International Journal of Pediatrics

Current Issue

By Issue

By Author

By Subject

Author Index

Keyword Index

About Journal

Aims and Scope

Editorial Board

Publication Ethics

Indexing and Abstracting

Related Links

FAQ

Peer Review Process

News

The Association between Red Blood Cell Distribution Width and Metabolic Syndrome in Adolescent Girls

Document Type : original article

Authors

1 Department of medical genetic and molecular medicine, faculty of medicine, mashhad university of medical sciences

2 Department of Anesthesiology, Faculty of Medicine, Sabzevar University of Medical Sciences, Sabzevar, Iran.

3 Antimicrobial Resistance Research Center, Mashhad University of Medical Sciences, Mashhad, Iran

4 Metabolic syndrome Research center, Mashhad University of Medical Sciences, Mashhad, Iran

5 Clinical Nutrition Department, School of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran

6 Student Research Committee, Mashhad University of Medical Sciences, Mashhad, Iran

7 Metabolic Syndrome Research Center, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran

8 Department of Medical Biochemistry, School of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran

9 Department of Physiology & Pharmacology, Cellular and Molecular Research Center, Sabzevar University of Medical Sciences, Sabzevar, Iran

10 Brighton & Sussex Medical School, Division of Medical Education, Falmer, Brighton, Sussex BN1 9PH, UK

11 Director of Department of New Sciences and Technology, Founding Member of Cardiovascular Research Center, Faculty of Medicine, Mashhad University of Medical Sciences,Mashhad, Iran.

Abstract

Background: Metabolic syndrome (MetS) is characterized by metabolic and anthropometric abnormalities which are associated with an increased risk of cardiovascular disease (CVD). Red blood cell distribution width is a candidate biomarker for CVD.
Method: Nine hundred and eighty-eight girls who were between 12 to 18 years old were enrolled. Anthropometric parameters and blood pressure were measured, together with biochemical and hematological variables, using routine measures. International diabetes federation (IDF) criteria were used for the diagnosis of MetS.
Result: Some of the demographic parameters such as weight, neck circumference (NC), waist circumference (WC) and hip circumference (HP) were significantly different between the groups with and without MetS, as may be expected. Significantly higher values for red blood cell distribution width (RDW) were observed only in subjects with waist circumference (P= 0.017) and fasting blood glucose levels (P= 0.038). RDW measures were directly associated with MetS status (r=0.076 (P =0.043)), WC (r=0.097 (P =0.016)), and fasting blood glucose (FBG) (r= -0.085 (P =0.037)). It was found that the RDW had specificity and sensitivity for MetS-based IDF criteria 48.01 and 77.78, respectively. RDW related cure area (95% CI) for MetS was reported to be 0.588 (0.380- 0.796).
Conclusion: We found that an elevated RDW was associated with the presence of MetS and with some its components; but ROC analysis revealed that a weak specificity in spite of good sensitivity of RDW for MetS, along with a low AUC may make it unusable for the diagnostic prediction of MetS in this population.

