Red Cell Distribution Width Research Articles

Association of dietary inflammatory index and dietary oxidative balance score with gastrointestinal cancers in NHANES 2005–2018

Background&AimsGastrointestinal (GI) cancers, including gastric, liver, esophageal, pancreatic, and colorectal cancers, represent significant global health burdens. Emerging evidence suggests that dietary patterns, particularly their inflammatory and oxidative properties, may influence cancer risk. The Dietary Inflammatory Index (DII) and Dietary Oxidative Balance Score (DOBS) assess the inflammatory and oxidative effects of diets, respectively. This study aims to explore the association between DII, DOBS, and the combined risk of GI cancers, and investigates the potential mediating roles of serum albumin and red cell distribution width (RDW).MethodsData from 26,320 participants in the NHANES 2005–2018 cycles were analyzed. DII was calculated based on 28 dietary components, and DOBS included 17 nutrients (3 pro-oxidants and 14 antioxidants). Logistic regression models assessed the associations between DII, DOBS, and GI cancers. Restricted cubic spline (RCS) models examined dose-response relationships. Mediation analysis evaluated the roles of serum albumin and RDW. Subgroup analyses explored interactions with demographic and health-related factors.ResultsHigher DII was associated with increased GI cancer risk (OR: 1.26, 95% CI: 1.07–1.49 per unit increase), while higher DOBS was associated with reduced risk (OR: 0.90, 95% CI: 0.76–0.99 per unit increase). RCS analysis indicated a significant nonlinear relationship between DII and GI cancer risk. Serum albumin and RDW partially mediated the associations between DII, DOBS, and GI cancers. Subgroup analyses showed stronger associations for DII among certain demographics, and significant interactions were found between DII and BMI. For DOBS, significant interactions were observed with age and BMI.ConclusionThis study reveals significant associations between dietary inflammatory and oxidative balance scores and GI cancer risk. Higher DII is linked to increased risk, while higher DOBS is protective. The mediating roles of serum albumin and RDW provide insights into underlying mechanisms. These findings underscore the potential of dietary modifications in GI cancer prevention and management, emphasizing the importance of anti-inflammatory and antioxidant-rich diets.

The Association Between Hematological Indices and Type 2 Diabetes Mellitus in Iranian Population

Background: Hematological alterations have been observed in diabetes, with some studies showing controversial associations between specific hematologic parameters and type 2 diabetes mellitus (T2DM). Objectives: This study aims to determine the association between hematological indices, specifically white blood cell (WBC) count, red cell distribution width (RDW), and platelet distribution width (PDW), and the presence of T2DM in an Iranian population, using data from the Bandare-Kong non-communicable diseases (BKNCD) cohort. Methods: Data from the BKNCD cohort, which includes 4063 individuals aged 35 - 70 years, was used in this study. After excluding participants with conditions that could interfere with the analysis, 2318 subjects remained for final evaluation. Results: Among the 2318 individuals, T2DM was present in 530 (22.9%). Binary logistic regression analysis revealed that the odds of T2DM increased by approximately 7% for every 109/L increase in WBC count, after adjusting for variables such as occupation, age, body mass index, sex, place of residence, education, smoking, marital status, systolic and diastolic blood pressure (DBP), and physical activity (adjusted odds ratio (aOR) = 1.066, 95% confidence interval (CI) = 1.003; 1.133, P = 0.039). Additionally, elevated PDW was associated with a 63% increase in the odds of T2DM (aOR = 1.625, 95% CI 1.159; 2.279, P = 0.005), while increased RDW was associated with decreased odds of T2DM (aOR = 0.801, 95% CI 0.716; 0.895, P < 0.001). Conclusions: Elevated PDW and WBC counts in T2DM patients in this study suggest an inflammatory state and hypercoagulability. However, the paradoxically decreased RDW may be linked to poor glycemic control in these patients.

Dietary restriction impacts health and lifespan of genetically diverse mice.

