Relation of Red Cell Distribution Width to Glucose Metabolism and Adverse Long-Term Prognosis in Patients with Acute Coronary Syndrome

Abstract

Introduction Red cell distribution width (RDW) reflects the heterogeneity of red blood cell size. However, few studies examined whether RDW is related to glucose metabolism indices, such as fasting blood glucose (FBG) and hemoglobin A1c (HbA1c), diabetic mellitus (DM) state or long-term outcomes of acute coronary syndrome (ACS) patients. Methods and Results A total of 448 consecutive patients with ACS were enrolled in this study. All patients were followed up for major cardiovascular adverse events (MACEs), and the mean follow-up was 952 days. Linear regression analysis showed that RDW inversely correlated with FBG but not HbA1c or DM. Kaplan-Meier survival curve analysis demonstrated that higher RDW levels were significantly positively associated with MACEs in the whole study population and the ACS patients with high FBG but not the low FBG group. Cox multivariate regression analysis revealed the independent function of RDW on MACEs in all ACS patients and ACS patients with high FBG. The receiver operating characteristic (ROC) curve demonstrated the optimal cutoff value of RDW for MACEs. Conclusion We first reported that higher RDW was associated with decreased FBG but not HbA1c or DM and an increased risk of MACEs in patients with ACS. This relationship was also found in ACS patients with higher FBG levels but not in ACS patients with lower FBG.

Correlation between HbA1c Levels and Red Distribution Cell Width in Type 2 Diabetes Mellitus Patients

“…This difference in red blood cell size ultimately increases RDW. Hyperglycemia, insulin resistance, and hyperinsulinemia, which are the main clinical abnormalities in DM, promote inflammation, oxidative stress, and other pathophysiological abnormalities ( Ke Xiong et al, 2023 ).…”

Complete blood count, lipid profiles, and inflammatory markers associated with atherosclerotic cardiovascular disease in patients with diabetes

“…20 Increased RDW has also been found to be associated with increased major adverse cardiovascular events (MACEs) in patients with ACS. 21 Meanwhile, lower RDW has been linked to a lower risk of cardiovascular mortality and MACEs following ACS. 19 Our study demonstrated increased levels of total and differential leucocytes (Table 1) and HbA1c was also found to be significantly positively correlated with leucocytes and segmented neutrophils (Table 2).…”