients with CAD from July 2020 to June 2021 in the Hematology Department of Chughtai Lab Lahore. Patients were graded according to the degree of coronary artery stenosis as follows: Grade 1,30%-50%; Grade 2, 51%-70%; and Grade 3,>70%. The HDL-C level was measured from venous blood samples by a fully automated Abbot Alinity analyzer. The RDW was measured by Sysmex XN-5000. The sample size was calculated using the Select Statistics calculator. The mean RDW and HDL-C of the patients were calculated, and correlation analyses were performed using the Pearson correlation coefficient. Results The HDL-C level was inversely related to the RDW. Of the 120 patients, 38, 44, and 38 had Grade 1, Grade 2, and Grade 3 stenosis, respectively. The mean HDL-C level and RDW were 30.58 ±3.77 mg/dL and 16.04% ±1.66%, respectively. The value of r was −0.8622 (strongly negative). Data were stratified based on the degree of stenosis. The values of r in Grades 1, 2, and 3 were −0.43 (moderately negative), −0.604 (moderately negative), and −0.27 (weakly negative), respectively. Conclusion The RDW can be used as an additional marker to determine the disease status in CAD patients.
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13
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Xiu WJ, Zheng YY, Wu TT, Hou XG, Yang Y, Ma YT, Xie X. Hemoglobin-to-Red-Cell Distribution Width Ratio Is a Novel Predictor of Long-Term Patient Outcomes After Percutaneous Coronary Intervention: A Retrospective Cohort Study. Front Cardiovasc Med 2022; 9:726025. [PMID: 35252370 PMCID: PMC8889075 DOI: 10.3389/fcvm.2022.726025] [Citation(s) in RCA: 18] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2021] [Accepted: 01/17/2022] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND The hemoglobin level and red cell distribution width (RDW) have been linked to the prognosis of coronary atherosclerotic heart disease (CAHD). However, the relationship between the ratio of hemoglobin to the RDW (HRR) and clinical outcomes after percutaneous coronary intervention (PCI) is not known. Here, we explored the impact of the HRR on clinical outcomes after PCI. METHODS In our study, we selected 6,046 CAHD patients with PCI hospitalized in the First Affiliated Hospital of Xinjiang Medical University from 2008 to 2016. The patients were grouped according to their HRR ratio: group A (HRR < 10.25, n = 2,344) and group B (HRR ≥ 10.25, n = 3,702). The difference in clinical outcomes between the two groups was compared. Patients were followed up for 35.9 ± 22.6 months. RESULTS Three hundred nine patients died during follow-up. These included 166 patients (7.1%) in the HRR < 10.25 group and 143 patients (3.9%) in the HRR ≥ 10.25 group (P < 0.001). The incidences of cardiogenic death (5.7 vs. 3.2%) and major cardiovascular adverse events (16.5 vs. 12.9%) also differed significantly between the groups (both Ps < 0.001). Analysis using the multivariate Cox proportional hazard model found a significant association between a decreased HRR and post-PCI mortality (all-cause death, adjusted HR: 1.479, 95% CI: 1.156-1.893, p = 0.002; cardiac death, adjusted HR: 1.470, 95% CI: 1.116-1.936, p = 0.006). CONCLUSION The HRR is predictive of post-PCI mortality among CAHD patients.
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Affiliation(s)
- Wen-Juan Xiu
- Department of Cardiology, First Affiliated Hospital of Xinjiang Medical University, Urumqi, China
| | - Ying-Ying Zheng
- Department of Cardiology, First Affiliated Hospital of Xinjiang Medical University, Urumqi, China
- Key Laboratory of Cardiac Injury and Repair of Henan Province, Department of Cardiology, First Affiliated Hospital of Zhengzhou University, Zhengzhou, China
| | - Ting-Ting Wu
- Department of Cardiology, First Affiliated Hospital of Xinjiang Medical University, Urumqi, China
| | - Xian-Geng Hou
- Department of Cardiology, First Affiliated Hospital of Xinjiang Medical University, Urumqi, China
| | - Yi Yang
- Department of Cardiology, First Affiliated Hospital of Xinjiang Medical University, Urumqi, China
| | - Yi-Tong Ma
- Department of Cardiology, First Affiliated Hospital of Xinjiang Medical University, Urumqi, China
| | - Xiang Xie
- Department of Cardiology, First Affiliated Hospital of Xinjiang Medical University, Urumqi, China
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14
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Valenti AC, Vitolo M, Manicardi M, Arrotti S, Magnavacchi P, Gabbieri D, Tondi S, Guiducci V, Losi L, Vignali L, Sgura FA, Boriani G. Red blood cell distribution width in patients undergoing transcatheter aortic valve implantation: Implications for outcomes. Int J Clin Pract 2021; 75:e14153. [PMID: 33735532 DOI: 10.1111/ijcp.14153] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/21/2021] [Accepted: 03/14/2021] [Indexed: 12/15/2022] Open
Abstract
BACKGROUND Red cell distribution width (RDW) is recently emerging as a prognostic indicator in many cardiovascular diseases. However, less is known about its predictive role in patients undergoing transcatheter aortic valve implantation (TAVI). METHODS We retrospectively included very high-risk patients with severe aortic valve stenosis undergoing TAVI between February 2012 and December 2019. Patients were classified according to RDW tertiles. Our primary endpoint was long-term all-cause mortality. The secondary endpoint was a composite of in-hospital major adverse events as defined by the Valve Academic Research Consortium 2 criteria and/or long-term all-cause mortality. RESULTS A total of 424 patients [median age 83.5 years, 52.6% females] were analysed. After a median follow-up of 1.55 years, all-cause mortality was 25.5%. At the multivariate-adjusted Cox regression analysis, patients in the highest RDW tertile were associated with a higher risk for all-cause mortality [hazard ratio [HR] 1.73, 95%confidence interval [CI] 1.02-2.95] compared with the lowest tertile. When considering RDW as a continuous variable, we found an 11% increased risk in overall mortality [HR 1.11, 95% CI 1.00-1.24] for each increased point in RDW. The highest RDW tertile was also independently associated with the occurrence of the composite endpoint [odds ratio [OR] 2.10, 95% CI 1.17-3.76] compared with lower tertiles. CONCLUSIONS In our cohort, elevated basal RDW values were independent predictors of increased long-term mortality and higher rate of in-hospital adverse events. The inclusion of a routinely available biomarker as RDW, may help the pre-operative risk assessment in potential TAVI candidates and optimise their management.
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Affiliation(s)
- Anna Chiara Valenti
- Cardiology Division, Department of Biomedical, Metabolic and Neural Sciences, University of Modena and Reggio Emilia, Policlinico di Modena, Modena, Italy
| | - Marco Vitolo
- Cardiology Division, Department of Biomedical, Metabolic and Neural Sciences, University of Modena and Reggio Emilia, Policlinico di Modena, Modena, Italy
- Clinical and Experimental Medicine PhD Program, University of Modena and Reggio Emilia, Modena, Italy
| | - Marcella Manicardi
- Cardiology Division, Department of Biomedical, Metabolic and Neural Sciences, University of Modena and Reggio Emilia, Policlinico di Modena, Modena, Italy
| | - Salvatore Arrotti
- Cardiology Division, Department of Biomedical, Metabolic and Neural Sciences, University of Modena and Reggio Emilia, Policlinico di Modena, Modena, Italy
| | | | | | - Stefano Tondi
- Cardiology Division, Baggiovara Hospital, Modena, Italy
| | | | - Luciano Losi
- Cardiology Division, Ospedale Guglielmo da Saliceto, Piacenza, Italy
| | - Luigi Vignali
- Cardiology Division, Azienda Ospedaliero-Universitaria di Parma, Parma, Italy
| | - Fabio Alfredo Sgura
- Cardiology Division, Department of Biomedical, Metabolic and Neural Sciences, University of Modena and Reggio Emilia, Policlinico di Modena, Modena, Italy
| | - Giuseppe Boriani
- Cardiology Division, Department of Biomedical, Metabolic and Neural Sciences, University of Modena and Reggio Emilia, Policlinico di Modena, Modena, Italy
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15
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Huang S, Zhou Q, Guo N, Zhang Z, Luo L, Luo Y, Qin Z, Ge L. Association between red blood cell distribution width and in-hospital mortality in acute myocardial infarction. Medicine (Baltimore) 2021; 100:e25404. [PMID: 33847638 PMCID: PMC8052072 DOI: 10.1097/md.0000000000025404] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/15/2020] [Accepted: 03/14/2021] [Indexed: 01/04/2023] Open
Abstract
Previous studies have shown an independent association between increased red cell distribution width (RDW) and mortality after acute myocardial infarction (AMI). However, evidence regarding the predictive significance of repeated measures of RDW in patients with AMI remains scarce. We aimed to investigate the association between the dynamic profile of RDW and in-hospital mortality in patients with AMI.This was a cross-sectional study. We extracted clinical data from the Medical Information Mart for Intensive Care IIIV1.4 database. Demographic data, vital signs, laboratory test data, and comorbidities were collected from the database. The clinical endpoint was in-hospital mortality. Cox proportional hazards models were used to evaluate the prognostic values of basic RDW, and the Kaplan-Meier method was used to plot survival curves. Subgroup analyses were performed to measure mortality across various subgroups. The repeated-measures data were compared using a generalized additive mixed model.In total, 3101eligible patients were included. In multivariate analysis, adjusted for age, sex, and ethnicity, RDW was a significant risk predictor of in-hospital mortality. Furthermore, after adjusting for more confounding factors, RDW remained a significant predictor of in-hospital mortality (tertile 3 vs tertile 1: hazard ratio 2.3; 95% confidence interval 1.39-4.01; P for trend <.05). The Kaplan-Meier curve for tertiles of RDW indicated that survival rates were highest when RDW was ≤13.2% and lowest when RDW was ≥14.2% after adjustment for age, sex, and ethnicity. During the intensive care unit stay, the RDW of nonsurvivors progressively increased until death occurred.Our findings showed that a higher RDW was associated with an increased risk of in-hospital mortality in patients with AMI.
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16
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Lazzeroni D, Moderato L, Marazzi PL, Pellegrino C, Musiari E, Castiglioni P, Camaiora U, Bini M, Geroldi S, Brambilla L, Brambilla V, Coruzzi P. Red blood cell distribution width as a novel prognostic marker after myocardial revascularization or cardiac valve surgery. Sci Rep 2021; 11:7889. [PMID: 33846483 PMCID: PMC8041885 DOI: 10.1038/s41598-021-87075-4] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2020] [Accepted: 02/02/2021] [Indexed: 01/12/2023] Open
Abstract
The red blood cell distribution width (RDW) measures the variability in the size of circulating erythrocytes. Previous studies suggested a powerful correlation between RDW obtained from a standard complete blood count and cardiovascular diseases in both primary and secondary cardiovascular prevention. The current study aimed to evaluate the prognostic role of RDW in patients undergoing cardiac rehabilitation after myocardial revascularization and/or cardiac valve surgery. The study included 1.031 patients with available RDW levels, prospectively followed for a mean of 4.5 ± 3.5 years. The mean age was 68 ± 12 years, the mean RDW was 14.7 ± 1.8%; 492 patients (48%) underwent cardiac rehabilitation after myocardial revascularization, 371 (36%) after cardiac valve surgery, 102 (10%) after valve-plus-coronary artery by-pass graft surgery, 66 (6%) for other indications. Kaplan-Meier analysis and Cox hazard analysis were used to associate RDW with mortality. Kaplan-Meier analysis demonstrated worse survival curves free from overall (log-rank p < 0.0001) and cardiovascular (log-rank p < 0.0001) mortality in the highest RDW tertile. Cox analysis showed RDW levels correlated significantly with the probability of overall (HR 1.26; 95% CI 1.19-1.32; p < 0.001) and cardiovascular (HR 1.31; 95% CI 1.23-1.40; p < 0.001) mortality. After multiple adjustments for cardiovascular risk factors, hemoglobin, hematocrit, C-reactive protein, microalbuminuria, atrial fibrillation, glomerular filtration rate,left ventricular ejection fraction and number of exercise training sessions attended, the increased risk of overall (HR 1.10; 95% CI 1.01-1.27; p = 0.039) and cardiovascular (HR 1.13; 95% CI 1.01-1.34; p = 0.036)mortality with increasing RDW values remained significant. The RDW represents an independent predictor of overall and cardiovascular mortality in secondary cardiovascular prevention patients undergoing cardiac rehabilitation.
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Affiliation(s)
- Davide Lazzeroni
- IRCCS Fondazione Don Carlo Gnocchi, Milan, Italy.
