Red blood cell distribution width is associated with increased interactions of blood cells with vascular wall

Ananthaseshan, Sharan; Bojakowski, Krzysztof; Sacharczuk, Mariusz; Poznański, Piotr; Skiba, Dominik; Wittberg, Lisa Prahl; McKenzie, Jordan; Szkulmowska, Anna; Berg, Niclas; Andziak, Piotr; Menkens, Hanna; Wojtkowski, Maciej; Religa, Dorota; Lundell, Fredrik; Guzik, T. G.; Gaciong, Zbigniew; Religa, Piotr

doi:10.1038/s41598-022-17847-z

Cited by 27 publications

(27 citation statements)

References 34 publications

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“…Other possible causes of higher RDW include poor nutrition and erythrocyte fragmentation [1, 2, 31]. In addition, direct causality of high RDW and impaired intravascular haemodynamics, especially with vascular pathologies, has been presented [31]. Telomere shortening may be a link for poor outcomes in older vulnerable patients, as this is associated with both MCV variation and ageing-related all-cause mortality [43,44].…”

Section: Discussionmentioning

confidence: 99%

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Red cell distribution width and mortality in older patients with frailty in the emergency department

et al. 2023

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Background The red cell distribution width (RDW) reflects the degree of heterogeneity of red blood cells. Elevated RDW is associated both with frailty and with increased mortality in hospital-admitted patients. In this study we evaluate whether high RDW values are associated with mortality in older emergency department (ED) patients with frailty, and if the association is independent of the degree of frailty. Methods We included ED patients with the following criteria: ≥ 75 years of age, Clinical Frailty Scale (CFS) score of 4 to 8, and RDW % measured within 48 h of ED admission. Patients were allocated to six classes by their RDW value: ≤ 13%, 14%, 15%, 16%, 17%, and ≥ 18%. The outcome was death within 30 days of ED admission. Crude and adjusted odds ratios (OR) with 95% confidence intervals (CI) for a one-class increase in RDW for 30-day mortality were calculated via binary logistic regression analysis. Age, gender and CFS score were considered as potential confounders. Results A total of 1407 patients (61.2% female), were included. The median age was 85 with an inter-quartile range (IQR) of 80–89, median CFS score 6 (IQR: 5–7), and median RDW 14 (IQR: 13–16). Of the included patients, 71.9% were admitted to hospital wards. A total of 85 patients (6.0%) died during the 30-day follow-up. Mortality rate was associated with RDW increase (p for trend < .001). Crude OR for a one-class increase in RDW for 30-day mortality was 1.32 (95% CI: 1.17–1.50, p < .001). When adjusted for age, gender and CFS-score, OR of mortality for one-class RDW increase was still 1.32 (95% CI: 1.16–1.50, p < .001). Conclusion Higher RDW values had a significant association with increased 30-day mortality risk in frail older adults in the ED, and this risk was independent of degree of frailty. RDW is a readily available biomarker for most ED patients. It might be beneficial to include it in risk stratification of older frail ED patients to identify those who could benefit from further diagnostic assessment, targeted interventions, and care planning.

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Section: Discussionmentioning

confidence: 99%

“…Older patients in emergency departments (EDs) and hospital wards have an increased risk of mortality if their RDW is elevated [8,12,[28][29][30]. Although several mechanisms for this association have been presented [1,2,31], defined mechanisms for the association of elevated RDW and increased mortality have not yet been established.…”

Section: Introductionmentioning

confidence: 99%

Red cell distribution width and mortality in older patients with frailty in the emergency department

et al. 2023

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“…Importantly, cellular levels of ADMA can be 5‐ to 20‐fold greater than plasma levels and the range at cellular levels can tonically inhibit NOS [30]. Relatively recent data using both human and animal models have shown that anisocytosis disrupts intravascular hemodynamics and leads to increased interactions between circulating cells and vessel walls, which contribute to subsequent vascular pathology [31]. It is worth noting that the erythrocyte is a storage site for ADMA [32].…”

