The Relationship between Red Blood Cell Distribution Width and Incident Diabetes in Chinese Adults: A Cohort Study

Abstract

Background. Previous studies reported the controvertible association between red blood cell distribution width (RDW) and diabetes. The aim of this study is to explore whether RDW is associated with incident diabetes. Methods. We performed this cohort study in 16,971 Chinese adults (9,956 men and 7,015 women, aged 43.3±12.8 years). The level of RDW was measured at baseline (2014). All the participants were further classified into four quartile groups based on baseline RDW. Fasting blood glucose (FBG) and glycated hemoglobin A1c (HbA1c) were measured annually during follow-up (2014-2019). Diabetes was diagnosed if either FBG≥7.0 mmol/L or HbA1c≥6.5%. We used the Cox proportional hazards regression model to evaluate the association between baseline RDW and incident diabetes. Results. We identified 2,703 new cases of diabetes during five-year follow-up. The incidence was 15.9%. Comparing with participants in the lowest quartile group (reference group), the adjusted hazard ratios (HR) for the risk of diabetes were 1.31 (95% CI: 1.16, 1.48) for the highest quartile group (p trend<0.001), after adjustment for potential confounders. Further adjusting baseline FBG and HbA1c did not materially change the association between RDW and incident diabetes. Each unit increase of RDW was associated with a 16% higher risk of incident diabetes (HR=1.16, 95% CI: 1.06, 1.26) in a fully adjusted model. Sensitivity analysis generated similar results with prospective analyses after excluding aged participants, participants who are overweight and with obesity, participants with elevated blood pressure, participants with decreased eGFR, and those with anemia at baseline. Conclusions. High RDW was associated with high risk of developing diabetes in Chinese adults. As RDW is an inexpensive, noninvasive, and convenient indicator, RDW might be considered for inclusion in the risk assessment of high-risk groups of diabetes.

Basit Bir Tam Kan Sayımı Gestastonel Diyabetes Mellitusu Öngörebilir Mi?

“…Recently it has been shown to reflect the systemic inflammatory states and has been associated with the severity and prognosis in several diseases including diabetes. [26] Anisocytosis was reported to be more prevalent in GDM. [27] In their cohort study including 16971 adults Wang et al found that each unit increase of RDW was associated with a 16% higher incident diabetes and concluded that high RDW was associated with high risk of diabetes.…”

ΔRDW: A Novel Indicator with Predictive Value for the Diagnosis and Treatment of Multiple Diseases

“…52 People with diabetes have distinctly higher RDW values than those without diabetes, each unit increase of RDW represents a 16% higher risk of incident diabetes. 53 Higher RDW predicts a higher risk of diabetic complications, such as diabetic ketoacidosis (DKA) or diabetic retinopathy. 54 , 55 This was due to the presence of micro- and macro-angiopathy with hyperglycemia that shortens the lifespan of RBCs.…”

Associations of complete blood count parameters with pancreatic beta‐cell function and insulin resistance in prediabetes and type 2 diabetes mellitus

“…Some studies have found associations between T2DM and CBC parameters such as the RDW 14‐16 and the red blood cell (RBC) count 17,18 . In a 5‐year follow‐up study, high RDW was associated with a high risk of developing diabetes in Chinese adults 14 15 found an independent association between low RDW and increased diabetes incidence.…”

“…The red cell distribution width (RDW) was also suggested as an important predictor of vascular complications of diabetes mellitus. Some studies have found associations between T2DM and CBC parameters such as the RDW 14 , 15 , 16 and the red blood cell (RBC) count. 17 , 18 In a 5‐year follow‐up study, high RDW was associated with a high risk of developing diabetes in Chinese adults.…”

“… 17 , 18 In a 5‐year follow‐up study, high RDW was associated with a high risk of developing diabetes in Chinese adults. 14 Meanwhile, Engström et al 15 found an independent association between low RDW and increased diabetes incidence. Furthermore, a study of a sample of Chinese patients with T2DM 16 demonstrated that RDW values were significantly associated with HOMA2‐β and HbA1c, but found no correlation between RDW and HOMA2‐IR.…”