- , Piazzale dei Servi, n°3, 43121, Parma, Italy.
| | | | | | | | | | | | | | | | | | | | | | - Paolo Coruzzi
- Department of Medicine and Surgery, University of Parma, Parma, Italy
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17
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Knychala MA, Garrote-Filho MDS, Batista da Silva B, Neves de Oliveira S, Yasminy Luz S, Marques Rodrigues MO, Penha-Silva N. Red cell distribution width and erythrocyte osmotic stability in type 2 diabetes mellitus. J Cell Mol Med 2021; 25:2505-2516. [PMID: 33591627 PMCID: PMC7933938 DOI: 10.1111/jcmm.16184] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/23/2019] [Revised: 01/30/2020] [Accepted: 11/07/2020] [Indexed: 12/15/2022] Open
Abstract
This study aimed to investigate the relationship between red cell distribution width (RDW) and erythrocyte osmotic stability in non‐diabetic and diabetic individuals in both sexes. The study sample (N = 122) was constituted by 53 type 2 diabetics (DM) and 69 non‐diabetics (ND), being 21 and 22 men in each group, respectively. The osmotic stability of erythrocytes was obtained by the variation in saline concentration (dX) capable of determining hypoosmotic lysis. Higher RDW values and lower serum iron concentrations were found in the diabetic group when compared to the non‐diabetic volunteers. In the group of diabetic women, RDW was positively correlated with the reticulocyte index, and both RDW and dX were negatively correlated with iron, haemoglobin, transferrin saturation index, mean corpuscular haemoglobin and mean corpuscular haemoglobin concentration. In all the groups studied, RDW was positively correlated with dX, especially in the diabetic group, where the correlation was the strongest. RDW elevation in both women and men with type 2 diabetes mellitus was associated with decreased serum iron indicators. Furthermore, RDW has a similar meaning to dX, as small erythrocytes have less haemoglobin, resulting in both an increase of RDW and dX.
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Affiliation(s)
| | | | | | | | - Sarah Yasminy Luz
- Institute of Biotechnology, Federal University of Uberlândia, Uberlândia, Brazil
| | | | - Nilson Penha-Silva
- Institute of Biotechnology, Federal University of Uberlândia, Uberlândia, Brazil
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18
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Cui Z, Liu C, Sun G, Huang L, Zhou W. A prognostic nomogram incorporating red cell distribution width for patients with intracerebral hemorrhage. Medicine (Baltimore) 2020; 99:e23557. [PMID: 33327308 PMCID: PMC7738053 DOI: 10.1097/md.0000000000023557] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/27/2022] Open
Abstract
Intracerebral hemorrhage (ICH) is the second most common subtype of stroke with higher mortality and morbidity, and it lacks effective prognostic markers. The aim of this research is to construct newly valuable prognostic nomogram incorporating red blood cell distribution width (RDW) for ICH patients.We retrospectively analyzed 953 adult patients with ICH. The impacts of RDW on short-term mortality and functional prognosis were calculated using Akaike information criterion (AIC), Bayesian information criteria (BIC) and the area under the curve (AUC) respectively, which could be used to compare with Glasgow coma scale (GCS) and ICH score. The independent factors of prognosis were identified by univariate and multivariate logistic regression analysis. A nomogram based on RDW for nerve functional prognosis was further constructed and validated. Its clinical value was subsequently explored utilizing decision curve analysis.Cumulative clinical results were retrieved for 235 inpatients from Jan 2012 to June 2017. In 30-day mortality sets, GCS and ICH score had better prognostic performance than RDW (AUC: 0.929 and 0.917 vs 0.764; AIC: 124.101 and 134.188 vs 221.372; BIC: 131.021 and 141.107 vs 228.291). In 30-day functional prognosis sets, the consequences of evaluation systems were inconsistent. GCS was the best parameter for predicting outcome using AIC (262.350 vs 276.392 and 264.756) and BIC (269.269 vs 283.311 and 271.675). However, RDW was higher than GCS and ICH score considering AUC (0.784 vs 0.759 and 0.722). Age, GCS, RDW, platelet distribution width, and surgery were independent prognostic factors by multivariate logistic regression analysis, and those coefficients were used to formulate a nomogram. This nomogram can provide accurate prediction with the concordance index of 0.880 (95% CI, 0.837-0.922) higher than Harrell's concordance index of GCS system 0.759 (95% CI, 0.698-0.819) and RDW 0.784 (95% CI, 0.721-0.847). The calibration plots showed optimal consistency between bootstrap-predicted and the actual observed values of 30-day unfavorable prognosis. Decision curve analysis showed an increased net benefit for utilizing the nomogram.High RDW values are associated with an unfavorable outcome after ICH. The established nomogram incorporating RDW should be considered for a 30-day functional prognosis.
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Affiliation(s)
- Zhe Cui
- Division of Hematology and Transfusion Medicine, Department of Laboratory Medicine, Tianjin Baodi Hospital, Tianjin Baodi Affiliated Hospital of Tianjin Medical University, Baodi District, Tianjin
| | - Chengwang Liu
- Division of Hematology and Transfusion Medicine, Department of Laboratory Medicine, Tianjin Baodi Hospital, Tianjin Baodi Affiliated Hospital of Tianjin Medical University, Baodi District, Tianjin
| | - Guozhong Sun
- Division of Hematology and Transfusion Medicine, Department of Laboratory Medicine, Tianjin Baodi Hospital, Tianjin Baodi Affiliated Hospital of Tianjin Medical University, Baodi District, Tianjin
| | - Liping Huang
- Department of Oncology, the First Affiliated Hospital of Zhengzhou University, Zhengzhou, Henan Province
| | - Weiwen Zhou
- Department of Emergency Medicine, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Yuexiu District, Guangzhou, China
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Red Blood Cell Distribution Width Is Associated with Deterioration of Renal Function and Cardiovascular Morbidity and Mortality in Patients with Diabetic Kidney Disease. Life (Basel) 2020; 10:life10110301. [PMID: 33266382 PMCID: PMC7700598 DOI: 10.3390/life10110301] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/22/2020] [Revised: 11/11/2020] [Accepted: 11/20/2020] [Indexed: 12/21/2022] Open
Abstract
We sought to investigate the possible association between Red Blood Cell Distribution Width (RDW), vascular calcification, oxidative stress and renal function and all-cause/cardiovascular (CV) mortality, CV events and progression of kidney disease in a cohort of patients with Diabetic Kidney Disease (DKD). Carotid intima media thickness (cIMT) and oxidized low-density cholesterol were measured in 104 Type 2 Diabetes Mellitus (T2DM) patients with established DKD, distributed in all five stages of kidney disease and 38 diabetics with normal renal function. All patients were followed for 7 years with end-points all-cause and CV mortality, CV events and progression to End-Stage Renal Disease (ESRD). RDW was positively correlated with diabetes duration (r = 0.19, p = 0.023) and albuminuria (r = 0.29, p = 0.002). Multivariate regression analysis revealed that RDW was a strong, independent predictor of cIMT value (β = 0.031, p = 0.012). Kaplan-Meier curves and Cox proportional hazard models revealed that after adjustment for several cofounders, RDW was a significant and independent predictor for all-cause mortality, CV mortality, CV event and progression to ESRD (HR 1.75, p = 0.001, HR 2.03, p = 0.001, HR = 1.66, p < 0.0001 and HR 2.14, p = 0.001 respectively). RDW predicts mortality, CV events and deterioration of renal function in DKD, probably reflecting atherosclerosis.
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20
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Torres-Chable OM, García-Herrera RA, González-Garduño R, Ojeda-Robertos NF, Peralta-Torres JA, Chay-Canul AJ. Relationships among body condition score, FAMACHA© score and haematological parameters in Pelibuey ewes. Trop Anim Health Prod 2020; 52:3403-3408. [PMID: 32929586 DOI: 10.1007/s11250-020-02373-9] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2020] [Accepted: 09/07/2020] [Indexed: 11/25/2022]
Abstract
The objective of the present study was to determine the associations between the FAMACHA© score, body condition score (BCS) and several haematological parameters of Pelibuey ewes. In total, 52 clinically healthy Pelibuey ewes were evaluated in this study. A blood sample was collected from each animal to determine haematological variables. The BCS was evaluated on a scale of 1 to 5 and subsequently grouped into four categories: (1) < 1.5, (2) 2.0-2.5, (3) 3.0-3.5 and (4) > 4.0. The coloration of conjunctival mucosa was evaluated using the FAMACHA© system. The analysed haematological parameters were red blood cell (RBC) count, haemoglobin (HGB), haematocrit (HCT), mean corpuscular volume (MCV), mean corpuscular haemoglobin (MCH), mean corpuscular haemoglobin concentration (MCHC), red blood cell distribution width standard deviation (RDW-SD) and red blood cell distribution width coefficient of variation (RDW-CV). A descriptive statistical analysis was performed, and the Pearson correlation coefficients between variables were estimated. Haematological parameters were analysed with one-way analyses of variance, and the Tukey test was applied when significant differences were detected. The FAMACHA© score was only associated with MCHC (r = - 0.30, P < 0.05). The haematological parameters of RBC count, HCT, RDW-SD and RDW-CV statistically differed among BCS groups. The BCS was associated with RBC count, HCT, RDW-SD and RDW-CV, with r values ranging from 0.35 to 0.48. The haematological values were similar to those reported in ewes from Iran and Iraq. Hence, the optimization of the BCS calculation of Pelibuey ewes can generate association tables with haematological parameters to aid in the sanitary and feeding management of sheep.
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Affiliation(s)
- Oswaldo Margarito Torres-Chable
- División Académica de Ciencias Agropecuarias, Universidad Juárez Autónoma de Tabasco. Carretera Villahermosa-Teapa, km 25, R/A. La Huasteca 2ª Sección, CP 86280, Villahermosa, Tabasco, Mexico
| | - Ricardo Alfonso García-Herrera
- División Académica de Ciencias Agropecuarias, Universidad Juárez Autónoma de Tabasco. Carretera Villahermosa-Teapa, km 25, R/A. La Huasteca 2ª Sección, CP 86280, Villahermosa, Tabasco, Mexico
| | - Roberto González-Garduño
- Unidad Regional Universitaria Sursureste Universidad Autónoma Chapingo, Km 7.5, Carretera Teapa-Vicente Guerrero, CP 86800, Teapa, Tabasco, Mexico
| | - Nadia Florencia Ojeda-Robertos
- División Académica de Ciencias Agropecuarias, Universidad Juárez Autónoma de Tabasco. Carretera Villahermosa-Teapa, km 25, R/A. La Huasteca 2ª Sección, CP 86280, Villahermosa, Tabasco, Mexico
| | - Jorge Alonso Peralta-Torres
- División Académica de Ciencias Agropecuarias, Universidad Juárez Autónoma de Tabasco. Carretera Villahermosa-Teapa, km 25, R/A. La Huasteca 2ª Sección, CP 86280, Villahermosa, Tabasco, Mexico
| | - Alfonso Juventino Chay-Canul
- División Académica de Ciencias Agropecuarias, Universidad Juárez Autónoma de Tabasco. Carretera Villahermosa-Teapa, km 25, R/A. La Huasteca 2ª Sección, CP 86280, Villahermosa, Tabasco, Mexico.
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21
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Yang QY, Li XF, Lin MQ, Xu JH, Yan H, Zhang ZM, Wang SY, Chen HC, Chen XN, Lin KY, Guo YS. Association between red blood cell distribution width and long-term mortality among patients undergoing percutaneous coronary intervention with previous history of cancer. Biomarkers 2020; 25:260-267. [PMID: 32141338 DOI: 10.1080/1354750x.2020.1734860] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
Abstract
Background: The number of patients suffering from coronary heart disease with cancer is rising. There is scarce evidence concerning the biomarkers related to prognosis among patients undergoing percutaneous coronary intervention (PCI) with cancer. Thus, the aim of this study was to investigate the association between red blood cell distribution width (RDW) and prognosis in this population.Methods: A total of 172 patients undergoing PCI with previous history of cancer were enrolled in this retrospective study. The endpoint was long-term all-cause mortality. According to tertiles of RDW, the patients were classified into three groups: Tertile 1 (RDW <12.8%), Tertile 2 (RDW ≥12.8% and <13.5%) and Tertile 3 (RDW ≥13.5%).Results: During an average follow-up period of 33.3 months, 29 deaths occurred. Compared with Tertile 3, mortality of Tertile 1 and Tertile 2 was significantly lower in the Kaplan-Meier analysis. In multivariate Cox regression analysis, RDW remained an independent risk factor of mortality (HR: 1.938, 95% CI: 1.295-2.655, p < 0.001). The all-cause mortality in Tertile 3 was significantly higher than that in Tertile 1 (HR: 5.766; 95% CI: 1.426-23.310, p = 0.014).Conclusions: An elevated RDW level (≥13.5%) was associated with long-term all-cause mortality among patients undergoing PCI with previous history of cancer.
