Red Blood Cell Distribution Width Is Associated with Severity of Leukoaraiosis

Abstract

Red blood cell distribution width (RDW) is one of the routine hematologic parameters reported in the complete blood count test, which has been recognized as strong prognostic marker for various medical conditions, especially cardiovascular disease. We evaluated that RDW was also associated with the leukoaraiosis; common radiological finding of brain and that has been strongly associated with risk of stroke and dementia. In the present study, we included 1006 non-stroke individuals who underwent brain MRI and routine complete blood count test including RDW. Fazekas scale was used to measure the severity of leukoaraiosis based on fluid-attenuated inversion recovery image, and the severity was dichotomized to mild-degree (Fazekas scale: 0–1) and severe-degree leukoaraiosis (Fazekas scale: 2–3). Univariate and multivariate logistic regression models were constructed to evaluate independent risk factor for severe-degree of leukoaraiosis. Mean age of 1006 subjects was 64.34 ± 9.11 year, and mean of RDW was 12.97 ± 0.86%. The severe-degree of leukoaraiosis (Fazekas scale ≥ 2) was found in 28.83%. In the multivariate logistic regression, 4th quartile of RDW (> 13.3%) were significantly associated with the presence of severe-degree of leukoaraiosis (adjusted odds ratio, 1.87; 95% confidence interval, 1.20–2.92) compared to the 1st quartile of RDW (< 12.5%). The significance was not changed after adjustments for hemoglobin and other hematologic indices. These findings suggest that RDW is independently associated with severity of leukoaraiosis.

Are Monocyte/HDL, Lymphocyte/Monocyte and Neutrophil/Lymphocyte Ratios Prognostic or Follow-up Markers in Ischemic Cerebrovascular Patients?

“…In our study, we found that RDW levels were correlated with NIHSS scores; higher RDW levels were associated with poor prognosis. Recent studies showed that elevated RDW values may cause stroke severity and independently predict future cardiovascular and allcause mortality (16,17). Our data confirmed the results of these studies and RDW levels were significantly higher in moderate to severe stroke group.…”

Disturbed Red Blood Cell Structure and Function: An Exploration of the Role of Red Blood Cells in Neurodegeneration

“…Abnormally shaped red blood cells display an increased heterogeneity in cell volume, due to impaired erythropoiesis or to excessive fragmentation or destruction. This heterogeneity, expressed as an increase in red blood cell distribution width (RDW), is associated with ischemic cerebrovascular disease ( 38 ), with increased odds of having dementia ( 39 ), with Alzheimer disease ( 40 ), and with the severity of leukoaraiosis ( 41 ). In related studies, we found indications for disturbed red blood cell aging, which is associated with changes in cell morphology, in patients with beginning demantia ( 42 ).…”

Association between red blood cell distribution width and white matter hyperintensities: A large‐scale cross‐sectional study

“…Among the overall sample, 277 subjects with total WMHs (49.9%) and 321 controls (50.0%) were randomly selected for constructing ROC. With the highest Youden's index, the optimal cutoff value of 13.25% for higher RDW was identified, which was closed to 13.0% determined by the previous study (Lee et al., 2016). The remaining 278 subjects with total WMHs (50.1%) and 321 controls (50.0%) were used for further statistical analyses.…”

“…To date, though growing evidence suggests that RDW may serve as a predictor of ischemic strokes, the association between RDW and WMHs is rarely investigated. By comparing 716 controls (Fazekas scale: 0-1) with 290 severe WMHs cases (Fazekas scale: Lee et al (2016) reported that higher RDW (≥13.3%) was independently related to the severity of WMHs. In addition, an independent correlation between higher RDW and WMHs was observed in the Chinese population with acute ischemic stroke (Peng et al2017).…”