Red Cell Distribution Width is Associated with Future Incidence of Abdominal Aortic Aneurysm in a Population-Based Cohort Study

Xiao, Jun; Borné, Yan; Gottsäter, Anders; Pan, Jingxue; Acosta, Stefan; Engström, Gunnar

doi:10.1038/s41598-020-64331-7

Cited by 8 publications

(4 citation statements)

References 31 publications

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“…LabWAS results (Supplemental Figure 12, Supplemental Table 9) indicate that changes in erythrocytes distribution width is associated with aortic aneurysms. Erythrocytes wide distribution association with aortic aneurysms is reported 43 and based in our findings may be a good clinical laboratory test to detect aortic aneurysm. The clinical cardiac parameters QRS duration and ST segment ware associated with aortic aneurysm in our analysis.…”

Section: Discussionsupporting

confidence: 68%

Sox6 expression and aneurysms of the thoracic and abdominal aorta

Carmona-Berrio

Adarve-Rengifo

Marshall

et al. 2022

Preprint

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Background: Abdominal and thoracic aortic aneurysms (AAA; TAA) remain a large cause of deaths worldwide. This is in part a result of the lack of prognostic markers or early warning signs, leading to undiagnosed aortic aneurysms. Sox6 has been found to function as a regulator of renin expression controlling the rate limiting step in the renin angiotensin aldosterone system. We hypothesized that the transcription factor Sox6 may serve as an important regulator of mechanisms contributing to hypertension induced aortic aneurysms. Methods: Our approach includes mRNA analysis, immunohistology staining, and protein expression studies in human samples from patients affected with AAA and TAA. In vivo, we use Angiotensin (II) to induce AAA in mice with a tamoxifen inducible Cre to specifically knock out Sox6 in smooth muscle cells. Additionally, we utilize large-scale biobank data linking de-identified medical records with genotype information to perform phenotype and laboratory-wide association scans to assess the effects of SOX6 expression in a clinical cohort. Results: In a large biobank population, SOX6 gene expression is associated with aortic aneurysm in humans of European ancestry. Protein expression of Sox6 and TNF alpha was upregulated in tissue from patients affected by AAA and TAA. Moreover, we found that knocking out Sox6 in smooth muscle cells protected mice from hypertension-induced AAA, suggesting that Sox6 may be a molecular target in aortic aneurysms. Conclusions: The data presented here suggest that the transcription factor Sox6 functions in the development of abdominal aortic aneurysms, and hypertension-induced rupture.

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Section: Discussionsupporting

confidence: 68%

Sox6 expression and aneurysms of the thoracic and abdominal aorta

Carmona-Berrio

Adarve-Rengifo

Marshall

et al. 2022

Preprint

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“…Finally, several limitations should be stated and might be improved in future studies if possible. The previous study indicated that RDW was a stronger risk factor for AAA in smokers than in nonsmokers, [22] and we were unclear whether the association between RDW and in-hospital death can be mediated by smoking status. Our study did not include the smoking status in the final analysis, as there are too many missing values about the smoking history.…”

Section: Discussionmentioning

confidence: 91%

Clinical value identification of RDW on in-hospital death in unruptured abdominal aortic aneurysm