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Affiliation(s)
- Qing-Yong Yang
- Department of Internal Medicine, Jinshan Branch of Fujian Provincial Hospital, Fujian Cardiovascular Institute, Fuzhou, China.,Clinical Medical College of Fujian Provincial Hospital, Fujian Medical University, Fuzhou, China
| | - Xiu-Feng Li
- Clinical Medical College of Fujian Provincial Hospital, Fujian Medical University, Fuzhou, China.,Department of Cardiology, Fujian Provincial Hospital, Fujian Cardiovascular Institute, Fuzhou, China
| | - Mao-Qiang Lin
- Clinical Medical College of Fujian Provincial Hospital, Fujian Medical University, Fuzhou, China.,Department of Cardiology, Fujian Provincial Hospital, Fujian Cardiovascular Institute, Fuzhou, China
| | - Jia-Hao Xu
- Clinical Medical College of Fujian Provincial Hospital, Fujian Medical University, Fuzhou, China.,Department of Cardiology, Fujian Provincial Hospital, Fujian Cardiovascular Institute, Fuzhou, China
| | - Han Yan
- Clinical Medical College of Fujian Provincial Hospital, Fujian Medical University, Fuzhou, China.,Department of Cardiology, Fujian Provincial Hospital, Fujian Cardiovascular Institute, Fuzhou, China
| | - Zhi-Ming Zhang
- Clinical Medical College of Fujian Provincial Hospital, Fujian Medical University, Fuzhou, China.,Department of Cardiology, Fujian Provincial Hospital, Fujian Cardiovascular Institute, Fuzhou, China
| | - Sun-Ying Wang
- Clinical Medical College of Fujian Provincial Hospital, Fujian Medical University, Fuzhou, China.,Department of Cardiology, Fujian Provincial Hospital, Fujian Cardiovascular Institute, Fuzhou, China
| | - Han-Chuan Chen
- Clinical Medical College of Fujian Provincial Hospital, Fujian Medical University, Fuzhou, China.,Department of Cardiology, Fujian Provincial Hospital, Fujian Cardiovascular Institute, Fuzhou, China
| | - Xi-Nan Chen
- Clinical Medical College of Fujian Provincial Hospital, Fujian Medical University, Fuzhou, China.,Department of Cardiology, Fujian Provincial Hospital, Fujian Cardiovascular Institute, Fuzhou, China
| | - Kai-Yang Lin
- Clinical Medical College of Fujian Provincial Hospital, Fujian Medical University, Fuzhou, China.,Department of Cardiology, Fujian Provincial Hospital, Fujian Cardiovascular Institute, Fuzhou, China
| | - Yan-Song Guo
- Clinical Medical College of Fujian Provincial Hospital, Fujian Medical University, Fuzhou, China.,Department of Cardiology, Fujian Provincial Hospital, Fujian Cardiovascular Institute, Fuzhou, China
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22
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Lippi G, Cervellin G, Sanchis-Gomar F. Red blood cell distribution width: A marker of anisocytosis potentially associated with atrial fibrillation. World J Cardiol 2019; 11:292-304. [PMID: 31908729 PMCID: PMC6937412 DOI: 10.4330/wjc.v11.i12.292] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/13/2019] [Revised: 09/27/2019] [Accepted: 10/18/2019] [Indexed: 02/06/2023] Open
Abstract
The incorporation of biomarkers in the actually used risk scores seem to be helpful for early identifying atrial fibrillation (AF) patients at higher risk. The aim of this critical review of the scientific literature is to investigate the potential clinical significance of red blood cell distribution width (RDW) in AF. A systematic electronic search was carried out to identify all articles describing an epidemiological association between RDW and AF in adult human populations. Data abstraction was conducted on a final number of 35 articles (13 cross-sectional, 12 prospective and 10 retrospective studies). The results of these epidemiological investigations were all virtually concordant to emphasize that an enhanced RDW value is not only a predictive factor and a marker of AF but its measurement may also be helpful for predicting the risk of developing many adverse complications in patients with AF, such as recurrence and duration of AF, hospitalization for heart failure, bleeding, left atrial thrombosis and stasis, thromboembolic events and mortality. AF patients with RDW values exceeding the local reference range may be more aggressively investigated and managed, in order to identify and attenuate the impact of possible underlying disorders causing both anisocytosis and AF.
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Affiliation(s)
- Giuseppe Lippi
- Section of Clinical Biochemistry, University of Verona, Verona 37134, Italy
| | | | - Fabian Sanchis-Gomar
- Department of Physiology, Faculty of Medicine, University of Valencia and INCLIVA Biomedical Research Institute, Valencia 46010, Spain
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23
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Raspante Cerqueira Teixeira K, de Medeiros LA, Mendes JA, Vaz ER, Cunha TM, de Oliveira EP, Penha-Silva N, Crispim CA. The erythrocyte membrane stability is associated with sleep time and social jetlag in shift workers. PLoS One 2019; 14:e0222698. [PMID: 31545844 PMCID: PMC6756543 DOI: 10.1371/journal.pone.0222698] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2018] [Accepted: 09/05/2019] [Indexed: 11/19/2022] Open
Abstract
The osmotic stability of the erythrocyte membrane (OSEM) has been associated with changes in lipid profile, blood glucose and blood pressure. Changes in these parameters are very frequent in shift workers, possibly because of the lack of synchronization of biological rhythms, which results in the social jetlag. However, the existence of association between OSEM and circadian misalignment has not been investigated in this population. Therefore, this study investigated whether shift work, sleep time and social jetlag (SJL) are associated with biochemical and hematological variables. A population consisting of 79 men working at night (n = 37) or during the day (n = 42), aged between 21 and 65 years and with a mean BMI of 27.56 ± 4.0 kg/m2, was investigated cross-sectionally in relation to sleep time, SJL, anthropometric (height, weight and waist circumference) and blood variables, with emphasis on the OSEM. SJL was calculated by the absolute difference between the midpoint of sleep on work and rest days. The Generalized Linear Model (GzLM) was used to investigate the existence of associations between SJL and average sleep time in relation to the analyzed variables. Workers without SJL presented lower baseline lysis values of erythrocytes in isotonic medium in relation to workers with SJL. In addition, workers who slept on average less than 6 hours had higher OSEM, and higher total and LDL-cholesterol in relation to those who slept more than 6 hours, regardless of the shift. It is possible that the association of sleep deprivation and SJL with erythrocyte membrane stability is mediated through changes in the lipid profile.
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Affiliation(s)
| | | | | | - Emília Rezende Vaz
- Institute of Biotechnology, Federal University of Uberlândia, Uberlândia, MG, Brazil
| | | | | | - Nilson Penha-Silva
- Institute of Biotechnology, Federal University of Uberlândia, Uberlândia, MG, Brazil
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24
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Hao K, Chen BY, Li KQ, Zhang Y, Li CX, Wang Y, Jiang LX, Shen J, Guo XC, Zhang W, Zhu MH, Wang Z. Cytotoxicity of anti-tumor herbal Marsdeniae tenacissimae extract on erythrocytes. J Zhejiang Univ Sci B 2018; 18:597-604. [PMID: 28681584 DOI: 10.1631/jzus.b1600228] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
Marsdeniae tenacissimae extract (MTE) has been used as an adjuvant medicine for cancer therapy for a long time. Although massive studies demonstrated its considerable anti-cancer effect, there is no research on its influence on erythrocytes, which are firstly interacted with MTE in the circulation. To investigate the influence of MTE on erythrocytes, we used a flow cytometer to detect the MTE-treated alternations of morphology, calcium concentration, and reactive oxygen species (ROS) level in erythrocytes. We used hemolysis under different osmotic solutions to evaluate the fragility of erythrocytes. Data showed that MTE treatment dose-dependently increased the ratio of erythrocyte fragmentation (P<0.001) and shrinking, and elevated the forward scatter (FSC) value (P<0.001) and calcium accumulation (P<0.001). MTE induced ROS production of erythrocytes under the high glucose condition (P<0.01) and consequently caused a rise in fragility (P<0.05). These results suggest that MTE induces cytotoxicity and aging in erythrocytes in a dose-dependent manner, and presents the possibility of impairment on cancer patients' circulating erythrocytes when MTE is used as an anti-cancer adjuvant medicine.
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Affiliation(s)
- Ke Hao
- Research Center of Blood Transfusion Medicine, Ministry of Education Key Laboratory of Laboratory Medicine, Department of Blood Transfusion, Zhejiang Provincial People's Hospital, People's Hospital of Hangzhou Medical College, Hangzhou 310014, China
| | - Bing-Yu Chen
- Research Center of Blood Transfusion Medicine, Ministry of Education Key Laboratory of Laboratory Medicine, Department of Blood Transfusion, Zhejiang Provincial People's Hospital, People's Hospital of Hangzhou Medical College, Hangzhou 310014, China
| | - Kai-Qiang Li
- Research Center of Blood Transfusion Medicine, Ministry of Education Key Laboratory of Laboratory Medicine, Department of Blood Transfusion, Zhejiang Provincial People's Hospital, People's Hospital of Hangzhou Medical College, Hangzhou 310014, China
| | - Yu Zhang
- Research Center of Blood Transfusion Medicine, Ministry of Education Key Laboratory of Laboratory Medicine, Department of Blood Transfusion, Zhejiang Provincial People's Hospital, People's Hospital of Hangzhou Medical College, Hangzhou 310014, China
| | - Cai-Xia Li
- Department of Blood Transfusion, Lishui People's Hospital, Lishui 323000, China
| | - Ying Wang
- Research Center of Blood Transfusion Medicine, Ministry of Education Key Laboratory of Laboratory Medicine, Department of Blood Transfusion, Zhejiang Provincial People's Hospital, People's Hospital of Hangzhou Medical College, Hangzhou 310014, China
| | - Lu-Xi Jiang
- Research Center of Blood Transfusion Medicine, Ministry of Education Key Laboratory of Laboratory Medicine, Department of Blood Transfusion, Zhejiang Provincial People's Hospital, People's Hospital of Hangzhou Medical College, Hangzhou 310014, China
| | - Jiang Shen
- Research Center of Blood Transfusion Medicine, Ministry of Education Key Laboratory of Laboratory Medicine, Department of Blood Transfusion, Zhejiang Provincial People's Hospital, People's Hospital of Hangzhou Medical College, Hangzhou 310014, China
| | - Xiang-Chai Guo
- Research Center of Blood Transfusion Medicine, Ministry of Education Key Laboratory of Laboratory Medicine, Department of Blood Transfusion, Zhejiang Provincial People's Hospital, People's Hospital of Hangzhou Medical College, Hangzhou 310014, China
| | - Wei Zhang
- Research Center of Blood Transfusion Medicine, Ministry of Education Key Laboratory of Laboratory Medicine, Department of Blood Transfusion, Zhejiang Provincial People's Hospital, People's Hospital of Hangzhou Medical College, Hangzhou 310014, China
| | - Meng-Hua Zhu
- Research Center of Blood Transfusion Medicine, Ministry of Education Key Laboratory of Laboratory Medicine, Department of Blood Transfusion, Zhejiang Provincial People's Hospital, People's Hospital of Hangzhou Medical College, Hangzhou 310014, China
| | - Zhen Wang
- Research Center of Blood Transfusion Medicine, Ministry of Education Key Laboratory of Laboratory Medicine, Department of Blood Transfusion, Zhejiang Provincial People's Hospital, People's Hospital of Hangzhou Medical College, Hangzhou 310014, China
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25
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Lappegård J, Ellingsen TS, Hindberg K, Mathiesen EB, Njølstad I, Wilsgaard T, Løchen ML, Brækkan SK, Hansen JB. Impact of Chronic Inflammation, Assessed by hs-CRP, on the Association between Red Cell Distribution Width and Arterial Cardiovascular Disease: The Tromsø Study. TH OPEN 2018; 2:e182-e189. [PMID: 31249941 PMCID: PMC6524874 DOI: 10.1055/s-0038-1651523] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2018] [Accepted: 04/10/2018] [Indexed: 12/31/2022] Open
Abstract
Red cell distribution width (RDW), a measure of variability in size of circulating erythrocytes, is associated with arterial cardiovascular disease (CVD), but the underlying mechanism remains unclear. We aimed to investigate the impact of chronic inflammation as measured by high-sensitivity C-reactive protein (hs-CRP) on this relationship, and explore whether RDW could be a mediator in the causal pathway between inflammation and arterial CVD. Baseline characteristics, including RDW and hs-CRP, were obtained from 5,765 individuals attending a population-based cohort study. We followed up participants from inclusion in the fourth survey of the Tromsø Study (1994/1995) until December 31, 2012. Multivariable Cox-regression models were used to calculate hazard ratios (HR) with 95% confidence intervals (CI) for incident myocardial infarction (MI) and ischemic stroke across quintiles of hs-CRP and RDW. Subjects with hs-CRP in the highest quintile had 44% higher risk of MI (HR: 1.44, 95% CI: 1.14-1.80), and 64% higher risk of ischemic stroke (HR: 1.64, 95% CI: 1.20-2.24) compared with subjects in the lowest quintile. RDW mediated 7.2% (95% CI: 4.0-30.8%) of the association between hs-CRP and ischemic stroke. Subjects with RDW in the highest quintile had 22% higher risk of MI (HR: 1.22, 95% CI: 0.98-1.54) and 44% higher risk of ischemic stroke (HR: 1.44, 95% CI: 1.06-1.97) compared with subjects in the lowest quintile. These risk estimates were slightly attenuated after adjustments for hs-CRP. Our findings suggest that chronic inflammation is not a primary mechanism underlying the relationship between RDW and arterial CVD.
