Abstract
Whether red cell distribution width (RDW) can be a potential indicator for diabetic nephropathy (DN) is unknown. A total of 809 type 2 diabetes mellitus (T2D) patients were divided into 4 groups according to the quartiles (Q) of the RDW (%): Q1 ≤ 12.4 (n = 229), 12.4 < Q2 ≤ 12.9 (n = 202), 12.9 < Q3 < 13.5 (n = 168), Q4 ≥ 13.5 (n = 210). Results showed that the levels in Q4 group was higher in age, disease duration, systolic blood pressure, blood urea nitrogen, creatinine, uric acid and proteinuria but lower in hemoglobin, serum albumin and glycosylated hemoglobin compared to Q1 group. Furthermore, the incidences of DN, diabetic peripheral neuropathy, hypertension and coronary heart disease in the Q3 or Q4 group were higher compared to Q1 group. Medications including calcium channel blockers and antiplatelet therapy also showed higher frequencies in Q3 or Q4 group compared to Q1. Logistic regression indicated that the antiplatelet therapy (OR = 2.065), hypertension (OR = 2.819), creatinine (OR = 4.473) and proteinuria (OR = 2.085) were positively associated with level of Q4 group, but higher hemoglobin (OR = 0.021) and serum Ca2+ (OR = 0.178) were negatively associated with Q4. This data suggest that high level of RDW in T2D patients indicates a higher risk and a poor prognosis for DN.
Highlights
Diabetes mellitus (DM) is a metabolic disorder caused either by the insufficient production of insulin in islet cells of the pancreas or by resistance against secreted insulin in tissues, leading to an elevation in the glucose concentration in the blood
Several studies have focused on prognostic biomarkers that could indicate the incidences of coronary artery spasm (CAS), acute ischemic stroke (AIS), cardiovascular disease (CVD) and diabetic nephropathy (DN) in DM patients
Inflammatory biomarkers including WBC, TNF-α, matrix metalloproteinases (MMT) and dysglycemia are expressed concurrently to fit with the early stages of CVD in patients with diabetes[31]
Summary
Diabetes mellitus (DM) is a metabolic disorder caused either by the insufficient production of insulin in islet cells of the pancreas or by resistance against secreted insulin in tissues, leading to an elevation in the glucose concentration in the blood. Recent studies have demonstrated that RDW may be an effective predictor of morbidity and mortality in various diseases such as PH8, 9, NAFLD10, CHD11–15, stoke[16], atherosclerosis[17], prevalent dementia[18], IBD19, ESRD20 and heart failure[21]. A study following 8175 adults for up to 6 years showed that the measurement of RDW may be used to predict mortality in CVD, cancer and other diseases[22] in the early stages. In a 5.5-year follow-up of 13039 patients diagnosed with PAD, the 1% increase of RDW was accompanied by the increased 10% in all-cause mortality. The explicit relationship between RDW and the basic indexes, drug treatment and related complications (such as chronic heart disease and diabetic retinopathy) remains implicit in T2D patients. We study the characteristics of RDW and its association with distributions of clinical indexes in T2D patients. Abbreviation: SBP, systolic blood pressure; DBP, diastolic blood pressure; BMI, body mass index
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