Caloric restriction extends healthy lifespan in multiple species1. Intermittent fasting, an alternative form of dietary restriction, is potentially more sustainable in humans, but its effectiveness remains largely unexplored2-8. Identifying the most efficacious forms of dietary restriction is key for developing interventions to improve human health and longevity9. Here we performed an extensive assessment of graded levels of caloric restriction (20% and 40%) and intermittent fasting (1 and 2 days fasting per week) on the health and survival of 960 genetically diverse female mice. We show that caloric restriction and intermittent fasting both resulted in lifespan extension in proportion to the degree of restriction. Lifespan was heritable and genetics had a larger influence on lifespan than dietary restriction. The strongest trait associations with lifespan included retention of body weight through periods of handling-an indicator of stress resilience, high lymphocyte proportion, low red blood cell distribution width and high adiposity in late life. Health effects differed between interventions and exhibited inconsistent relationships with lifespan extension. 40% caloric restriction had the strongest lifespan extension effect but led to a loss of lean mass and changes in the immune repertoire that could confer susceptibility to infections. Intermittent fasting did not extend the lifespan of mice with high pre-intervention body weight, and two-day intermittent fasting was associated with disruption of erythroid cell populations. Metabolic responses to dietary restriction, including reduced adiposity and lower fasting glucose, were not associated with increased lifespan, suggesting that dietary restriction does more than just counteract the negative effects of obesity. Our findings indicate that improving health and extending lifespan are not synonymous and raise questions about which end points are the most relevant for evaluating aging interventions in preclinical models and clinical trials.

Soluble TREM-1 is not a useful biomarker in the diagnosis of early-onset neonatal sepsis.

Aim: Sepsis remains a significant cause of morbidity and mortality in neonates. We aimed to investigate the use and reliability of the soluble triggering receptor expressed on myeloid cells (sTREM-1) biomarker for suspected early onset of neonatal sepsis (EONS).Materials & methods: 52 patients with suspected EONS and 30 healthy newborns were analyzed for sTREM-1 and other biomarkers.Results: It revealed that elevated levels of C-reactive protein (CRP), neutrophil (%), red cell distribution width (RDW), neutrophil/lymphocyte ratio (NLR) and lactate, as well as decreased lymphocyte (%) were statistically significant for EONS. However, there was no statistically significant difference in sTREM-1 levels between the groups.Conclusion: Although no significant difference in sTREM-1 levels was found between the groups, further research involving repeated measurements and larger sample sizes is necessary to evaluate its practical utility in clinical settings.

Development and validation of a relatively accurate gastric cancer high-risk group screening scoring system in urban residents.

Our study aimed to develop a relatively accurate gastric cancer (GC) screening score system for urban residents and to validate the screening efficacy. The present study included a derivation cohort (n = 3406) and a validation cohort (n = 868) of urban residents. Applying the full-stack engineering intelligent system platform of Hualian Health Big Data of Shandong University, the clinical physical examination data of subjects were collected. Univariate and multivariate analyses were used to identify risk factors for GC, and subsequently, an optimal prediction rule was established to create three distinct scoring systems. In the GC-risk scoring system I, age, plateletocrit (PCT), carcinoembryonic antigen (CEA), glucose, albumin, creatinine were independent risk factors of GC, with scores ranging from 0 to 28 and optimal cut-off was 15.5. The second scoring system consisted of age, PCT, RDW-CV, CEA, glucose, albumin, and creatinine, with scores ranging from 0 to 31. The optimal cut-off point was determined to be 15.5. The scoring system III comprise of age, sex, PCT, RDW CV, CEA, glucose, with scores ranging from 0 to 21 and optimal cut-off was 10.5. All three scoring systems demonstrated excellent discrimination for GC, achieving an AUC of 0.884, 0.89, and 0.876, respectively. In external validation, the AUC values were 0.654, 0.658, and 0.714. Notably, the GC-risk scoring system III exhibited the highest screening efficiency. Urban residents benefited from the effective and verified GC-risk scoring systems, which demonstrated excellent performance in identifying individuals with an elevated risk of GC.

The importance of blood parameters in the detection of intestinal metaplasia and early diagnosis of gastric cancer

Background: We aimed to determine whether complete blood count(CBC) parameters, such as the white blood count(WBC), hemoglobin(Hb), platelet(PLT), red cell distribution width(RDW), mean platelet volume(MPV), platelet distribution width(PDW), neutrophil-to-lymphocyte ratio(NLR), platelet-to-lymphocyte ratio(PLR), and monocyte-to-lymphocyte ratio(MLR), have a predictive value in the detection of gastric cancer(GC) and intestinal metaplasia(IM). Methods: While proven GC, IM, and healthy control(HC) patients were included, patients with the comorbid disease were excluded, and univariate analyses compared three groups. The receiver operating characteristic(ROC) curve analysis was run for CBC parameters. The area under the curve(AUC) was evaluated, and a cut-off value was determined. The sensitivity and specificity of each parameter were considered. Results: The GC, IM, and HC groups consisted of 72(33%), 73(34%), and 72(33%) patients, respectively. RDW, PLT, NLR, PLR, and MLR were significant between GC and IM. The highest AUC (0.727) was obtained for the PLT yielding a 56.9% sensitivity and 79.4% specificity at a cut-off value of 151.8. The AUC of RDW was found as 0.691 and 0.626 for pairwise comparisons of GC-HC and IM-HC, respectively. At a cut-off value of 13.4, PLR yielded 70.8% sensitivity and 61.1% specificity in the detection of GC, while 64.4% sensitivity and 51.1% specificity for IM. Conclusion: CBC parameters, such as RDW, PLT, NLR, PLR, and MLR, have value in detecting GC. RDW also has diagnostic value in helping to detect IM. PLR can help to distinguish patients with GC from those with IM. These inexpensive, easily accessible parameters may help in the timely diagnosis of GC and IM. Keywords: Gastric cancer; intestinal Metaplasia; Monocyte to lymphocyte ratio; red cell distribution; hemoglobin; platelet; neutrophil-lymphocyte ratio; platelet-lymphocyte ratio; inflammation.

