Red Cell Distribution Width is Associated with Future Incidence of Abdominal Aortic Aneurysm in a Population-Based Cohort Study

Jun Xiao,Jingxue Pan,Stefan Acosta,Yan Borné,Gunnar Engström,Anders Gottsäter

doi:10.1038/s41598-020-64331-7

Abstract

Red cell distribution width (RDW) has been suggested to have a predictive potential for several cardiovascular diseases, but its association with abdominal aortic aneurysm (AAA) is unknown. We examined whether RDW is associated with the risk of AAA among 27,260 individuals from the population-based Malmö Diet and Cancer Study cohort. Data of baseline characteristics were collected during 1991–1996. Cox regression was used to estimate hazard ratios (HR) with 95% confidence intervals (CI) for AAA across quartiles of RDW. During a median follow-up of 21.7 years, 491 subjects developed AAA. After adjustment for other confounding factors, participants in the highest quartile of RDW experienced 61% increased risk of AAA as compared to those with the lowest quartile (HR = 1.61, CI = 1.20, 2.12). RDW showed similar relationship with severe (i.e. ruptured or surgically repaired) AAA or non-severe AAA (adjusted HR 1.58 and 1.60, respectively). The observed association between RDW and AAA risk was significant in current smokers (adjusted HR = 1.68, CI = 1.18, 2.38) but not in former smokers (adjusted HR = 1.13, CI = 0.72, 1.79), or never-smokers (adjusted HR = 1.77, CI = 0.74, 4.22). Elevated RDW is associated with increased future incidence of AAA, however the causal and pathophysiological mechanisms remain to be explored.

Highlights

Red cell distribution width (RDW) is an easy, inexpensive, and rapid measurement of the heterogeneity of erythrocyte volumes
Since previous studies have associated high RDW values with an increased risk of different cardiovascular diseases, we examined the hypothesis that RDW is related to an increased incidence of Abdominal aortic aneurysm (AAA)
Apolipoproteins A1 (ApoA1), white blood cell count, mean corpuscular volume (MCV), the proportion of female, daily smokers, and history of coronary heart disease (CHD) increased with increasing RDW, whereas it was opposite for waist circumference, diastolic blood pressure, ApoB, ApoB/ApoA1 ratio, hemoglobin, the proportion of diabetes, and history of anti-hypertensive medication

Summary

Introduction

Red cell distribution width (RDW) is an easy, inexpensive, and rapid measurement of the heterogeneity of erythrocyte volumes. This measure is routinely calculated for most patients in whom a complete blood count is requested. It was originally developed for classification of anemias in clinical practice, in combination with mean corpuscular volume (MCV). Since previous studies have associated high RDW values with an increased risk of different cardiovascular diseases, we examined the hypothesis that RDW is related to an increased incidence of AAA. This study was performed in the population-based Malmö Diet and Cancer study

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Results

Conclusion