Association between high red blood cell distribution width and metabolic syndrome. Influence of abdominal obesity

Abstract

To the Editor. The association between high red blood cell distribution width (RDW) and cardiovascular events and heart failure has been reported [4,7]. The link between elevated RDW and cardiovascular disease (CVD) risk may be due to an underlying chronic inflammation mediated by proinflammatory cytokines that could influence erythrocyte maturation [4]. The metabolic syndrome (MS) is a chronic inflammatory disorder that increases the risk of cardiovascular events and death [5]. A recent study [6] has found an association between RDW and MS with doubtful results, as the association is weak, lower than that for cardiovascular events and iron, vitamin B 12 and folic acid, which may influence RDW have not been determined either.We have performed a case-control study evaluating the association between RDW and MS as well as with the several components of MS, i.e., abdominal obesity, low HDL cholesterol, hypertension, hypertriglyceridemia and glucose intolerance. The study was performed in accordance with the ethical guidelines for Clinical Hemorheology and Microcirculation [2].We included 61 patients with MS classified according to the NCEP ATPIII criteria modified by Grundy et al. [5] and 94 controls without MS. We determined RDW along with iron, vitamin B 12 , folic acid, erythrocyte indices, glucose, lipids, fibrinogen, hs-CRP and neutrophil count.A cut-off point of 14% corresponding to the control group mean plus one SD was considered for high RDW; 358 mg/dL for high fibrinogen and 28.61 pg for low MCH.No differences in RDW nor in vitamin B 12 , folic acid, iron, or erythrocyte indices were observed (p > 0.05). Hematocrit was statistically higher in patients than in controls (p = 0.022) as were hs-CRP, fibrinogen and neutrophils count (p < 0.001) (Table 1).

The relationship between red blood cell distribution width and metabolic syndrome in elderly Chinese: a cross-sectional study

“…Laufer et al [29] demonstrated that high RDW (RDW ≥ 14%) was associated with increased risk of MS and long-term mortality, which also showed that hypertension was the strongest risk factor with RDW ≥ 14% in all criteria for MS. These results were not in good conformity with the study from Vaya et al [14]. In addition, a different point of view raised in the study of Emamian et al [7] was that level of RDW was higher among normotensive individuals than hypertensive.…”

“…The limitation of this study was that the number of samples (300 subjects) was too small to carry out subgroup analysis. In 2011, Vaya et al [14] pointed out that abdominal obesity was the only MS component associated with high RDW. However, Fujita et al [9] concluded that obesity was not necessarily positively correlated with RDW through animal models.…”

Association of erythrocyte parameters with metabolic syndrome in the Pearl River Delta region of China: a cross sectional study

“… 8 9 Numerous investigators previously reported that erythrocyte parameters, including red blood cell (RBC) count, haematocrit (HCT), haemoglobin (Hb) and red blood cell distribution width (RDW) were positively associated with insulin resistance and chronic low grade inflammation. 10–14 In fact, RBC, 14–16 HCT, 15 16 Hb 14 15 17 and RDW 18 were demonstrated in several studies worldwide to correlate with MetS in adults. However, the association between erythrocyte parameters and MetS remains controversial, because the results reported are inconsistent depending on the different ethnic populations studied.…”

Red Blood Cell Distribution Width in Patients With Cryptogenic Stroke

“…In a recent article on unselected outpatients from a general population, Lippi et al 25 observed that RDW was negatively associated with high-density lipoprotein cholesterol and positively associated with the atherogenic index of plasma. In this sense, Vayá et al 26 and Sánchez-Chaparro et al 27 found an association of RDW with metabolic syndrome and others with obesity, 24,28 hypertension, 29 and diabetes. 30 Given that CS affects a young population, and since we did not observe significant differences in the prevalence of cardiovascular risk factors (except higher obesity), the lack of correlation between RDW and plasmatic lipids is not surprising.…”