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Affiliation(s)
- Jostein Lappegård
- K.G. Jebsen Thrombosis Research and Expertise Center (TREC), Department of Clinical Medicine, UiT The Arctic University of Norway, Tromsø, Norway
| | - Trygve S Ellingsen
- K.G. Jebsen Thrombosis Research and Expertise Center (TREC), Department of Clinical Medicine, UiT The Arctic University of Norway, Tromsø, Norway
| | - Kristian Hindberg
- K.G. Jebsen Thrombosis Research and Expertise Center (TREC), Department of Clinical Medicine, UiT The Arctic University of Norway, Tromsø, Norway
| | - Ellisiv B Mathiesen
- K.G. Jebsen Thrombosis Research and Expertise Center (TREC), Department of Clinical Medicine, UiT The Arctic University of Norway, Tromsø, Norway.,Brain and Circulation Research Group, Department of Clinical Medicine, UiT The Arctic University of Norway, Tromsø, Norway.,Department of Neurology and Neurophysiology, University Hospital of North Norway, Tromsø, Norway
| | - Inger Njølstad
- K.G. Jebsen Thrombosis Research and Expertise Center (TREC), Department of Clinical Medicine, UiT The Arctic University of Norway, Tromsø, Norway.,Department of Community Medicine, UiT The Arctic University of Norway, Tromsø, Norway
| | - Tom Wilsgaard
- Department of Community Medicine, UiT The Arctic University of Norway, Tromsø, Norway
| | - Maja-Lisa Løchen
- Department of Community Medicine, UiT The Arctic University of Norway, Tromsø, Norway
| | - Sigrid K Brækkan
- K.G. Jebsen Thrombosis Research and Expertise Center (TREC), Department of Clinical Medicine, UiT The Arctic University of Norway, Tromsø, Norway.,Division of Internal Medicine, University Hospital of North Norway, Tromsø, Norway
| | - John-Bjarne Hansen
- K.G. Jebsen Thrombosis Research and Expertise Center (TREC), Department of Clinical Medicine, UiT The Arctic University of Norway, Tromsø, Norway.,Division of Internal Medicine, University Hospital of North Norway, Tromsø, Norway
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26
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Weitzman D, Raz R, Steinvil A, Zeltser D, Berliner S, Chodick G, Shalev V, Arbel Y. Red blood cell distribution width and the risk of cardiovascular morbidity and all-cause mortality. Thromb Haemost 2017; 111:300-7. [DOI: 10.1160/th13-07-0567] [Citation(s) in RCA: 67] [Impact Index Per Article: 8.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2013] [Accepted: 09/26/2013] [Indexed: 11/05/2022]
Abstract
SummaryRed blood cell distribution width (RDW) has been shown to predict cardiovascular mortality in various populations, but studies were less conclusive regarding cardiovascular morbidity. We aimed at evaluating the prognostic effect of RDW on cardiovascular morbidity and allcause mortality in the largest community cohort to date. We utilised the computerised database of a large community based healthcare maintenance organization (HMO) in Israel to identify a cohort of 225,006 eligible patients aged 40 or above who performed a blood count during 2006. We evaluated the relationship between 1% increments of RDW values and major cardiovascular events and all-cause mortality over a period of five years. A total of 21,939 incident cases of a major cardiovascular event and 4,287 deaths were documented during a total of six years of follow up, respectively. In comparison with patients with RDW level <13%, the hazard ratio for total mortality gradually increased to 4.57 (95% confidence interval [CI]: 3.35–6.24, p<0.001) among male patients and to 3.26 (95% CI: 2.49–4.28, p<0.001) among female patients with a RDW of 17% or above. Similar results were evident in anaemic and non-anaemic populations. RDW above 17% was also associated with a modest increased risk of major cardiovascular events in females 1.26 (95% CI: 1.03–1.52, p=0.021), while in men it was not significant, 1.08 (95% CI: 0.82–1.41, p=NS). In conclusion, increasing RDW levels significantly increased risk of cardiovascular morbidity and all-cause mortality. Our observation is evident in both anaemic and non-anaemic patients.
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27
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Olszewska-Banaszczyk M, Jackowska P, Gorzelak-Pabiś P, Pytel E, Koter-Michalak M, Broncel M. Comparison of the effects of rosuvastatin monotherapy and atorvastatin-ezetimibe combined therapy on the structure of erythrocyte membranes in patients with coronary artery disease. Pharmacol Rep 2017; 70:258-262. [PMID: 29475008 DOI: 10.1016/j.pharep.2017.11.004] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2017] [Revised: 09/18/2017] [Accepted: 11/16/2017] [Indexed: 01/04/2023]
Abstract
BACKGROUND Abnormalities in the physical properties of the red blood cells (RBCs) membranes may underlie the defects that are strongly linked to cardiovascular diseases (CVD). The aim of the study was to compare the effects of two therapies of equal hipolipemic efficacy on the erythrocyte membrane fluidity, concentration of membrane cholesterol, lipids peroxidation and RBCs distribution witdh in patients with CVD. METHODS The study included 44 patients with angiographic evidence of CVD, who despite previous 6-month hypolipemic therapy, did not achieve the concentration of LDL-C <70mg/dl. They were randomly assigned to: rosuvastatin 20mg/day (R20) and atorvastatin 10mg/day combined with ezetimibe 10mg/day (A10+E10). The membrane fluidity, the concentration of thiobarbituric acid reactive substances -TBARS, concentration of membrane cholesterol were evaluated after 6 months therapy. RESULTS An improvement in lipid parameters was observed in each of the groups studied. In R20 the treatment resulted in 33% reduction concentrations of TBARS in serum, as well as in a decrease in membrane cholesterol by 16%, fluorescence anisotropy of TMA-DPH by 17.7%, fluorescence anisotropy of DPH by 2.8%. In A10+E10 the reduction of TBARS by 20.5% in serum, membrane cholesterol by 15.8% as well as a 14.25% increase in RBC membrane fluidity in the superficial layer (TMA-DPH) and decrease fluidity in the deep layer (DPH) were observed. CONCLUSION Rosuvastatin increases the fluidity of erythrocyte membrane and decreases the TBARS in serum to greater extent than does equal hipolipemic combined therapy atorvastatin with ezetimibe.
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Affiliation(s)
| | - Paulina Jackowska
- Department of Internal Diseases and Clinical Pharmacology, Medical University of Łódź, Łódź, Poland
| | - Paulina Gorzelak-Pabiś
- Department of Internal Diseases and Clinical Pharmacology, Medical University of Łódź, Łódź, Poland
| | - Edyta Pytel
- Department of Environment Pollution Biophysics, Faculty of Biology and Environmental Protection, University of Łódź, Łódź, Poland
| | - Maria Koter-Michalak
- Department of Environment Pollution Biophysics, Faculty of Biology and Environmental Protection, University of Łódź, Łódź, Poland
| | - Marlena Broncel
- Department of Internal Diseases and Clinical Pharmacology, Medical University of Łódź, Łódź, Poland
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28
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Abstract
PURPOSE OF REVIEW The purpose of this study is to show how an excess of cholesterol in the erythrocyte membrane contributes stochastically to the progression of atherosclerosis, leading to damage in blood rheology and O2 transport, deposition of cholesterol (from trapped erythrocytes) in an area of intraplaque hemorrhage, and local exacerbation of oxidative stress. RECENT FINDINGS Cholesterol contained in the membrane of erythrocytes trapped in an intraplaque hemorrhage contributes to the growth of the necrotic nucleus. There is even a relationship between the amount of cholesterol in the erythrocyte membrane and the severity of atherosclerosis. In addition, the volume variability among erythrocytes, measured by RDW, is predictive of a worsening of this disease. Erythrocytes contribute to the development of atherosclerosis in several ways, especially when trapped in intraplate hemorrhage. These erythrocytes are oxidized and phagocytosed by macrophages. The cholesterol present in the membrane of these erythrocytes subsequently contributes to the growth of the atheroma plaque. In addition, when they rupture, erythrocytes release hemoglobin, which leads to the generation of free radicals. Finally, increased RDW may predict the worsening of atherosclerosis, due to the effects of inflammation and oxidative stress on erythropoiesis and erythrocyte volume. A better understanding of erythrocyte participation in atherosclerosis may contribute to the improvement of the prevention and treatment strategies of this disease.
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29
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Li N, Zhou H, Tang Q. Red Blood Cell Distribution Width: A Novel Predictive Indicator for Cardiovascular and Cerebrovascular Diseases. DISEASE MARKERS 2017; 2017:7089493. [PMID: 29038615 PMCID: PMC5606102 DOI: 10.1155/2017/7089493] [Citation(s) in RCA: 159] [Impact Index Per Article: 19.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/17/2017] [Revised: 07/17/2017] [Accepted: 07/25/2017] [Indexed: 02/06/2023]
Abstract
The red blood cell distribution width (RDW) obtained from a standard complete blood count (CBC) is a convenient and inexpensive biochemical parameter representing the variability in size of circulating erythrocytes. Over the past few decades, RDW with mean corpuscular volume (MCV) has been used to identify quite a few hematological system diseases including iron-deficiency anemia and bone marrow dysfunction. In recent years, many clinical studies have proved that the alterations of RDW levels may be associated with the incidence and prognosis in many cardiovascular and cerebrovascular diseases (CVDs). Therefore, early detection and intervention in time of these vascular diseases is critical for delaying their progression. RDW as a new predictive marker and an independent risk factor plays a significant role in assessing the severity and progression of CVDs. However, the mechanisms of the association between RDW and the prognosis of CVDs remain unclear. In this review, we will provide an overview of the representative literatures concerning hypothetical and potential epidemiological associations between RDW and CVDs and discuss the underlying mechanisms.
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Affiliation(s)
- Ning Li
- Department of Cardiology, Renmin Hospital of Wuhan University, Wuhan 430060, China
- Cardiovascular Research Institute, Wuhan University, Wuhan 430060, China
- Hubei Key Laboratory of Cardiology, Wuhan 430060, China
| | - Heng Zhou
- Department of Cardiology, Renmin Hospital of Wuhan University, Wuhan 430060, China
- Cardiovascular Research Institute, Wuhan University, Wuhan 430060, China
- Hubei Key Laboratory of Cardiology, Wuhan 430060, China
| | - Qizhu Tang
- Department of Cardiology, Renmin Hospital of Wuhan University, Wuhan 430060, China
- Cardiovascular Research Institute, Wuhan University, Wuhan 430060, China
- Hubei Key Laboratory of Cardiology, Wuhan 430060, China
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30
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Brief Report: Elevated Red Cell Distribution Width Identifies Elevated Cardiovascular Disease Risk in Patients With HIV Infection. J Acquir Immune Defic Syndr 2017; 74:298-302. [PMID: 27828877 DOI: 10.1097/qai.0000000000001231] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
Abstract
Red cell distribution width (RDW) is linked to cardiovascular risk in the general population, an association that might be driven by inflammation. Whether this relationship holds for patients with HIV infection has not been previously studied. Using a large clinical registry, we show that elevated RDW (>14.5%) is independently associated with increased risk of coronary artery disease {odds ratio [OR] 1.39 [95% confidence interval (CI): 1.25 to 1.55]}, peripheral vascular disease [OR 1.41 (95% CI: 1.29 to 1.53)], myocardial infarction [1.43 (95% CI: 1.25 to 1.63)], heart failure [OR 2.23 (95% CI: 1.99 to 2.49)], and atrial fibrillation [OR 1.96 (95% CI: 1.64 to 2.33)]. In conclusion, in the context of the inflammatory milieu that accompanies HIV infection, RDW remains a powerful marker of cardiovascular disease.
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Shah N, Pahuja M, Pant S, Handa A, Agarwal V, Patel N, Dusaj R. Red cell distribution width and risk of cardiovascular mortality: Insights from National Health and Nutrition Examination Survey (NHANES)-III. Int J Cardiol 2017; 232:105-110. [PMID: 28117138 DOI: 10.1016/j.ijcard.2017.01.045] [Citation(s) in RCA: 31] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/31/2016] [Revised: 11/13/2016] [Accepted: 01/04/2017] [Indexed: 11/28/2022]
Abstract
INTRODUCTION Red cell distribution width (RDW) has been linked to cardiovascular disease. We sought to determine whether addition of RDW improved the Framingham risk score (FRS) model to predict cardiovascular mortality in a healthy US cohort. METHODS We performed a post-hoc analysis of the National Health and Nutritional Examination Survey-III (1988-94) cohort, including non-anemic subjects aged 30-79years. Primary endpoint was death from coronary heart disease (CHD). We divided the cohort into three risk categories: <6%, 6-20% and >20%. RDW>14.5 was considered high. Kaplan-Meier survival curves and Cox proportional hazards models were created. Discrimination, calibration and reclassification were used to assess the value of addition of RDW to the FRS model. RESULTS We included 7005 subjects with a mean follow up of 14.1years. Overall, there were 233 (3.3%) CHD deaths; 27 (8.2%) in subjects with RDW>14.5 compared to 206 (3.1%) in subjects with RDW≤14.5 (p<0.001). Adjusted hazard ratio of RDW in predicting CHD mortality was 2.02 (1.04-3.94, p=0.039). Addition of RDW to FRS model showed significant improvement in C-statistic (0.8784 vs. 0.8751, p=0.032) and area under curve (0.8565 vs. 0.8544, p=0.05). There was significant reclassification of FRS with a net reclassification index (NRI) of 5.6% (p=0.017), and an intermediate-risk NRI of 9.6% (p=0.011). Absolute integrated discrimination index (IDI) was 0.004 (p=0.02), with relative IDI of 10.4%. CONCLUSIONS Our study demonstrates that RDW is a promising biomarker which improves prediction of cardiovascular mortality over and above traditional cardiovascular risk factors.