The First Comprehensive Evaluation of Immuno-Inflammatory Markers for Prognosis in Esophageal Cancer Patients: A South Asian Perspective.

Background: Esophageal cancer (EC) remains a significant health challenge in South Asia, with poor prognosis despite advancements in diagnostics and treatment. Identifying and validating prognostic factors is essential for improving patient outcomes. Methods: A prospective study was conducted with 146 biopsy-confirmed EC patients at the Dr. Ruth K.M. Pfau Civil Hospital, Karachi, Pakistan. Clinical and laboratory data were collected and analyzed using descriptive statistics, receiver operating characteristic (ROC) analysis, and the Chi-square test. Survival outcomes were assessed using Kaplan-Meier curves, log-rank tests, and Cox proportional hazard models for univariate and multivariate regression analyses, with statistical significance set at p ≤ 0.05. Results: Bivariate analysis showed significant associations of the neutrophil lymphocyte ratio (NLR) (p = 0.017), C-reactive protein to albumin ratio (CAR) (p = 0.033), red cell distribution width to platelet ratio (RPR) (p = 0.020), and systemic immune-Inflammation index (SII) (p = 0.009) with patient survival. Univariate analysis identified tumor length >10 cm (p = 0.016), T4 stage (p = 0.015), metastasis (p < 0.001), surgery not performed (p < 0.001), and SII (p = 0.022) as significant factors for survival, with higher SII linked to poorer overall survival (p = 0.020). Interestingly, in the multivariate model, only metastasis (p < 0.001) and surgery not performed (p = 0.011) remained significant. Conclusions: Immuno-inflammatory markers may be less pertinent prognostic factors for EC in the South Asian population.

Accounting for Red Cell Distribution Width Improves Risk Stratification by Commonly Used Mortality/Deterioration Risk Scores in Adult Patients Hospitalized Due to COVID-19.

Higher red blood cell distribution width (RDW) levels have gained attention in the prognostication of many chronic metabolic and malignant diseases, as well as coronavirus disease 2019 (COVID-19). We aimed to evaluate whether accounting for RDW might contribute to risk stratification when added to commonly used risk scoring systems in adult COVID-19 patients. We retrospectively analyzed a cohort of 3212 non-critical COVID-19 patients hospitalized in a tertiary-level institution from March 2020 to June 2021. Admission RDW values were considered normal if they were ≤14.5% in males or ≤16.1% in females. The Modified Early Warning Score (MEWS), International Severe Acute Respiratory and Emerging Infections Consortium Coronavirus Clinical Characterisation Consortium score (ISARIC 4C), and Veterans Health Administration COVID-19 (VACO) index were evaluated as prognostic scores. RDW exceeded the upper limit in 628 (19.6%) of the patients. When RDW was accounted for, risks of the predicted outcomes were considerably different within the same MEWS, 4C score, and VACO index levels. The same patterns applied equally to patients who started, and those who did not start, remdesivir before deterioration. RDW may be a useful tool for stratifying risk when considered on top of commonly used prognostic scores in non-critical COVID-19 patients.

Comparison between statistical and machine learning methods to detect the hematological indices with the greatest influence on elevated serum levels of low-density lipoprotein cholesterol

