Association between high red blood cell distribution width and metabolic syndrome. Influence of abdominal obesity

Abstract

To theEditor. The association between high red blood cell distribution width (RDW) and cardiovascular events and heart failure has been reported [4, 7]. The link between elevated RDW and cardiovascular disease (CVD) risk may be due to an underlying chronic inflammation mediated by proinflammatory cytokines that could influence erythrocyte maturation [4]. The metabolic syndrome (MS) is a chronic inflammatory disorder that increases the risk of cardiovascular events and death [5]. A recent study [6] has found an association between RDW and MS with doubtful results, as the association is weak, lower than that for cardiovascular events and iron, vitamin B12 and folic acid, which may influence RDW have not been determined either. We have performed a case-control study evaluating the association between RDW and MS as well as with the several components of MS, i.e., abdominal obesity, low HDL cholesterol, hypertension, hypertriglyceridemia and glucose intolerance. The study was performed in accordance with the ethical guidelines for Clinical Hemorheology and Microcirculation [2]. We included 61 patients with MS classified according to the NCEP ATPIII criteria modified by Grundy et al. [5] and 94 controls without MS. We determined RDW along with iron, vitamin B12, folic acid, erythrocyte indices, glucose, lipids, fibrinogen, hs-CRP and neutrophil count. A cut-off point of 14% corresponding to the control group mean plus one SD was considered for high RDW; 358 mg/dL for high fibrinogen and 28.61 pg for low MCH. No differences in RDW nor in vitamin B12, folic acid, iron, or erythrocyte indices were observed (p> 0.05). Hematocrit was statistically higher in patients than in controls (p= 0.022) as were hs-CRP, fibrinogen and neutrophils count (p< 0.001) (Table 1).