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Affiliation(s)
- Neeraj Shah
- Department of Cardiology, Lehigh Valley Health Network, Allentown, PA, United States.
| | - Mohit Pahuja
- Department of Internal Medicine, St. Joseph Hospital and Medical Center, Phoenix, AZ, United States
| | - Sadip Pant
- Department of Cardiology, University of Louisville, Louisville, KY, United States
| | - Aman Handa
- Medical Student, Kasturba Medical College, India
| | - Vratika Agarwal
- Department of Cardiology, Staten Island University Hospital, Staten Island, NY
| | - Nileshkumar Patel
- Department of Cardiology, University of Miami, Miami, FL, United States
| | - Raman Dusaj
- Department of Cardiology, Lehigh Valley Health Network, Allentown, PA, United States
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Vayá A, Alis R, Suescún M, Rivera L, Murado J, Romagnoli M, Solá E, Hernandez-Mijares A. Association of erythrocyte deformability with red blood cell distribution width in metabolic diseases and thalassemia trait. Clin Hemorheol Microcirc 2016; 61:407-15. [PMID: 25062717 DOI: 10.3233/ch-141859] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/02/2023]
Abstract
Increased red blood distribution width (RDW) in anemia is related to disturbances in the cellular surface/volume ratio, usually accompanied by morphological alterations, while it has been shown in inflammatory diseases that the activity of pro-inflammatory cytokines disturbing erythropoiesis increases RDW. Recently it has been reported that higher RDW is related with decreased erythrocyte deformability, and that it could be related with the association of RDW and increased risk of cardiovascular diseases. In order to analyze the influence of morphological alterations and proinflammatory status on the relationship between RDW and erythrocyte deformability, we analyzed erythrocyte deformability along with RDW and other hematological and biochemical parameters in 36 α-thalassemia, 20 β-thalassemia, 20 δβ-thalassemia trait carriers, 61 metabolic syndrome patients and 76 morbidly obese patients. RDW correlated inversely with erythrocyte deformability in minor β-thalassemia (r =-0.530, p < 0.05), and directly in both metabolic syndrome and morbidly obese patients (ρ= 0.270, p < 0.05 and ρ= 0.258, p < 0.05, respectively). Minor β-thalassemia is often accompanied by more marked cell-shaped perturbations than other thalassemia traits. This could be the reason for this negative association only in this setting. Higher anisocytosis seems to be associated with greater morphologic alterations (shape/volume), which reduce erythrocyte deformability. The proinflammatory profile in metabolic patients can be related to the positive association of RDW with erythrocyte deformability found in these patients. However, further research is needed to explain the mechanisms underlying this association.
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Affiliation(s)
- Amparo Vayá
- Hemorheology and Haemostasis Unit, Service of Clinical Pathology, La Fe University Hospital, Valencia, Spain
| | - Rafael Alis
- Research Universitary Institute "Dr. Viña Giner", Molecular and Mitochondrial Medicine, Catholic University of Valencia "San Vicente Mártir", Valencia, Spain.,Faculty of Medicine, Catholic University of Valencia "San Vicente Mártir", Valencia, Spain
| | - Marta Suescún
- Hemorheology and Haemostasis Unit, Service of Clinical Pathology, La Fe University Hospital, Valencia, Spain
| | - Leonor Rivera
- Hemorheology and Haemostasis Unit, Service of Clinical Pathology, La Fe University Hospital, Valencia, Spain
| | - Julian Murado
- Hemorheology and Haemostasis Unit, Service of Clinical Pathology, La Fe University Hospital, Valencia, Spain
| | - Marco Romagnoli
- Research Universitary Institute "Dr. Viña Giner", Molecular and Mitochondrial Medicine, Catholic University of Valencia "San Vicente Mártir", Valencia, Spain.,Department of Physical Education and Sports, Catholic University of Valencia "San Vicente Mártir", Valencia, Spain
| | - Eva Solá
- Endocrinology Service, Dr. Peset University Hospital, Valencia, Spain
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Erdem A, Ceylan US, Esen A, Zencirci E, Topcu B, Ozden K, Yazici S, Terzi S, Emre A, Yesilcimen K. Clinical usefulness of red cell distribution width to angiographic severity and coronary stent thrombosis. Int J Gen Med 2016; 9:319-24. [PMID: 27672339 PMCID: PMC5024766 DOI: 10.2147/ijgm.s109452] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
Background Red cell distribution width (RDW) is a quantitative measurement and shows heterogeneity of red blood cell size in peripheral blood. RDW has recently been associated with cardiovascular events and cardiovascular diseases, and it is a novel predictor of mortality. In this study, we aimed to evaluate the clinical usefulness of measuring RDW in patients with coronary stent thrombosis. Patients and methods We retrospectively reviewed 3,925 consecutive patients who presented with acute coronary syndrome and who underwent coronary angiography at the Siyami Ersek Hospital between May 2011 and December 2013. Of the 3,925 patients, 73 patients (55 males, mean age 59±11 years, 55 with ST elevated myocardial infarction) with stent thrombosis formed group 1. Another 54 consecutive patients who presented with acute coronary syndrome (without coronary stent thrombosis, 22 patients with ST elevated myocardial infarction, 44 males, mean age 54±2 years) and underwent percutaneous coronary intervention in May 2011 formed group 2. Data were collected from all groups for 2 years. The RDW values were calculated from patients 1 month later at follow-up. Syntax scores were calculated for all the patients. The patients were also divided as low syntax score group and moderate–high syntax score group. Results The patients in group 1 with stent thrombosis had significantly higher RDW level (13.85) than the patients in group 2 without stent thrombosis (12) (P<0.001). In addition, in all study patients, the moderate–high syntax score group had significantly higher RDW level (13.6) than the low syntax score group (12.9) (P=0.009). A positive correlation was determined between RDW and syntax scores (r=0.204). Conclusion RDW is a new marker of poor prognosis in coronary artery disease. Increased RDW level is correlated with angiographic severity of coronary artery disease, and RDW may be an important clinical marker of coronary stent thrombosis in patients undergoing coronary intervention.
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Affiliation(s)
- Aysun Erdem
- Department of Cardiology, Siyami Ersek Thoracic and Cardiovascular Surgery Training and Research Hospital, Istanbul, Turkey
| | - Ufuk Sadik Ceylan
- Department of Cardiology, Siyami Ersek Thoracic and Cardiovascular Surgery Training and Research Hospital, Istanbul, Turkey
| | - Aycan Esen
- Department of Cardiology, Siyami Ersek Thoracic and Cardiovascular Surgery Training and Research Hospital, Istanbul, Turkey
| | - Ertugrul Zencirci
- Department of Cardiology, Acibadem Hospital Maslak, Istanbul, Turkey
| | - Birol Topcu
- Department of Biostatistics, Faculty of Medicine, Namik Kemal University, Tekirdag, Turkey
| | - Kivilcim Ozden
- Department of Cardiology, Siyami Ersek Thoracic and Cardiovascular Surgery Training and Research Hospital, Istanbul, Turkey
| | - Selcuk Yazici
- Department of Cardiology, Siyami Ersek Thoracic and Cardiovascular Surgery Training and Research Hospital, Istanbul, Turkey
| | - Sait Terzi
- Department of Cardiology, Siyami Ersek Thoracic and Cardiovascular Surgery Training and Research Hospital, Istanbul, Turkey
| | - Ayse Emre
- Department of Cardiology, Siyami Ersek Thoracic and Cardiovascular Surgery Training and Research Hospital, Istanbul, Turkey
| | - Kemal Yesilcimen
- Department of Cardiology, Siyami Ersek Thoracic and Cardiovascular Surgery Training and Research Hospital, Istanbul, Turkey
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Vayá A, Sarnago A, Fuster O, Alis R, Romagnoli M. Influence of inflammatory and lipidic parameters on red blood cell distribution width in a healthy population. Clin Hemorheol Microcirc 2016; 59:379-85. [PMID: 25159489 DOI: 10.3233/ch-141862] [Citation(s) in RCA: 51] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Red blood cell distribution width (RDW) is a routine red blood cell count parameter which has been shown to be associated with inflammatory parameters. Recently, some authors proposed that RDW seems to be a marker of an adverse lipidic profile. In order to clarify whether RDW is related to inflammation, plasma lipids, or both, we determined anthropometric, hematimetric, inflammatory and lipidic parameters in 1111 healthy subjects. RDW correlated directly with age, body mass index (BMI), inflammatory parameters (plasma viscosity, erythrocyte sedimentation rate (ESR), fibrinogen, leukocyte and neutrophil count), and inversely with iron and hematimetric parameters (P < 0.05). When subjects were divided according to gender, RDW correlated inversely with triglycerides only in women (P < 0.05). When subjects were classified into RDW-quartiles, increased RDW values were accompanied by decreased serum iron levels and hematimetric indices (P < 0.01), whereas age and inflammatory markers increased according to RDW-quartiles (P < 0.001 and P < 0.05, respectively). However, plasma lipids did not change with increasing RDW-quartiles (P > 0.05). In the linear regression analysis, age, hemoglobin, MCV (beta coefficient: 0.202, -0.234, -0.316, P < 0.001) and fibrinogen (beta coefficient: 0.059, P = 0.048) were the only independent predictors of RDW. The present study indicates that RDW is associated with inflammatory markers and hematimetric indices, but not with plasma lipid levels in a healthy population.
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Affiliation(s)
- Amparo Vayá
- Hemorheology and Haemostasis Unit, Service of Clinical Pathology, La Fe University Hospital, Valencia, Spain
| | - Ana Sarnago
- Hemorheology and Haemostasis Unit, Service of Clinical Pathology, La Fe University Hospital, Valencia, Spain
| | - Oscar Fuster
- Hemorheology and Haemostasis Unit, Service of Clinical Pathology, La Fe University Hospital, Valencia, Spain
| | - Rafael Alis
- Research University Institute "Dr. Viña Giner", Molecular and Mitochondrial Medicine, Catholic University of Valencia, "San Vicente Mártir", Valencia, Spain.,Faculty of Medicine, Catholic University of Valencia, "San Vicente Mártir", Valencia, Spain
| | - Marco Romagnoli
- Research University Institute "Dr. Viña Giner", Molecular and Mitochondrial Medicine, Catholic University of Valencia, "San Vicente Mártir", Valencia, Spain.,Department of Physical Education and Sports, Catholic University of Valencia "San Vicente Mártir", Valencia, Spain
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Bokori-Brown M, Petrov PG, Khafaji MA, Mughal MK, Naylor CE, Shore AC, Gooding KM, Casanova F, Mitchell TJ, Titball RW, Winlove CP. Red Blood Cell Susceptibility to Pneumolysin: CORRELATION WITH MEMBRANE BIOCHEMICAL AND PHYSICAL PROPERTIES. J Biol Chem 2016; 291:10210-27. [PMID: 26984406 DOI: 10.1074/jbc.m115.691899] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2015] [Indexed: 12/20/2022] Open
Abstract
This study investigated the effect of the biochemical and biophysical properties of the plasma membrane as well as membrane morphology on the susceptibility of human red blood cells to the cholesterol-dependent cytolysin pneumolysin, a key virulence factor of Streptococcus pneumoniae, using single cell studies. We show a correlation between the physical properties of the membrane (bending rigidity and surface and dipole electrostatic potentials) and the susceptibility of red blood cells to pneumolysin-induced hemolysis. We demonstrate that biochemical modifications of the membrane induced by oxidative stress, lipid scrambling, and artificial cell aging modulate the cell response to the toxin. We provide evidence that the diversity of response to pneumolysin in diabetic red blood cells correlates with levels of glycated hemoglobin and that the mechanical properties of the red blood cell plasma membrane are altered in diabetes. Finally, we show that diabetic red blood cells are more resistant to pneumolysin and the related toxin perfringolysin O relative to healthy red blood cells. Taken together, these studies indicate that the diversity of cell response to pneumolysin within a population of human red blood cells is influenced by the biophysical and biochemical status of the plasma membrane and the chemical and/or oxidative stress pre-history of the cell.
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Affiliation(s)
- Monika Bokori-Brown
- From the College of Life and Environmental Sciences, School of Biosciences, University of Exeter, Exeter EX4 4QD, United Kingdom,
| | - Peter G Petrov
- the College of Engineering, Mathematics and Physical Sciences, School of Physics, University of Exeter, Exeter EX4 4QL, United Kingdom
| | - Mawya A Khafaji
- the College of Engineering, Mathematics and Physical Sciences, School of Physics, University of Exeter, Exeter EX4 4QL, United Kingdom
| | - Muhammad K Mughal
- the Institute of Microbiology and Infection, University of Birmingham, Birmingham B15 2TT, United Kingdom
| | - Claire E Naylor
- the Department of Biological Sciences, Birkbeck College, Malet Street, London WC1E 7HX, United Kingdom
| | - Angela C Shore
- the Department of Diabetes and Vascular Medicine, University of Exeter Medical School, Barrack Road, Exeter EX2 5AX, United Kingdom, the National Institute for Health Research Exeter Clinical Research Facility, Royal Devon and Exeter National Health Service Foundation Trust, Exeter EX2 5DW, United Kingdom, and
| | - Kim M Gooding
- the Department of Diabetes and Vascular Medicine, University of Exeter Medical School, Barrack Road, Exeter EX2 5AX, United Kingdom, the National Institute for Health Research Exeter Clinical Research Facility, Royal Devon and Exeter National Health Service Foundation Trust, Exeter EX2 5DW, United Kingdom, and
| | - Francesco Casanova
- the Department of Diabetes and Vascular Medicine, University of Exeter Medical School, Barrack Road, Exeter EX2 5AX, United Kingdom, the National Institute for Health Research Exeter Clinical Research Facility, Royal Devon and Exeter National Health Service Foundation Trust, Exeter EX2 5DW, United Kingdom, and
| | - Tim J Mitchell
- the Institute of Microbiology and Infection, University of Birmingham, Birmingham B15 2TT, United Kingdom
| | - Richard W Titball
- From the College of Life and Environmental Sciences, School of Biosciences, University of Exeter, Exeter EX4 4QD, United Kingdom
| | - C Peter Winlove
- the College of Engineering, Mathematics and Physical Sciences, School of Physics, University of Exeter, Exeter EX4 4QL, United Kingdom
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The Prognostic Role of Red Blood Cell Distribution Width in Coronary Artery Disease: A Review of the Pathophysiology. DISEASE MARKERS 2015; 2015:824624. [PMID: 26379362 PMCID: PMC4563066 DOI: 10.1155/2015/824624] [Citation(s) in RCA: 61] [Impact Index Per Article: 6.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 06/18/2015] [Revised: 08/14/2015] [Accepted: 08/18/2015] [Indexed: 12/30/2022]
Abstract
Red blood cell distribution width (RDW) is a measure of red blood cell volume variations (anisocytosis) and is reported as part of a standard complete blood count. In recent years, numerous studies have noted the importance of RDW as a predictor of poor clinical outcomes in the settings of various diseases, including coronary artery disease (CAD). In this paper, we discuss the prognostic value of RDW in CAD and describe the pathophysiological connection between RDW and acute coronary syndrome. In our opinion, the negative prognostic effects of elevated RDW levels may be attributed to the adverse effects of independent risk factors such as inflammation, oxidative stress, and vitamin D3 and iron deficiency on bone marrow function (erythropoiesis). Elevated RDW values may reflect the intensity of these phenomena and their unfavorable impacts on bone marrow erythropoiesis. Furthermore, decreased red blood cell deformability among patients with higher RDW values impairs blood flow through the microcirculation, resulting in the diminution of oxygen supply at the tissue level, particularly among patients suffering from myocardial infarction treated with urgent revascularization.