IntroductionElevated levels of low-density lipoprotein-cholesterol (LDL-C) is a significant risk factor for the development of cardiovascular diseases (CVD)s. Furthermore, studies have revealed an association between indices of the complete blood count (CBC) and dyslipidemia. We aimed to investigate the relationship between CBC parameters and serum levels of LDL. MethodIn a prospective study involving 9704 participants aged 35–65 years, comprehensive screening was conducted to estimate LDL-C levels and CBC indicators. The association between these biomarkers and high LDL-C (LDL-C≥130 mg/dL (3.25 mmol/L)) was investigated using various analytical methods, including Logistic Regression (LR), Decision Tree (DT), Random Forest (RF), Neural Network (NN), and Support Vector Machine (SVM) methodologies. ResultThe present study found that age, hemoglobin (HGB), hematocrit (HCT), platelet count (PLT), lymphocyte (LYM), PLT-LYM ratio (PLR), PLT-High-Density Lipoprotein (HDL) ratio (PHR), HGB-LYM ratio (HLR), red blood cell count (RBC), Neutrophil-HDL ratio (NHR), and PLT-RBC ratio (PRR) were all statistically significant between the two groups (p<0.05). Another important finding was that red cell distribution width (RDW) was a significant predictor for higher LDL levels in women. Furthermore, in men, RDW-PLT ratio (RPR) and PHR were the most important indicators for assessing the elevated LDL levels. ConclusionThe study found that sex increases LDL-C odds in females by 52.9 %, while age and HCT increase it by 4.1 % and 5.5 %, respectively. RPR and PHR were the most influential variables for both genders. Elevated RPR and PHR were negatively correlated with increased LDL levels in men, and RDW levels was a statistically significant factor for women. Moreover, RDW was a significant factor in women for high levels of HDL-C.The study revealed that females have higher LDL-C levels (16 % compared to 14 % of males), with significant differences across variables like age, HGB, HCT, PLT, RLR, PHR, RBC, LYM, NHR, RPR, and key factors like RDW and SII.

Clustering Based on Laboratory Data in Patients With Heart Failure Admitted to the Intensive Care Unit.

Heart failure (HF) is a common condition that imposes a significant burden on healthcare systems. We aimed to identify subgroups of patients with heart failure admitted to the ICU using routinely measured laboratory biomarkers. A large dataset (N = 1176) of patients with heart failure admitted to the ICU at the Beth Israel Deaconess Medical Center in Boston, USA, between June 1, 2001, and October 31, 2012, was analyzed. We clustered patients to identify laboratory phenotypes. Cluster profiling was then performed to characterize each cluster, using a binary logistic model. Two distinct clusters of patients were identified (N = 679 and 497). There was a significant difference in the mortality rate between Clusters 1 and 2 (50 [7.4%] vs. 109 [21.9%], respectively, p < 0.001). Patients in the Cluster 2 were significantly older (mean [SD] age = 72.35 [14.40] and 76.37 [11.61] years, p < 0.001) with a higher percentage of chronic kidney disease (167 [24.6%] vs. 262 [52.7%], respectively, p < 0.001). The logistic model was significant (Log-likelihood ratio p < 0.001, pseudo R2 = 0.746) with an area under the curve of 0.905. The odds ratio for leucocyte count, mean corpuscular volume (MCV), red blood cell (RBC) distribution width, hematocrit (HcT), lactic acid, blood urea nitrogen (BUN), serum potassium, magnesium, and sodium were significant (all p < 0.05). Laboratory data revealed two phenotypes of ICU-admitted patients with heart failure. The two phenotypes are of prognostic importance in terms of mortality rate. They can be differentiated using blood cell count, kidney function status, and serum electrolyte concentrations.

Monocyte to high-density lipoprotein cholesterol ratio reflects the peripheral inflammatory state in parkinsonian disorders

BackgroundIn Parkinson’s disease (PD) and Parkinson plus syndrome (PPS), inflammation is recognized as a relevant or contributing factor in the advancement of the diseases. For this reason, numerous biomarkers signaling immune alteration in both the central and peripheral nervous systems have been evaluated in PD and PPS. Nonetheless, the comprehensive inflammatory indices derived from readily available standard blood tests in PD, PPS, and healthy controls (HC) were rarely evaluated especially in the early stage of the diseases. ObjectiveThe aim of this study is to explore the serum level of peripheral inflammatory markers among the patients and investigate whether these markers contribute to symptoms. MethodClinical data and blood test results from drug naïve, early-stage 139 PD and 87 PPS patients, along with 139 age- and sex-matched healthy controls (HC) to PD were enrolled, with exclusion criteria applied to conditions potentially affecting inflammation. The study examined the disparities in peripheral inflammation among the groups, using total and subpopulation of white blood cells (WBCs), platelet count, red cell distribution width (RDW), high-density lipoprotein cholesterol (HDL-C), and other composite values reflecting inflammation including RDW to platelet ratio (RPR), neutrophil to lymphocyte ratio (NLR), monocyte to lymphocyte ratio (MLR), platelet to lymphocyte ratio (PLR), neutrophil to HDL-C ratio (NHR), monocyte to HDL-C ratio (MHR), lymphocyte to HDL-C ratio (LHR), platelet to HDL-C ratio (PHR), systemic inflammation index (SII), systemic inflammation response index (SIRI), and aggregate index of systemic inflammation (AISI). ResultThe MHR values were significantly higher in both PD and PPS groups compared to HC (p < 0.001), and NHR was significantly higher in the PPS group only compared to the HC group (p < 0.001). However, no significant differences in all the inflammatory markers were observed between PPS and PD (p > 0.05). Subgroup analysis of progressive supranuclear palsy (PSP) and multiple system atrophy (MSA) patients revealed significantly higher NHR and MHR levels compared to the HC group (p = 0.025, p = 0.050, respectively), with no significant difference among PSP, MSA, and PD groups. After adjustment for age, sex, and disease duration, MHR was positively associated with H&Y in the total population (β = 0.288, p < 0.001), negatively associated with MMSE in the PD group (β = −0.245, p = 0.017), and positively associated with both H&Y (β = 0.432, p < 0.001) and UPDRS part II (β = 0.295, p = 0.018) in PPS group. ConclusionNHR and MHR values are not effective as reliable diagnostic markers due to overlap among groups and their limited discriminative capacity in ROC analyses. However, MHR may potentially serve as an indicator reflecting peripheral inflammation in the early stage of PD and PPS compared to HC.