Section: Discussionmentioning

confidence: 99%

Metabolomic markers mediate erythrocyte anisocytosis in older adults: Results from three independent aging cohorts

et al. 2023

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Background Anisocytosis reflects unequal‐sized red blood cells and is quantified using red blood cell distribution width (RDW). RDW increases with age and has been consistently associated with adverse health outcomes, such as cardiovascular disease and mortality. Why RDW increases with age is not understood. We aimed to identify plasma metabolomic markers mediating anisocytosis with aging. Methods We performed mediation analyses of plasma metabolomics on the association between age and RDW using resampling techniques after covariate adjustment. We analyzed data from adults aged 70 or older from the main discovery cohort of the Baltimore Longitudinal Study of Aging (BLSA, n = 477, 46% women) and validation cohorts of the Health, Aging and Body Composition Study (Health ABC, n = 620, 52% women) and Invecchiare in Chianti, Aging in the Chianti Area (InCHIANTI) study (n = 735, 57% women). Plasma metabolomics was assayed using the Biocrates MxP Quant 500 kit in BLSA and Health ABC and liquid chromatography with tandem mass spectrometry in InCHIANTI. Results In all three cohorts, symmetric dimethylarginine (SDMA) significantly mediated the association between age and RDW. Asymmetric dimethylarginine (ADMA) and 1‐methylhistidine were also significant mediators in the discovery cohort and one validation cohort. In the discovery cohort, we also found choline, homoarginine, and several long‐chain triglycerides significantly mediated the association between age and RDW. Conclusions and relevance This metabolomics study of three independent aging cohorts identified a specific set of metabolites mediating anisocytosis with aging. Whether SDMA, ADMA, and 1‐methylhistidine are released by the damaged erythrocytes with high RDW or they affect the physiology of erythrocytes causing high RDW should be further investigated.

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“…A number of studies have found that variation in RBC size has a significant impact on the severity of cardiovascular disease caused by changes in blood flow through vessels. Changes in blood flow lead to interactions between morphotic elements and the vascular endothelium [ 50 ], which results in the development of inflammation, which leads to the development of atherosclerosis. The literature on the effect of certain forms of exercise on RDW-CV is limited, making it difficult to correctly interpret changes in RDW-CV values [ 51 ].…”

Section: Discussionmentioning

confidence: 99%

The Effects of 6-Month Aqua Aerobics Training on Cardiometabolic Parameters in Perimenopausal Women—A Randomized Controlled Trial

Sobczak¹,

Wochna²,

Antosiak-Cyrak³

et al. 2023

Biology

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Background: Menopause is a time when women experience a number of physiological and anatomical changes resulting from a decline in ovarian function. It can be concluded that cardiovascular disease increases in perimenopausal and postmenopausal women, irrespective of age-related changes. Engaging in the amount of moderate physical activity recommended by the World Health Organization helps reduce the risk of death and adverse health events. The aim of the present study was to assess the effect of a 6-month aqua aerobics programme on cardiometabolic (anthropometric and biochemical) parameters in perimenopausal women. Methods: In this study, 30 women (control group—16, study group—14) participated in the 6-month aqua aerobics training programme. The mean age of women was 47.67 ± 6.79 year and BMI 26.33 ± 3.64 kg/m2. At the beginning and at the end of the study, anthropometric and blood samples analysis were performed. In the blood, lipid profile, morphotic elements were determined. Body composition, waist–hip ratio (WHR), visceral adiposity index (VAI), blood pressure (BP) were measured. Results: The aqua aerobics programme resulted in a significant decrease in the WHR (p < 0.05; ES: 2.143), diastolic blood pressure (DBP) (p < 0.05; ES: 1.005), and platelet-to-lymphocyte ratio (PRL) (p < 0.05; ES: 0.460) and an increase in haemoglobin (HGB) concentration (p < 0.05; ES: 0.643). Conclusions: The type of physical activity described in the present study is a great way for perimenopausal women to take care of their overall well-being. The reduction in selected cardiometabolic parameters is important from the point of view of the protection of women’s health.

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Red blood cell distribution width is associated with increased interactions of blood cells with vascular wall

Cited by 27 publications

References 34 publications

Red cell distribution width and mortality in older patients with frailty in the emergency department

Red cell distribution width and mortality in older patients with frailty in the emergency department

Metabolomic markers mediate erythrocyte anisocytosis in older adults: Results from three independent aging cohorts

The Effects of 6-Month Aqua Aerobics Training on Cardiometabolic Parameters in Perimenopausal Women—A Randomized Controlled Trial

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