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Thacker SG, Rousset X, Esmail S, Zarzour A, Jin X, Collins HL, Sampson M, Stonik J, Demosky S, Malide DA, Freeman L, Vaisman BL, Kruth HS, Adelman SJ, Remaley AT. Increased plasma cholesterol esterification by LCAT reduces diet-induced atherosclerosis in SR-BI knockout mice. J Lipid Res 2015; 56:1282-95. [PMID: 25964513 PMCID: PMC4479333 DOI: 10.1194/jlr.m048629] [Citation(s) in RCA: 33] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2014] [Revised: 04/27/2015] [Indexed: 12/15/2022] Open
Abstract
LCAT, a plasma enzyme that esterifies cholesterol, has been proposed to play an antiatherogenic role, but animal and epidemiologic studies have yielded conflicting results. To gain insight into LCAT and the role of free cholesterol (FC) in atherosclerosis, we examined the effect of LCAT over- and underexpression in diet-induced atherosclerosis in scavenger receptor class B member I-deficient [Scarab(-/-)] mice, which have a secondary defect in cholesterol esterification. Scarab(-/-)×LCAT-null [Lcat(-/-)] mice had a decrease in HDL-cholesterol and a high plasma ratio of FC/total cholesterol (TC) (0.88 ± 0.033) and a marked increase in VLDL-cholesterol (VLDL-C) on a high-fat diet. Scarab(-/-)×LCAT-transgenic (Tg) mice had lower levels of VLDL-C and a normal plasma FC/TC ratio (0.28 ± 0.005). Plasma from Scarab(-/-)×LCAT-Tg mice also showed an increase in cholesterol esterification during in vitro cholesterol efflux, but increased esterification did not appear to affect the overall rate of cholesterol efflux or hepatic uptake of cholesterol. Scarab(-/-)×LCAT-Tg mice also displayed a 51% decrease in aortic sinus atherosclerosis compared with Scarab(-/-) mice (P < 0.05). In summary, we demonstrate that increased cholesterol esterification by LCAT is atheroprotective, most likely through its ability to increase HDL levels and decrease pro-atherogenic apoB-containing lipoprotein particles.
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Affiliation(s)
- Seth G. Thacker
- Lipoprotein Metabolism Section, Cardiovascular-Pulmonary Branch, National Heart, Lung, and Blood Institute, National Institutes of Health, Bethesda, MD 20892
| | - Xavier Rousset
- Lipoprotein Metabolism Section, Cardiovascular-Pulmonary Branch, National Heart, Lung, and Blood Institute, National Institutes of Health, Bethesda, MD 20892
| | - Safiya Esmail
- Lipoprotein Metabolism Section, Cardiovascular-Pulmonary Branch, National Heart, Lung, and Blood Institute, National Institutes of Health, Bethesda, MD 20892
| | - Abdalrahman Zarzour
- Lipoprotein Metabolism Section, Cardiovascular-Pulmonary Branch, National Heart, Lung, and Blood Institute, National Institutes of Health, Bethesda, MD 20892
| | - Xueting Jin
- Experimental Atherosclerosis Section, Center for Molecular, National Heart, Lung, and Blood Institute, National Institutes of Health, Bethesda, MD 20892
| | | | - Maureen Sampson
- Department of Laboratory Medicine, Clinical Center, National Institutes of Health, Bethesda, MD 20892
| | - John Stonik
- Lipoprotein Metabolism Section, Cardiovascular-Pulmonary Branch, National Heart, Lung, and Blood Institute, National Institutes of Health, Bethesda, MD 20892
| | - Stephen Demosky
- Lipoprotein Metabolism Section, Cardiovascular-Pulmonary Branch, National Heart, Lung, and Blood Institute, National Institutes of Health, Bethesda, MD 20892
| | - Daniela A. Malide
- Light Microscopy Core, National Heart, Lung, and Blood Institute, National Institutes of Health, Bethesda, MD 20892
| | - Lita Freeman
- Lipoprotein Metabolism Section, Cardiovascular-Pulmonary Branch, National Heart, Lung, and Blood Institute, National Institutes of Health, Bethesda, MD 20892
| | - Boris L. Vaisman
- Lipoprotein Metabolism Section, Cardiovascular-Pulmonary Branch, National Heart, Lung, and Blood Institute, National Institutes of Health, Bethesda, MD 20892
| | - Howard S. Kruth
- Experimental Atherosclerosis Section, Center for Molecular, National Heart, Lung, and Blood Institute, National Institutes of Health, Bethesda, MD 20892
| | | | - Alan T. Remaley
- Lipoprotein Metabolism Section, Cardiovascular-Pulmonary Branch, National Heart, Lung, and Blood Institute, National Institutes of Health, Bethesda, MD 20892
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Liu S, Hempe JM, McCarter RJ, Li S, Fonseca VA. Association between Inflammation and Biological Variation in Hemoglobin A1c in U.S. Nondiabetic Adults. J Clin Endocrinol Metab 2015; 100:2364-71. [PMID: 25867810 PMCID: PMC4454807 DOI: 10.1210/jc.2014-4454] [Citation(s) in RCA: 69] [Impact Index Per Article: 6.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/18/2014] [Accepted: 04/08/2015] [Indexed: 01/01/2023]
Abstract
CONTEXT Inflammation is associated with higher glycated hemoglobin (HbA1c) levels. Whether the relationship is independent of blood glucose concentration remains unclear. OBJECTIVE The hemoglobin glycation index (HGI) was used to test the hypothesis that interindividual variation in HbA1c is associated with inflammation. PARTICIPANTS This study used nondiabetic adults from the National Health and Nutrition Examination Survey (1999-2008). MAIN OUTCOME MEASURES A subsample of participants was used to estimate the linear regression relationship between HbA1c and fasting plasma glucose (FPG). Predicted HbA1c were calculated for 7323 nondiabetic participants by inserting FPG into the equation, HbA1c = 0.017 × FPG (mg/dL) + 3.7. HGI was calculated as the difference between the observed and predicted HbA1c and the population was divided into low, moderate, and high HGI subgroups. Polymorphonuclear leukocytes (PMNL), monocytes, and C-reactive protein (CRP) were used as biomarkers of inflammation. RESULTS Mean HbA1c, CRP, monocyte, and PMNL levels, but not FPG, progressively increased in the low, moderate, and high HGI subgroups. There were disproportionately more Blacks than whites in the high HGI subgroup. CRP (ß, 0.009; 95% confidence interval [CI], 0.0001-0.017), PMNL (ß, 0.036; 95% CI, 0.010-0.062), and monocyte count (ß, 0.072; 95% CI, 0.041-0.104) were each independent predictors of HGI after adjustment for age, sex, race, triglycerides, hemoglobin level, mean corpuscular volume, red cell distribution width, and obesity status. CONCLUSIONS HGI reflects the effects of inflammation on HbA1c in a nondiabetic population of U.S. adults and may be a marker of risk associated with inflammation independent of FPG, race, and obesity.
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Affiliation(s)
- Shuqian Liu
- Department of Medicine (S.L., V.A.F.), Tulane University Health Sciences Center, New Orleans, Louisiana 70112; Department of Global Health System and Development (S.L.), School of Public Health and Tropical Medicine, Tulane University, New Orleans, Louisiana 70112; Department of Pediatrics (J.M.H.), Louisiana State University Health Sciences Center and Children's Hospital Research Institute for Children, New Orleans, Louisiana 70118; Research Division of Biostatistics and Study Methodology (R.J.M.), Children's National Medical Center, Washington, District of Columbia 20010; Department of Epidemiology (S.L.), School of Public Health and Tropical Medicine, Tulane University, New Orleans, Louisiana 70112
| | - James M Hempe
- Department of Medicine (S.L., V.A.F.), Tulane University Health Sciences Center, New Orleans, Louisiana 70112; Department of Global Health System and Development (S.L.), School of Public Health and Tropical Medicine, Tulane University, New Orleans, Louisiana 70112; Department of Pediatrics (J.M.H.), Louisiana State University Health Sciences Center and Children's Hospital Research Institute for Children, New Orleans, Louisiana 70118; Research Division of Biostatistics and Study Methodology (R.J.M.), Children's National Medical Center, Washington, District of Columbia 20010; Department of Epidemiology (S.L.), School of Public Health and Tropical Medicine, Tulane University, New Orleans, Louisiana 70112
| | - Robert J McCarter
- Department of Medicine (S.L., V.A.F.), Tulane University Health Sciences Center, New Orleans, Louisiana 70112; Department of Global Health System and Development (S.L.), School of Public Health and Tropical Medicine, Tulane University, New Orleans, Louisiana 70112; Department of Pediatrics (J.M.H.), Louisiana State University Health Sciences Center and Children's Hospital Research Institute for Children, New Orleans, Louisiana 70118; Research Division of Biostatistics and Study Methodology (R.J.M.), Children's National Medical Center, Washington, District of Columbia 20010; Department of Epidemiology (S.L.), School of Public Health and Tropical Medicine, Tulane University, New Orleans, Louisiana 70112
| | - Shengxu Li
- Department of Medicine (S.L., V.A.F.), Tulane University Health Sciences Center, New Orleans, Louisiana 70112; Department of Global Health System and Development (S.L.), School of Public Health and Tropical Medicine, Tulane University, New Orleans, Louisiana 70112; Department of Pediatrics (J.M.H.), Louisiana State University Health Sciences Center and Children's Hospital Research Institute for Children, New Orleans, Louisiana 70118; Research Division of Biostatistics and Study Methodology (R.J.M.), Children's National Medical Center, Washington, District of Columbia 20010; Department of Epidemiology (S.L.), School of Public Health and Tropical Medicine, Tulane University, New Orleans, Louisiana 70112
| | - Vivian A Fonseca
- Department of Medicine (S.L., V.A.F.), Tulane University Health Sciences Center, New Orleans, Louisiana 70112; Department of Global Health System and Development (S.L.), School of Public Health and Tropical Medicine, Tulane University, New Orleans, Louisiana 70112; Department of Pediatrics (J.M.H.), Louisiana State University Health Sciences Center and Children's Hospital Research Institute for Children, New Orleans, Louisiana 70118; Research Division of Biostatistics and Study Methodology (R.J.M.), Children's National Medical Center, Washington, District of Columbia 20010; Department of Epidemiology (S.L.), School of Public Health and Tropical Medicine, Tulane University, New Orleans, Louisiana 70112
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Salvagno GL, Sanchis-Gomar F, Picanza A, Lippi G. Red blood cell distribution width: A simple parameter with multiple clinical applications. Crit Rev Clin Lab Sci 2014; 52:86-105. [PMID: 25535770 DOI: 10.3109/10408363.2014.992064] [Citation(s) in RCA: 682] [Impact Index Per Article: 62.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Abstract
The red blood cell distribution width (RDW) is a simple and inexpensive parameter, which reflects the degree of heterogeneity of erythrocyte volume (conventionally known as anisocytosis), and is traditionally used in laboratory hematology for differential diagnosis of anemias. Nonetheless, recent evidence attests that anisocytosis is commonplace in human disorders such as cardiovascular disease, venous thromboembolism, cancer, diabetes, community-acquired pneumonia, chronic obstructive pulmonary disease, liver and kidney failure, as well as in other acute or chronic conditions. Despite some demographic and analytical issues related to the routine assessment that may impair its clinical usefulness, an increased RDW has a high negative predictive value for diagnosing a variety of disorders, but also conveys important information for short- and long-term prognosis. Even more importantly, the value of RDW is now being regarded as a strong and independent risk factor for death in the general population. Although it has not been definitely established whether an increased value of RDW is a risk factor or should only be considered an epiphenomenon of an underlying biological and metabolic imbalance, it seems reasonable to suggest that the assessment of this parameter should be broadened far beyond the differential diagnosis of anemias. An increased RDW mirrors a profound deregulation of erythrocyte homeostasis involving both impaired erythropoiesis and abnormal red blood cell survival, which may be attributed to a variety of underlying metabolic abnormalities such as shortening of telomere length, oxidative stress, inflammation, poor nutritional status, dyslipidemia, hypertension, erythrocyte fragmentation and alteration of erythropoietin function. As such, the aim of this article is to provide general information about RDW and its routine assessment, to review the most relevant implications in health and disease and give some insights about its potential clinical applications.