Clinical values of preoperative red blood cell distribution width and platelet parameters in patients with papillary thyroid carcinoma.

The prevalence of thyroid carcinoma is increasing, and papillary thyroid carcinoma (PTC) is the most frequent subtype. More and more attention is being concentrated on the association between inflammation indicators and malignant tumors. The aim of the present study was to analyze whether the preoperative red blood cell distribution width (RDW) and platelet parameters, including mean platelet volume (MPV) and platelet distribution width (PDW), can be applied to distinguish between patients with PTC or papillary thyroid microcarcinoma (PTMC) and healthy controls, and to explore the associations with clinicopathological characteristics. The study retrospectively compared the RDW, MPV and PDW values of 780 patients with PTC or PTMC against a healthy control group. Receiver operating characteristic (ROC) curves were conducted to determine diagnostic accuracy. Furthermore, the clinicopathological features of the patients with PTC or PTMC were compared between higher and lower platelet parameter groups based on the RDW, MPV and PDW values. Significantly higher preoperative RDW, MPV and PDW values were found in patients with PTC or PTMC compared with those of the healthy group. ROC curve analysis showed that the area under the curve (AUC) plus 95% confidence interval (95% CI) values of RDW, MPV and PDW were 0.808 (0.780-0.835), 0.771 (0.743-0.799) and 0.711 (0.681-0.742), respectively. When RDW and MPV were combined together, the AUC (95% CI) value was enhanced to 0.858 (0.835-0.881) for the patients with PTC. For the patients with PTMC, RDW, MPV and PDW had AUC (95% CI) values of 0.812 (0.783-0.840), 0.779 (0.749-0.808) and 0.718 (0.685-0.751), respectively. When RDW and MPV were combined together, the AUC (95% CI) value was enhanced to 0.858 (0.835-0.881). A higher RDW was significantly associated with being female, deeper tumor infiltration, and normal FT3 and FT4 levels. A higher PDW was significantly associated with elevated thyrotropin receptor antibody levels. In conclusion, as convenient and available inflammation indicators, RDW, PDW and MPV have diagnostic ability and can distinguish between patients with PTC or PTMC and healthy controls. In addition, the combined application of RDW and MPV can improve the diagnostic power. The values of RDW and MPV were associated with clinicopathological characteristics. To the best of our knowledge, this is the first study to prove the usefulness of preoperative RDW combined with MPV in diagnosing patients with PTC or PTMC.

Evaluating The Diagnostic Value Of Red Cell Distribution Width (RDW) In Identifying Iron Deficiency Anemia: A Retrospective Analysis