Cheng,

Shen

2024

Medicine

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This study aimed to identify highly valuable blood indicators for predicting the clinical outcomes of patients with aortic aneurysms (AA). Baseline data of 1180 patients and 16 blood indicators were obtained from the public Medical Information Mart for Intensive Care-IV (MIMIC-IV) database. The association of blood indicators with 4 types of clinical outcomes was analyzed, and the prediction performance of core indicators on different outcomes was next evaluated. Then, we explored the detailed association between core indicators and key outcomes among subgroups. Finally, a machine learning model was established to improve the prediction performance. Generalized linear regression analysis indicated that only red cell volume distribution width (RDW) was commonly associated with 4 end-points including surgery requirement, ICU stay requirement, length of hospital stay, and in-hospital death (all P < .05). Further, RDW showed the best performance for predicting in-hospital death by receiver operating characteristic (ROC) analysis. The significant association between RDW and in-hospital death was then determined by 3 logistic regression models adjusting for different variables (all P < .05). Stratification analysis showed that their association was mainly observed in unruptured AA and abdominal AA (AAA, all P < .05). We subsequently established an RDW-based model for predicting the in-hospital death only in patients with unruptured AAA. The favorable prediction performance of the RDW-based model was verified in training, validation, and test sets. RDW was found to make the greatest contribution to in-hospital death within the model. RDW had favorable clinical value for predicting the in-hospital death of patients, especially in unruptured AAA.

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“…Also, our previous studies reported RDW was associated with mortality and abdominal aortic aneurysm after multiple adjustments of routine laboratory parameters (i.e., WBC, etc.) ( 5 , 47 ). Hence, other routine laboratory parameters do not seem to fully explain the relationships between RDW and mortality or cardiovascular outcomes.…”

Section: Discussionmentioning

confidence: 99%

Red cell distribution width and its polygenic score in relation to mortality and cardiometabolic outcomes

Pan,

Sun,

Goncalves

et al. 2023

Front. Cardiovasc. Med.

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IntroductionElevated red cell distribution width (RDW) has been associated with a range of health outcomes. This study aims to examine prognostic and etiological roles of RDW levels, both phenotypic and genetic predisposition, in predicting cardiovascular outcomes, diabetes, chronic kidney disease (CKD) and mortality.MethodsWe studied 27,141 middle-aged adults from the Malmö Diet and Cancer study (MDCS) with a mean follow up of 21 years. RDW was measured with a hematology analyzer on whole blood samples. Polygenic scores for RDW (PGS-RDW) were constructed for each participant using genetic data in MDCS and published summary statistics from genome-wide association study of RDW (n = 408,112). Cox proportional hazards regression was used to assess associations between RDW, PGS-RDW and cardiovascular outcomes, diabetes, CKD and mortality, respectively.ResultsPGS-RDW was significantly associated with RDW (Pearson's correlation coefficient = 0.133, p < 0.001). RDW was significantly associated with incidence of stroke (hazard ratio (HR) per 1 standard deviation = 1.06, 95% confidence interval (CI): 1.02–1.10, p = 0.003), atrial fibrillation (HR = 1.09, 95% CI: 1.06–1.12, p < 0.001), heart failure (HR = 1.13, 95% CI: 1.08–1.19, p < 0.001), venous thromboembolism (HR = 1.21, 95% CI: 1.15–1.28, p < 0.001), diabetes (HR = 0.87, 95% CI: 0.84–0.90, p < 0.001), CKD (HR = 1.08, 95% CI: 1.03–1.13, p = 0.004) and all-cause mortality (HR = 1.18, 95% CI: 1.16–1.20, p < 0.001). However, PGS-RDW was significantly associated with incidence of diabetes (HR = 0.96, 95% CI: 0.94–0.99, p = 0.01), but not with any other tested outcomes.DiscussionRDW is associated with mortality and incidence of cardiovascular diseases, but a significant association between genetically determined RDW and incident cardiovascular diseases were not observed. However, both RDW and PGS-RDW were inversely associated with incidence of diabetes, suggesting a putative causal relationship. The relationship with incidence of diabetes needs to be further studied.

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Red Cell Distribution Width is Associated with Future Incidence of Abdominal Aortic Aneurysm in a Population-Based Cohort Study

Cited by 8 publications

References 31 publications

Sox6 expression and aneurysms of the thoracic and abdominal aorta

Sox6 expression and aneurysms of the thoracic and abdominal aorta

Clinical value identification of RDW on in-hospital death in unruptured abdominal aortic aneurysm

Red cell distribution width and its polygenic score in relation to mortality and cardiometabolic outcomes

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