Red blood cell distribution width is a potential prognostic index for liver disease

Zhide Hu; Yi Sun; Qianqian Wang; Zhijun Han; Yuanlan Huang; Xiaofei Liu; Chunmei Ding; Chengjin Hu; Qin Qin; Anmei Deng

doi:10.1515/cclm-2012-0704

Article

Red blood cell distribution width is a potential prognostic index for liver disease

Zhide Hu , Yi Sun , Qianqian Wang , Zhijun Han , Yuanlan Huang , Xiaofei Liu , Chunmei Ding , Chengjin Hu , Qin Qin and Anmei Deng

Published/Copyright: January 11, 2013

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From the journal Clinical Chemistry and Laboratory Medicine Volume 51 Issue 7

Abstract

Background: Red blood cell distribution width (RDW) is increased in liver disease. Its clinical significance, however, remains largely unknown. The aim of this study was to identify whether RDW was a prognostic index for liver disease.

Methods: We studied, retrospectively, 33 patients with non-cirrhotic HBV chronic hepatitis, 125 patients with liver cirrhosis after HBV infection, 81 newly diagnosed primary hepatocellular carcinoma (pHCC) patients, 17 alcoholic liver cirrhosis patients and 42 patients with primary biliary cirrhosis (PBC). Sixty-six healthy individuals represented the control cohort. We analyzed the relationship between RDW on admission and clinical features. The association between RDW and hospitalization outcome was estimated by receiver operating curve (ROC) analysis and a multivariable logistic regression model.

Results: Increased RDW was observed in liver disease patients. RDW was positively correlated with serum bilirubin and creatinine levels, prothrombin time, and negatively correlated with platelet counts and serum albumin concentration. A subgroup analysis, considering the different etiologies, revealed similar findings. Among the patients with liver cirrhosis, RDW increased with worsening of Child-Pugh grade. In patients with PBC, RDW positively correlated with Mayo risk score. Increased RDW was associated with worse hospital outcome, as shown by the AUC [95% confidence interval (CI)] of 0.76 (0.67–0.84). RDW above 15.15% was independently associated with poor hospital outcome after adjustment for serum bilirubin, platelet count, prothrombin time, albumin and age, with the odds ratio (95% CI) of 13.29 (1.67–105.68).

Conclusions: RDW is a potential prognostic index for liver disease.

Keywords: hepatitis; liver cirrhosis; primary hepatocellular carcinoma; red blood cell distribution width

Corresponding authors: Chengjin Hu, MD, Department of Laboratory Medicine, General Hospital of Ji’nan Military Command Region. Ji’nan 250031, P.R. China, Phone: +86 0531 51666289, Fax: +86 0531 51666289; Qin Qin, MS, Department of Laboratory Diagnosis, Changhai Hospital, Second Military Medical University, Shanghai 200433, P.R. China, Phone: +86 021 31162079; and Anmei Deng, MD, PhD, Department of Laboratory Diagnosis, Changhai Hospital, Second Military Medical University, Shanghai 200433, P.R. China, Phone: +86 021 31162061, Fax: +86 021 31162061

This work was supported by a grant from the National Natural Science Foundation of China (No. 30972730) and Shanghai Municipal Commission for Science and Technology (09JC1405400). We thank Medjaden Bioscience Limited for assisting in the preparation of this manuscript

Conflict of interest statement

Authors’ conflict of interest disclosure: The authors stated that there are no conflicts of interest regarding the publication of this article.

Research funding: None declared.

Employment or leadership: None declared.

Honorarium: None declared.

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Received: 2012-10-16

Accepted: 2012-12-10

Published Online: 2013-01-11

Published in Print: 2013-07-01

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Articles in the same Issue

https://doi.org/10.1515/cclm-2012-0704

Keywords for this article

hepatitis; liver cirrhosis; primary hepatocellular carcinoma; red blood cell distribution width