Background: Iron Deficiency Anemia (IDA) is the most prevalent form of anemia globally, with a significant impact on public health, especially in low-resource settings like Bangladesh. Accurate and early diagnosis of IDA is essential for effective treatment. Red Cell Distribution Width (RDW) has emerged as a promising, accessible diagnostic tool for IDA, yet its utility remains underexplored in this context. Methods: This retrospective cross-sectional study, conducted between July 2022 and July 2024 at Addin Barrister Rafique-ul Huq Hospital in Bangladesh, included 106 patients diagnosed with microcytic hypochromic anemia. Key hematological parameters, including hemoglobin, RBC count, MCV, and RDW, were analyzed. Correlation analyses were performed to assess the relationships between RDW and other parameters such as hemoglobin, MCV, RBC count, and Erythrocyte Sedimentation Rate (ESR). Results: RDW was elevated (&gt;14.5%) in 92.45% of the participants, with a mean RDW of 17.59±3.33%. Significant negative correlations were observed between RDW and hemoglobin (r = -0.435, p &lt; 0.001) and between RDW and MCV (r = -0.664, p &lt; 0.001). RDW showed positive correlations with RBC count (r = 0.315, p = 0.001) and ESR (r = 0.225, p = 0.041). The study confirmed RDW’s strong diagnostic value in distinguishing IDA, particularly in resource-constrained settings. Conclusion: RDW, combined with other hematological parameters, is a sensitive and reliable marker for diagnosing IDA. Its incorporation into routine diagnostic protocols could significantly enhance IDA detection and management in low-resource settings like Bangladesh.

Are Red Blood Cell Distribution Width and Platelet Count Useful for Diagnosing Periprosthetic Joint Infection in Patients Undergoing Re-Revision Arthroplasty.

Accurate and prompt identification of periprosthetic joint infections (PJIs) is critical prior to re-revision arthroplasty to ensure optimal surgical outcomes. Among routinely measured blood indices, red blood cell distribution width (RDW) and platelet count (PLT) have shown strong correlations with infection presence. This study aimed to assess the utility of RDW and PLT for diagnosing PJI in patients scheduled for re-revision arthroplasty. This retrospective research encompassed all patients who underwent re-revision hip or knee arthroplasty at our institution from 2008 to 2022. Participants were categorized into either the PJI (n = 41) or the non-PJI (n = 47) group following the guidelines established in the 2013 International Consensus Meeting on PJI. In this analysis, RDW and PLT counts were evaluated alongside conventional inflammatory markers, including C-reactive protein (CRP) and erythrocyte sedimentation rate (ESR). The efficacy of these diagnostics was evaluated by the area under the receiver operating characteristic (ROC) curve ([area under the curve AUC]). RDW demonstrated a modest AUC of 0.678 with sensitivity at 61.0% and specificity at 71.7%, using a threshold of 14.5%. PLT was on par with ESR, showing an AUC of 0.773, and both sensitivity and specificity around 73% at a threshold of 201 × 109/L. CRP presented the highest diagnostic accuracy with an AUC of 0.815, achieving a sensitivity of 82.9% and specificity of 73.9% at a 6.9 mg/L threshold, surpassing ESR's AUC of 0.754. None of the biomarkers, individually or combined, outperformed CRP alone (p > 0.05). In the context of re-revision arthroplasty, RDW and PLT demonstrate limited efficacy as diagnostic biomarkers for PJI. However, CRP retains its reliability as a biomarker when the diagnostic threshold is appropriately recalibrated.

Red cell distribution width and mean platelet volume detection in patients with endometrial cancer and endometrial hyperplasia.

Endometrial cancer is the most common malignancy in women in developed countries, and its incidence is increasing annually. Due to the availability and cost-effectiveness of serum markers of red cell distribution width (RDW), and mean platelet volume (MPV), we decided to investigate these two important markers in patients with endometrial cancer and assess their role in diagnosing the tumor and differentiate it from endometrial hyperplasia and other causes of bleeding. This is a case-control study that examined the data of patients who were referred to Al-Zahra Hospital during 2022-2023 with complaints of abnormal bleeding and underwent diagnostic curettage. Based on the pathology findings, the patients were divided into 3 groups, including endometrial cancer, endometrial hyperplasia, and control. The clinical characteristics and results of MPV and RDW were compared in these three groups. The IBM SPSS Statistics for Windows, Version 21.0. was used for data analysis. In this study, 87 women were examined in three groups endometrial cancer, endometrial hyperplasia, and control with a mean age of 52.70 ± 11.63 years. The results showed that the endometrial cancer group, had higher gravida, underlying disease, history of radiation therapy, anticoagulant therapy, blood transfusion, surgery, and family history of cancer (p < 0.05). Meanwhile, the endometrial cancer group had lower menstrual age and history of using contraceptives than other groups (p < 0.05). In addition, in this study, the results indicated that the levels of MPV and RDW in the endometrial cancer group were significantly higher than in the endometrial hyperplasia and control groups (p < 0.05). Since MPV and RDW are cheap and accessible and can be easily obtained from complete blood count panels, they can be used as suitable diagnostic markers for endometrial cancer. However, conducting comprehensive multicenter prospective studies with a larger sample size can be helpful.