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Affiliation(s)
- Gian Luca Salvagno
- Clinical Chemistry Section, Department of Life and Reproductive Sciences, Academic Hospital of Verona , Verona , Italy
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40
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Red Blood Cell Distribution Width (RDW) and long-term survival in patients with ST Elevation Myocardial Infarction. Thromb Res 2014; 134:976-9. [DOI: 10.1016/j.thromres.2014.08.016] [Citation(s) in RCA: 27] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2014] [Revised: 08/12/2014] [Accepted: 08/19/2014] [Indexed: 11/17/2022]
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Association of the total cholesterol content of erythrocyte membranes with the severity of disease in stable coronary artery disease. CHOLESTEROL 2014; 2014:821686. [PMID: 25400944 PMCID: PMC4221908 DOI: 10.1155/2014/821686] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/27/2014] [Revised: 09/20/2014] [Accepted: 09/28/2014] [Indexed: 12/04/2022]
Abstract
Increasing evidence suggests that erythrocytes may participate in atherogenesis. We sought to investigate whether the total cholesterol content of erythrocyte membranes (CEM) is significantly different in patients with stable coronary artery disease (CAD) compared to patients with nonsignificant coronary stenosis and determine the correlation between CEM and the severity of coronary stenosis. Methods. The population included 144 patients, undergoing clinically indicated coronary angiography. The severity of coronary stenosis was scored after coronary angiography and patients were divided into two groups; the S-stenosis group (CAD patients, n = 82) had a significant stenosis indicated by coronary angiography and the second group, N-stenosis (n = 62), had nonsignificant coronary stenosis. Lipid parameters were determined by routine laboratory methods. CEM was measured using an enzymatic assay, and protein content was assessed by the modified Lowry method. Results. The mean of CEM levels was higher (P < 0.001) in stable CAD patients (137.2 µg/mg of membrane protein) compared with N-stenosis patients (110.0 µg/mg of membrane protein). The coronary artery scores were correlated positively with CEM levels (r = 0.296, P < 0.001). Conclusion. CEM levels are positively associated with the severity of CAD, meaning that CEM might contribute to the development of CAD.
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Wang P, Wang Y, Li H, Wu Y, Chen H. Relationship between the red blood cell distribution width and risk of acute myocardial infarction. J Atheroscler Thromb 2014; 22:21-6. [PMID: 25186020 DOI: 10.5551/jat.23937] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022] Open
Abstract
AIMS Recently, a number of studies have shown an increased red blood cell distribution width (RDW) to be a strong and independent predictor of the prognosis of coronary artery disease. The aim of this study was to investigate the underlying mechanisms responsible for the relationship between the RDW and a poor prognosis of coronary artery disease. METHODS Four hundred and twenty-four patients with ST elevation myocardial infarction treated with primary percutaneous coronary intervention (pPCI) were analyzed retrospectively. We evaluated the relationships between the RDW and the high-sensitivity C-reactive protein (hsCRP) N-terminal pro-brain natriuretic peptide (NTpro-BNP), fasting blood glucose and lipid levels, as well as other parameters of blood examinations and angiographic manifestations. RESULTS There were 85 patients in the RDW ≥ 14% group (mean age 60.62 ± 11.29 years, and men: 87%) and 339 patients in the RDW < 14% group (mean age: 59.74 ± 11.55 years, and men: 78%). The RDW ≥ 14% group had higher platelet distribution width (PDW), NTpro-BNP and hsCRP values on admission, a heavier intracoronary thrombotic burden and a higher incidence of three-branch vascular lesions than the RDW < 14% group. In the multiple logistic regression analysis, the associations between the RDW and the NTpro-BNP level, incidence of three-branch and left main lesions and intracoronary thrombotic burden remained. CONCLUSIONS A high RDW may be associated with the severity and instability of acute myocardial infarction.
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Affiliation(s)
- Ping Wang
- Department of heart center Capital Medical University Affiliated Beijing Friendship Hospital
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Skjelbakken T, Lappegård J, Ellingsen TS, Barrett-Connor E, Brox J, Løchen ML, Njølstad I, Wilsgaard T, Mathiesen EB, Brækkan SK, Hansen JB. Red cell distribution width is associated with incident myocardial infarction in a general population: the Tromsø Study. J Am Heart Assoc 2014; 3:jah3631. [PMID: 25134681 PMCID: PMC4310408 DOI: 10.1161/jaha.114.001109] [Citation(s) in RCA: 67] [Impact Index Per Article: 6.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Abstract
Background Red cell distribution width (RDW), a measure of the variability in size of circulating erythrocytes, is associated with mortality and adverse outcome in selected populations with cardiovascular disease. It is scarcely known whether RDW is associated with incident myocardial infarction (MI). We aimed to investigate whether RDW was associated with risk of first‐ever MI in a large cohort study with participants recruited from a general population. Methods and Results Baseline characteristics, including RDW, were collected for 25 612 participants in the Tromsø Study in 1994–1995. Incident MI during follow‐up was registered from inclusion through December 31, 2010. Cox regression models were used to calculate hazard ratios with 95% confidence intervals for MI, adjusted for age, sex, body mass index, smoking, hemoglobin, white blood cells, platelets, and other traditional cardiovascular risk factors. A total of 1779 participants experienced a first‐ever MI during a median follow‐up time of 15.8 years. There was a linear association between RDW and risk of MI, for which a 1% increment in RDW was associated with a 13% increased risk (hazard ratio 1.13; 95% CI, 1.07 to 1.19). Participants with RDW above the 95th percentile had 71% higher risk of MI compared with those with RDW in the lowest quintile (hazard ratio 1.71; 95% CI, 1.34 to 2.20). All effect estimates were essentially similar after exclusion of participants with anemia (n=1297) from the analyses. Conclusion RDW is associated with incident MI in a general population independent of anemia and cardiovascular risk factors.
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Affiliation(s)
- Tove Skjelbakken
- K.G. Jebsen Thrombosis Research and Expertise Center (TREC), Department of Clinical Medicine, UiT The Arctic University of Norway, Tromsø, Norway (T.S., J.L., T.S.E., J.B., I.N., E.B.M., S.K.B., J.B.H.) Hematological Research Group (HERG), Department of Clinical Medicine, UiT The Arctic University of Norway, Tromsø, Norway (T.S., J.L., T.S.E., J.B., S.K.B., J.B.H.) Division of Internal Medicine, University Hospital of North-Norway, Tromsø, Norway (T.S., S.K.B., J.B.H.)
| | - Jostein Lappegård
- K.G. Jebsen Thrombosis Research and Expertise Center (TREC), Department of Clinical Medicine, UiT The Arctic University of Norway, Tromsø, Norway (T.S., J.L., T.S.E., J.B., I.N., E.B.M., S.K.B., J.B.H.) Hematological Research Group (HERG), Department of Clinical Medicine, UiT The Arctic University of Norway, Tromsø, Norway (T.S., J.L., T.S.E., J.B., S.K.B., J.B.H.)
| | - Trygve S Ellingsen
- K.G. Jebsen Thrombosis Research and Expertise Center (TREC), Department of Clinical Medicine, UiT The Arctic University of Norway, Tromsø, Norway (T.S., J.L., T.S.E., J.B., I.N., E.B.M., S.K.B., J.B.H.) Hematological Research Group (HERG), Department of Clinical Medicine, UiT The Arctic University of Norway, Tromsø, Norway (T.S., J.L., T.S.E., J.B., S.K.B., J.B.H.)
| | - Elizabeth Barrett-Connor
- Division of Epidemiology, Department of Family and Preventive Medicine, School of Medicine, University of California San Diego, La Jolla, CA (E.B.C.)
| | - Jan Brox
- K.G. Jebsen Thrombosis Research and Expertise Center (TREC), Department of Clinical Medicine, UiT The Arctic University of Norway, Tromsø, Norway (T.S., J.L., T.S.E., J.B., I.N., E.B.M., S.K.B., J.B.H.) Hematological Research Group (HERG), Department of Clinical Medicine, UiT The Arctic University of Norway, Tromsø, Norway (T.S., J.L., T.S.E., J.B., S.K.B., J.B.H.) Department of Medical Biochemistry, University Hospital of North-Norway, Tromsø, Norway (J.B.)
| | - Maja-Lisa Løchen
- Department of Community Medicine, UiT The Arctic University of Norway, Tromsø, Norway (M.L., I.N., T.W.)
| | - Inger Njølstad
- K.G. Jebsen Thrombosis Research and Expertise Center (TREC), Department of Clinical Medicine, UiT The Arctic University of Norway, Tromsø, Norway (T.S., J.L., T.S.E., J.B., I.N., E.B.M., S.K.B., J.B.H.) Department of Community Medicine, UiT The Arctic University of Norway, Tromsø, Norway (M.L., I.N., T.W.)
| | - Tom Wilsgaard
- Department of Community Medicine, UiT The Arctic University of Norway, Tromsø, Norway (M.L., I.N., T.W.)
| | - Ellisiv B Mathiesen
- K.G. Jebsen Thrombosis Research and Expertise Center (TREC), Department of Clinical Medicine, UiT The Arctic University of Norway, Tromsø, Norway (T.S., J.L., T.S.E., J.B., I.N., E.B.M., S.K.B., J.B.H.) Brain and Circulation esearch Group, Department of Clinical Medicine, UiT The Arctic University of Norway, Tromsø, Norway (E.B.M.) Department of Neurology and Neurophysiology, University Hospital of North-Norway, Tromsø, Norway (E.B.M.)
| | - Sigrid K Brækkan
- K.G. Jebsen Thrombosis Research and Expertise Center (TREC), Department of Clinical Medicine, UiT The Arctic University of Norway, Tromsø, Norway (T.S., J.L., T.S.E., J.B., I.N., E.B.M., S.K.B., J.B.H.) Hematological Research Group (HERG), Department of Clinical Medicine, UiT The Arctic University of Norway, Tromsø, Norway (T.S., J.L., T.S.E., J.B., S.K.B., J.B.H.) Division of Internal Medicine, University Hospital of North-Norway, Tromsø, Norway (T.S., S.K.B., J.B.H.)
| | - John-Bjarne Hansen
- K.G. Jebsen Thrombosis Research and Expertise Center (TREC), Department of Clinical Medicine, UiT The Arctic University of Norway, Tromsø, Norway (T.S., J.L., T.S.E., J.B., I.N., E.B.M., S.K.B., J.B.H.) Hematological Research Group (HERG), Department of Clinical Medicine, UiT The Arctic University of Norway, Tromsø, Norway (T.S., J.L., T.S.E., J.B., S.K.B., J.B.H.) Division of Internal Medicine, University Hospital of North-Norway, Tromsø, Norway (T.S., S.K.B., J.B.H.)
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A R S. Red Cell Distribution Width and Serum BNP Level Correlation in Diabetic Patients with Cardiac Failure: A Cross - Sectional Study. J Clin Diagn Res 2014; 8:FC01-3. [PMID: 25120987 DOI: 10.7860/jcdr/2014/8349.4431] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/03/2014] [Accepted: 05/08/2014] [Indexed: 11/24/2022]
Abstract
INTRODUCTION Red cell distribution width (RDW) is a red cell measurement given by fully automated hematology analyzers. It is a measure of heterogeneity in the size of circulating erythrocytes. Studies have shown that it is a prognostic marker in non - anemic diabetic patients with symptomatic cardiovascular disease but its correlation with cardiac failure in diabetics has not been studied so far. Moreover, studies have also shown that a higher RDW may reflect an underlying inflammatory state. Since Diabetes is a pro inflammatory state there is a possibility that it might have an influence on the RDW values even when there is no cardiac failure, but research data on this aspect is lacking. B-type natriuretic peptide (BNP) is a proven marker for cardiac failure whose values are comparable with echo cardio graphic findings in assessing the left ventricular dysfunction. AIM AND OBJECTIVES This study aimed to find out the correlation between RDW% and serum BNP levels in Diabetics with heart failure (cases) when compared to those without failure (controls). Further, we compared the RDW % values of the cases with controls. Settings and Design : The study was approved by institutional ethical and research committee. A cross-sectional study was conducted with patients attending the Diabetes clinic of a tertiary care hospital in Chennai, India, during the period of October to December 2013. Hundred known cases of type II Diabetes mellitus attending Diabetes centre of the Hospital, with clinical and Echo cardio graphic features of cardiac failure were included as cases. Hundred age and gender matched diabetics with negative history of cardiovascular disease and with normal Echo cardio graphic features were included as controls. Informed consent was obtained from all the cases and controls. Demographic data and clinical history were gathered from all the cases and controls by using a standardized self - administered questionnaire. Biochemical and hematological parameters which included Fasting and Postprandial blood sugar, Glycosylated hemoglobin, Complete Blood count including RDW and serum BNP were performed for all the cases and controls. STATISTICAL ANALYSIS RESULTS were tabulated and analysed using SPSS 20.0 version RESULTS A statistically significant correlation (p<.001) was found between Red cell Distribution Width % and Serum B type Natriuretic Peptide values in the cases. Further, RDW% showed a statistically significant difference between cases and controls. CONCLUSION RDW% can be used as a screening parameter to identify cardiac failure in Diabetic patients similar to non-diabetic cardiac failure. RDW% values are significantly higher in cases of Diabetes with failure in comparison to uncomplicated Diabetes.