Red cell distribution width and outcome in acute ischemic stroke patients

IntroductionSeveral biomarkers have proven prognostic value for acute ischemic stroke (AIS) patients. Red cell distribution width (RDW) has been associated with several diseases and all-cause mortality and suggested as an independent predictor of Ischemic Stroke severity and outcome. This study aimed to investigate RDW as an independent predictor of functional outcome and death in the 3 months following AIS. MethodsPatients with AIS were divided in four groups according to the quartile of the RDW value at admission. Baseline characteristics of patients in each RDW quartile were compared by Chi-square or Kruskal-Wallis tests, as applicable. We prospectively analyzed the patients for functional outcome in the 3 months following the event. Functional outcome (dichotomized as independent [0-2] or dependent [>2] according to the modified Rankin Scale score) and 90-day mortality was compared between the 4 groups. To conduct this evaluation, univariable and multivariable binary logistic regression analysis for functional independence and mortality at 3 months was conducted, considering the variables previously identified as potential confounders. ResultsThe study's final population was of 416 patients. The patients in higher RDW quartiles were older (p<0.001), had lower blood hemoglobin (p<0.001), higher C reactive protein levels (p=0.017), higher BNP values (p<0.001) and more frequently suffered from atrial fibrillation (p=0.015) and heart failure (p=0.004). Univariate analysis showed a negative association between RDW-Q4 and independence at 3 months (p=0.024), which wasn't verified in the multivariate analysis (p=0.871). Univariate analysis also identified a positive association between RDW-Q4 and 90-day mortality (p=0.049), which was not confirmed in the multivariate analysis (p=0.289). ConclusionsWhen adjusted to potential confounders, RDW does not predict functional outcome or death in the 90 days after acute ischemic stroke.

The effects of selenium administration on mean platelet volume, neutrophil-to-lymphocyte ratio, and red cell distribution width in critically ill older adults: A double-blinded randomized clinical trial

BackgroundLow serum Selenium (Se) levels in critical patients have been associated with poor clinical outcomes and higher mortality rates. The purpose of this study was to investigate the effect of Se administration on mean platelet volume (MPV), neutrophil-to-lymphocyte ratio (N/L), and red cell distribution width (RDW) in older adults admitted to the intensive care unit (ICU). MethodThis study was a double-blinded randomized clinical trial. Critically ill patients were randomly divided into two groups of Se and placebo. The Se group (N=30) initially received 3000 mg of Se at once within 3 hours, followed by a dose of 1500 mg daily for 10 days as a one-hour infusion. The control group (N=30) received normal saline for 10 days. A venous blood sample was collected on the first and 10th day. Statistical analysis was performed using SPSS.26 statistical software. To analyze quantitative data in two groups, based on the estimated normality, an independent t-test was used. P value less than 0.05 was considered statistically significant. ResultsOn day 10, the MPV value in the Se group was significantly lower compared to the placebo group (9.32 ± 1.78 and 10.43 ± 2.06, respectively, p = 0.03). Within the Se group, contrary to the controls, the MPV value decreased significantly from day 1 to day 10 (p<0.001). Further, the RDW value in the Se group was significantly lower compared to the placebo group (13.77 ± 1.57 and 15.32 ± 2.42, respectively, p = 0.005). The N/L ratio remained similar between the two groups before and after the intervention. ConclusionOur findings suggest that Se can affect the MPV and RDW parameters in older adults hospitalized in the ICU. However, further studies with a larger population are necessary to support these findings. Clinical Relevancy StatementThe effects of selenium administration on hematological parameters in older adults admitted to the ICU are not well-established. There is limited direct evidence linking serum selenium levels to erythrocyte and hemoglobin stability in humans. The current clinical trial promotes the current literature and shows that selenium holds potential in management of the older ICU patients.

Platelet Indices – Are They Really Biomarkers in Psoriasis? A Cross-sectional Study

Background: Psoriasis is a chronic inflammatory disorder with multiple systemic manifestations in common with other inflammatory disorders. Platelet activation has recently been proposed a major pathogenic factor in psoriasis. Mean platelet volume (MPV) and platelet distribution width (PDW) are considered platelet activation markers. Although there are various inflammatory markers reported to be abnormal in psoriasis, a simple cost-effective and clinically useful marker that could predict the severity of the disease and be used to know about its association with systemic abnormalities and response to treatment is still under study. Aim: The aim of our study was to look at the association of platelet indices with psoriasis and its severity. Methods: This was a single-center cross-sectional study in which 50 patients with psoriasis and 50 apparently healthy age and sex-matched controls who fulfilled the inclusion and exclusion criteria were enrolled after obtaining informed consent. A detailed history was elicited, and a clinical examination was done including anthropometric measurements and calculation of psoriasis area and severity index (PASI). Investigations including hemoglobin, red blood cell (RBC) count, packed cell volume (PCV), mean corpuscular volume, mean corpuscular hemoglobin (MCH), MCH concentration, white blood cell (WBC) and platelet count, plateletcrit, MPV, PDW, and red cell distribution width (RDW) were done. Results: Out of 50 psoriasis patients recruited, 40 (80%) had moderate-to-severe psoriasis, whereas 10 had mild psoriasis (10%) based on PASI scores. In majority of cases, the hemoglobin, PCV, RBC, and WBC counts were within the normal range and were comparable with that of controls. There was no statistically significant difference in the mean values of platelet count, MPV, PDW, plateletcrit, and RDW between cases and controls. There was no significant association between platelet indices and severity of psoriasis. Conclusion: There was no significant association between platelet indices including RDW and the presence or absence of psoriasis in our study. Furthermore, among patients with psoriasis, there was no significant association between platelet indices and severity of the disease.

Accuracy of the model derived from red blood cell indices in predicting α0-thalassemia trait among non-anemic pregnant women

BackgroundThe study aims to establish prediction model derived from red blood cell indices to improve the accuracy of α0-thalassemia trait screening in non-anemic pregnant women. MethodA diagnostic study as secondary analysis on the prospective database was conducted. The participants were pregnant women, undergoing α0-thalassemia screening at first visit antenatal care using red blood cell indices with confirmation by PCR method. Diagnostic performance of each of red blood cell parameter and their combination derived from logistic regression analysis in predicting α0-thalassemia trait were determined. FindingsThe total 587 Thai pregnant women were included in the analysis, consisting of 136 cases of α0-thalassemia trait and 451 normal controls. Diagnostic performance analysis revealed that, the mean corpuscular volume (MCV) provided a sensitivity of 98.5 % and a false positive rate of 20.2 %. While The mean corpuscular hemoglobin (MCH) provided a sensitivity of 99.3 % and a false positive rate of 15.7 %. The combined-parameters prediction model including hemoglobin (Hb), MCV, MCH, mean corpuscular hemoglobin concentration (MCHC), red cell distribution width (RDW), and red blood cell (RBC) count, demonstrated excellent diagnostic performance with an area under the curve (AUC) of 0.992, sensitivity of 99.3 %, and much lower false positive rate of 4 %. InterpretationThe combined-parameter prediction model provided excellent diagnostic performance with low false positive rate. The application of the prediction model could decrease unnecessary PCR method for α0-thalassemia testing, thereby decreasing the cost of investigation. Our proposed model can possibly have a great impact or significant change in clinical practice, especially in Southeast Asia.

Exploring the Gut Microbiota Landscape in Cow Milk Protein Allergy: Clinical Insights and Diagnostic Implications in Pediatric Patients

Cow milk protein allergy (CMPA) is a significant health concern characterized by adverse immune reactions to cow milk proteins. Biomarkers for the accurate diagnosis and prognosis of CMPA are lacking. This study analyzed the clinical features of CMPA, and 16S RNA sequencing was used to investigate potential biomarkers through fecal microbiota profiling. Children with CMPA exhibit a range of clinical symptoms, including gastrointestinal (83% of patients), skin (53% of patients), and respiratory manifestations (26% of patients), highlighting the complexity of this condition. Laboratory analysis revealed significant differences in red cell distribution width (RDW) and inflammatory markers between the CMPA and control groups, suggesting immune activation and inflammatory responses in CMPA. Microbial diversity analysis revealed higher specific diversity indices in the CMPA group compared with those in control group, with significant differences at the genus and species levels. Bacteroides were more abundant in the CMPA group, whereas Bifidobacterium, Ruminococcus, Faecalibacterium, and Parabacteroides were less abundant. The control group exhibited a balanced microbial profile, with a predominant presence of Bifidobacterium bifidum and Akkermansia muciniphila. The significant abundance of Bifidobacterium in the control group (23.19% vs 9.89% in CMPA) was associated with improved growth metrics such as height and weight, suggesting its potential as a probiotic to prevent CMPA and enhance gut health. Correlation analysis linked specific microbial taxa such as Coprococcus and Bifidobacterium to clinical parameters such as family allergy history, weight and height, providing insights into CMPA pathogenesis. Significant differences in bacterial abundance suggested diagnostic potential, with a panel of 6 bacteria achieving high predictive accuracy (area under curve (AUC) = 0.8708). This study emphasizes the complex relationship between the gut microbiota and CMPA, offering valuable insights into disease mechanisms and diagnostic strategies.