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Affiliation(s)
- Subhashree A R
- Professor, Department of Pathology, Sree Balaji Medical College, Bharath University , Chrompet, Chennai, India
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Mascarenhas Netto RDC, Fabbri C, de Freitas MV, Bernardino Neto M, Garrote-Filho MS, Lacerda MVG, Lima ES, Penha-Silva N. Influence of Plasmodium vivax malaria on the relations between the osmotic stability of human erythrocyte membrane and hematological and biochemical variables. Parasitol Res 2014; 113:863-74. [PMID: 24322291 DOI: 10.1007/s00436-013-3717-4] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2013] [Accepted: 11/21/2013] [Indexed: 01/28/2023]
Abstract
This study evaluated the influence of infection by Plasmodium vivax on the relations between hematological and biochemical variables and the osmotic stability of the erythrocyte membrane in a Brazilian Amazon population. A total of 72 patients with P. vivax malaria were included in the study and invited to return after 14 days, post-treatment with chloroquine and primaquine, for clinical and laboratorial reevaluations. The osmotic stability of the erythrocyte membrane was analyzed by nonlinear regression of the dependency of the absorbance of hemoglobin, released with hemolysis, as a function of the salt concentration, and it was represented by the inverse of the salt concentration at the midpoint of the curve (1/H 50) and by the variation of salt concentration, which promotes lysis (dX). Bivariate and multivariate methods were used in the analysis of the results. Prior to treatment of the disease, the erythrocytes showed greater stability, probably due to the natural selection of young and also more stable erythrocytes. The bivariate analysis showed that 1/H 50 was positively correlated with red cell distribution width (RDW), urea, triglycerides, and very low-density lipoprotein (VLDL)-cholesterol, but negatively associated with albumin, HDL-cholesterol, and indirect bilirubin, while dX was negatively associated with the mean corpuscular hemoglobin concentration. These associations were confirmed by canonical correlation analysis. Stepwise multiple linear regression showed that albumin, urea, triglycerides, and VLDL-cholesterol are the variables with the highest abilities of predicting erythrocyte stability. The bivariate analysis also showed that the hematological index RDW was related to elevated levels of bilirubin and decreased levels of albumin and urea, associated with liver damage resulting from malaria.
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de Freitas MV, Marquez-Bernardes LF, de Arvelos LR, Paraíso LF, Gonçalves e Oliveira AFM, Mascarenhas Netto RDC, Neto MB, Garrote-Filho MS, de Souza PCA, Penha-Silva N. Influence of age on the correlations of hematological and biochemical variables with the stability of erythrocyte membrane in relation to sodium dodecyl sulfate. Hematology 2013; 19:424-30. [DOI: 10.1179/1607845413y.0000000145] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/31/2022] Open
Affiliation(s)
- Mariana V. de Freitas
- Institute of Genetics and BiochemistryFederal University of Uberlândia, Uberlândia, MG, Brazil
| | | | - Letícia R. de Arvelos
- Institute of Genetics and BiochemistryFederal University of Uberlândia, Uberlândia, MG, Brazil
| | - Lara F. Paraíso
- Institute of Genetics and BiochemistryFederal University of Uberlândia, Uberlândia, MG, Brazil
| | | | | | - Morun Bernardino Neto
- Institute of Genetics and BiochemistryFederal University of Uberlândia, Uberlândia, MG, Brazil
| | - Mario S. Garrote-Filho
- Institute of Genetics and BiochemistryFederal University of Uberlândia, Uberlândia, MG, Brazil
| | - Paulo César A. de Souza
- Institute of Genetics and BiochemistryFederal University of Uberlândia, Uberlândia, MG, Brazil
| | - Nilson Penha-Silva
- Institute of Genetics and BiochemistryFederal University of Uberlândia, Uberlândia, MG, Brazil
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Uydu HA, Bostan M, Atak M, Yılmaz A, Demir A, Akçan B, Sümer F, Baltaş N, Karadağ Z, Uğurlu Y, Orem A. Cholesterol forms and traditional lipid profile for projection of atherogenic dyslipidemia: lipoprotein subfractions and erythrocyte membrane cholesterol. J Membr Biol 2013; 247:127-34. [PMID: 24240543 PMCID: PMC3905181 DOI: 10.1007/s00232-013-9611-2] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2013] [Accepted: 10/14/2013] [Indexed: 11/29/2022]
Abstract
Atherogenic dyslipidemia characterized by abnormal changes in plasma lipid profile such as low high-density lipoprotein (HDL) and increased triglyceride (TG) levels is strongly associated with atherosclerotic diseases. We aimed to evaluate the levels of pro- and antiatherogenic lipids and erythrocyte membrane cholesterol (EMC) content in normo- and dyslipidemic subjects to investigate whether EMC content could be a useful marker for clinical presentation of atherogenic dyslipidemia. Low-density lipoprotein (LDL), HDL and their subfraction levels and erythrocyte lipid content were determined in 64 normolipidemic (NLs), 42 hypercholesterolemic (HCs) and 42 mixed-type dyslipidemic subjects (MTDs). Plasma atherogenic lipid indices [small–dense LDL (sdLDL)/less-dense HDL (LHDL), TC/HDL-C, TG/HDL-C and Apo B/AI] were higher in MTDs compared to NLs (p < 0.001). The highest sdLDL level was observed in HCs (p < 0.01). Despite a slight increase in EMC level in dyslipidemic subgroups, the difference was not statistically significant. A significant negative correlation, however, was observed between EMC and sdLDL/LHDL in HCs (p < 0.035, r = −0.386). Receiver operating characteristic curves to predict sdLDL level showed that TG and EMC levels had higher area under curve values compared to other parameters in HCs. We showed that diameters of larger LDL and HDL particles tend to shift toward smaller values in MTDs. Our results suggest that EMC content and TG levels may be a useful predictor for sdLDL level in hypercholesterolemic patients.
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Affiliation(s)
- Hüseyin Avni Uydu
- Department of Medical Biochemistry, Faculty of Medicine, University of Recep Tayyip Erdoğan, Rize, Turkey,
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Fessler MB, Rose K, Zhang Y, Jaramillo R, Zeldin DC. Relationship between serum cholesterol and indices of erythrocytes and platelets in the US population. J Lipid Res 2013; 54:3177-88. [PMID: 23999863 DOI: 10.1194/jlr.p037614] [Citation(s) in RCA: 31] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/15/2023] Open
Abstract
Whereas dyslipidemia has been associated with leukocytosis, the relationship between serum cholesterol and other hematopoietic lineages is poorly defined. Erythrocytes and platelets, anucleate cells relegated to nonspecific diffusional exchange of cholesterol with serum, have been proposed to have a distinct relationship to cholesterol from leukocytes. We examined the relationship between serum cholesterol and circulating erythrocyte/platelet indices in 4,469 adult participants of the National Health and Nutrition Examination Survey (NHANES) 2005-2006. In linear regression analyses, serum non-high density lipoprotein-cholesterol (non-HDL-C) was positively associated with mean erythrocyte number, hematocrit, hemoglobin concentration, platelet count, and platelet crit independently of age, gender, race/ethnicity, smoking, body mass index, serum folate, and C-reactive protein. The magnitude of the relationship was most marked for platelets, with lowest versus highest non-HDL-C quartile subjects having geometric mean platelet counts of 258,000/μl versus 281,000/μl, respectively (adjusted model, P < 0.001 for trend). These associations persisted in a sensitivity analysis excluding several conditions that affect erythrocyte/platelet and/or serum cholesterol levels, and were also noted in an independent analysis of 5,318 participants from NHANES 2007-2008. As non-HDL-C, erythrocytes, and platelets all impact cardiovascular disease risk, there is a need for advancing understanding of the underlying interactions that govern levels of these three blood components.
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Affiliation(s)
- Michael B Fessler
- Laboratory of Respiratory Biology, National Institute of Environmental Health Sciences, National Institutes of Health, Department of Health and Human Services, Research Triangle Park, NC 27709
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Wang J, Wagner-Britz L, Bogdanova A, Ruppenthal S, Wiesen K, Kaiser E, Tian Q, Krause E, Bernhardt I, Lipp P, Philipp SE, Kaestner L. Morphologically homogeneous red blood cells present a heterogeneous response to hormonal stimulation. PLoS One 2013; 8:e67697. [PMID: 23840765 PMCID: PMC3695909 DOI: 10.1371/journal.pone.0067697] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/17/2012] [Accepted: 05/22/2013] [Indexed: 11/19/2022] Open
Abstract
Red blood cells (RBCs) are among the most intensively studied cells in natural history, elucidating numerous principles and ground-breaking knowledge in cell biology. Morphologically, RBCs are largely homogeneous, and most of the functional studies have been performed on large populations of cells, masking putative cellular variations. We studied human and mouse RBCs by live-cell video imaging, which allowed single cells to be followed over time. In particular we analysed functional responses to hormonal stimulation with lysophosphatidic acid (LPA), a signalling molecule occurring in blood plasma, with the Ca2+ sensor Fluo-4. Additionally, we developed an approach for analysing the Ca2+ responses of RBCs that allowed the quantitative characterization of single-cell signals. In RBCs, the LPA-induced Ca2+ influx showed substantial diversity in both kinetics and amplitude. Also the age-classification was determined for each particular RBC and consecutively analysed. While reticulocytes lack a Ca2+ response to LPA stimulation, old RBCs approaching clearance generated robust LPA-induced signals, which still displayed broad heterogeneity. Observing phospatidylserine exposure as an effector mechanism of intracellular Ca2+ revealed an even increased heterogeneity of RBC responses. The functional diversity of RBCs needs to be taken into account in future studies, which will increasingly require single-cell analysis approaches. The identified heterogeneity in RBC responses is important for the basic understanding of RBC signalling and their contribution to numerous diseases, especially with respect to Ca2+ influx and the associated pro-thrombotic activity.
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Affiliation(s)
- Jue Wang
- Institute for Molecular Cell Biology and Research Centre for Molecular Imaging and Screening, Saarland University, Homburg/Saar, Germany
| | | | - Anna Bogdanova
- Institute of Veterinary Physiology, Vetsuisse Faculty and the Zürich Center for Integrative Human Physiology, University of Zürich, Zürich, Switzerland
| | - Sandra Ruppenthal
- Institute for Molecular Cell Biology and Research Centre for Molecular Imaging and Screening, Saarland University, Homburg/Saar, Germany
| | - Kathrina Wiesen
- Institute for Molecular Cell Biology and Research Centre for Molecular Imaging and Screening, Saarland University, Homburg/Saar, Germany
| | - Elisabeth Kaiser
- Institute for Molecular Cell Biology and Research Centre for Molecular Imaging and Screening, Saarland University, Homburg/Saar, Germany
| | - Qinghai Tian
- Institute for Molecular Cell Biology and Research Centre for Molecular Imaging and Screening, Saarland University, Homburg/Saar, Germany
| | - Elmar Krause
- Physiology, Saarland University, Homburg/Saar, Germany
| | - Ingolf Bernhardt
- Biophysics Laboratory, Saarland University, Saarbrücken, Germany
| | - Peter Lipp
- Institute for Molecular Cell Biology and Research Centre for Molecular Imaging and Screening, Saarland University, Homburg/Saar, Germany
| | - Stephan E. Philipp
- Experimental and Clinical Pharmacology and Toxicology, Saarland University, Homburg/Saar, Germany
| | - Lars Kaestner
- Institute for Molecular Cell Biology and Research Centre for Molecular Imaging and Screening, Saarland University, Homburg/Saar, Germany
- * E-mail:
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de Arvelos LR, Rocha VCA, Felix GP, da Cunha CC, Bernardino Neto M, da Silva Garrote Filho M, de Fátima Pinheiro C, Resende ES, Penha-Silva N. Bivariate and multivariate analyses of the influence of blood variables of patients submitted to Roux-en-Y gastric bypass on the stability of erythrocyte membrane against the chaotropic action of ethanol. J Membr Biol 2013; 246:231-42. [PMID: 23344659 DOI: 10.1007/s00232-013-9524-0] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2012] [Accepted: 01/01/2013] [Indexed: 11/26/2022]
Abstract
The stability of the erythrocyte membrane, which is essential for the maintenance of cell functions, occurs in a critical region of fluidity, which depends largely on its composition and the composition and characteristics of the medium. As the composition of the erythrocyte membrane is influenced by several blood variables, the stability of the erythrocyte membrane must have relations with them. The present study aimed to evaluate, by bivariate and multivariate statistical analyses, the correlations and causal relationships between hematologic and biochemical variables and the stability of the erythrocyte membrane against the chaotropic action of ethanol. The validity of this type of analysis depends on the homogeneity of the population and on the variability of the studied parameters, conditions that can be filled by patients who undergo bariatric surgery by the technique of Roux-en-Y gastric bypass since they will suffer feeding restrictions that have great impact on their blood composition. Pathway analysis revealed that an increase in hemoglobin leads to decreased stability of the cell, probably through a process mediated by an increase in mean corpuscular volume. Furthermore, an increase in the mean corpuscular hemoglobin (MCH) leads to an increase in erythrocyte membrane stability, probably because higher values of MCH are associated with smaller quantities of red blood cells and a larger contact area between the cell membrane and ethanol present in the medium.
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Affiliation(s)
- Leticia Ramos de Arvelos
- Instituto de Genética e Bioquímica, Universidade Federal de Uberlândia, Av. Pará, 1720, Uberlândia, MG 38400-902, Brazil
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