Keywords

References
  1. Arbel Y, Eros Y, Rogowski O, Berliner S, Shapira I, Keren G, Vered Y, Banai S. Comparison of values of wide-range C-reactive protein to high-sensitivity C-reactive protein in patients undergoing coronary angiography. Am J Cardiol. 2007; 99(11):1504-6.
  2. Katzmarzyk PT, Church TS, Janssen I, Ross R, Blair SN. Metabolic syndrome, obesity, and mortality: impact of cardiorespiratory fitness. Diabetes Care. 2005; 28(2):391-7.
  3. Fazeli M, Mohammad-Zadeh M, Meshkat Z, Ghazizadeh H, Barati E, Ferns GA, et al. Metabolic Syndrome in Children and Adolescents: Looking to New Markers. Current Treatment Options in Pediatrics. 2021; 7(3):152-66.
  4. Expert Panel on Detection E. Executive summary of the Third Report of the National Cholesterol Education Program (NCEP) expert panel on detection, evaluation, and treatment of high blood cholesterol in adults (Adult Treatment Panel III). Jama. 2001; 285(19):2486.
  5. Arbel Y, Weitzman D, Raz R, Steinvil A, Zeltser D, Berliner S, Chodick G, Shalev V. Red blood cell distribution width and the risk of cardiovascular morbidity and all-cause mortality. A population-based study. Thromb Haemost. 2014; 111(2):300-7.
  6. Cavusoglu E, Chopra V, Gupta A, Battala VR, Poludasu S, Eng C, Marmur JD. Relation between red blood cell distribution width (RDW) and all-cause mortality at two years in an unselected population referred for coronary angiography. Int J Cardiol. 2010; 141(2):141-6.
  7. Inuzuka R, Abe J. Red blood cell distribution width as a link between ineffective erythropoiesis and chronic inflammation in heart failure. Circulation journal: official journal of the Japanese Circulation Society. 2015(0).
  8. Özden K, Yaman AE. The Association of High Red Blood Cell Distribution Width with Metabolic Syndrome in Stable Coronary Artery Disease. The Medical Journal of Haydarpaşa Numune Training and Research Hospital. 2020; 60(2):123-8.
  9. Pierce CN, Larson DF. Inflammatory cytokine inhibition of erythropoiesis in patients implanted with a mechanical circulatory assist device. Perfusion. 2005; 20(2):83-90.
  10. Lippi G, Targher G, Montagnana M, Salvagno GL, Zoppini G, Guidi GC. Relation between red blood cell distribution width and inflammatory biomarkers in a large cohort of unselected outpatients. Arch Pathol Lab Med. 2009; 133(4):628-32.
  11. Assessment CR. Higher red blood cell distribution width is associated with metabolic syndrome. 2010.
  12. Forhecz Z, Gombos T, Borgulya G, Pozsonyi Z, Prohaszka Z, Janoskuti L. Red cell distribution width in heart failure: prediction of clinical events and relationship with markers of ineffective erythropoiesis, inflammation, renal function, and nutritional state. Am Heart J. 2009; 158(4):659-66.
  13. Lee WS, Kim T. Relation between red blood cell distribution width and inflammatory biomarkers in rheumatoid arthritis. Arch Pathol Lab Med. 2010; 134(4):505-6.
  14. Fazeli M, Mohammad-Zadeh M, Darroudi S, Meshkat Z, Moslem A, Ghazizadeh H, Kargozar S, Ferns G, Bahrami-Taghanaki H, Ghayour-Mobarhan M. New anthropometric indices in the definition of metabolic syndrome in pediatrics. Diabetes & Metabolic Syndrome: Clinical Research & Reviews. 2019; 13(3):1779-84.
  15. Fazeli M, Mohammad-Zadeh M, Meshkat Z, Ferns G, Bahrami-Taghanaki H, Ghayour-Mobarhan M. Evaluation of Neck Circumference as Potential Marker for Metabolic Syndrome in Children. International Journal of Pediatrics. 2021; 9(6):13865-74.
  16. Zimmet P, Alberti KGMM, Kaufman F, Tajima N, Silink M, Arslanian S, Wong G, Bennett P, Shaw J, Caprio S; IDF Consensus Group. The metabolic syndrome in children and adolescents – an IDF consensus report. Pediatric Diabetes. 2007; 8(5):299-306.
  17. Ghazizadeh H, Bohn MK, Polus RK, Abdulkarimi R, Mahdavizadeh V, Zirak RG, et al. Comprehensive hematological reference intervals in a healthy adult male population. Cellular and Molecular Biology. 2020; 66(2):99-104.

 

Kamel Khodabandeh A, Zare-Feyzabadi R, Timar A, Mohammadi-Bajgiran M, Reza Oladi M, Esmaily H, Sharifan P, Sahranavard T, Kazemi E, Ekhteraee Toosi MS, Taghizadeh N, Najar Sedgh Doust F, Ferns GA, Adeli K, Ghayour-Mobarhan M

  1. Laufer Perl M, Havakuk O, Finkelstein A, Halkin A, Revivo M, Elbaz M, Herz I, Keren G, Banai S, Arbel Y. High red blood cell distribution width is associated with metabolic syndrome. Clin Hemorheol Microcirc. 2015; 63(1):35-43.
  2. Ani C, Ovbiagele B. Elevated red blood cell distribution width predicts mortality in persons with known stroke. J Neurol Sci. 2009; 277(1-2):103-8.
  3. Arbel Y, Birati EY, Finkelstein A, Halkin A, Berliner S, Katz BZ, Revivo M, Saranga H, Herz I, Keren G, Banai S. Red blood cell distribution width and 3-year outcome in patients undergoing cardiac catheterization. J Thromb Thrombolysis. 2014; 37(4):469-74.
  4. Felker GM, Allen LA, Pocock SJ, Shaw LK, McMurray JJ, Pfeffer MA, Swedberg K, Wang D, Yusuf S, Michelson EL, Granger CB, CHARM Investigators. Red cell distribution width as a novel prognostic marker in heart failure: data from the CHARM Program and the Duke Databank. J Am Coll Cardiol. 2007; 50(1):40-7.
  5. Fujita B, Strodthoff D, Fritzenwanger M, Pfeil A, Ferrari M, Goebel B, Figulla HR, Gerdes N, Jung C. Altered red blood cell distribution width in overweight adolescents and its association with markers of inflammation. Pediatr Obes. 2013; 8(5):385-91.
  6. Lappegard J, Ellingsen TS, Vik A, Skjelbakken T, Brox J, Mathiesen EB, Harald Johnsen S, Brækkan SK, Hansen JB. Red cell distribution width and carotid atherosclerosis progression. The Tromso Study. Thromb Haemost. 2015; 113(3):649-54.
  7. Monteiro R, Azevedo I. Chronic Inflammation in Obesity and Metabolic Syndrome. Mediators of Inflammation. 2010; 2010:289645.
  8. Grundy SM, Brewer HB, Cleeman JI, Smith SC, Lenfant C. Definition of metabolic syndrome. Circulation. 2004; 109(3):433-8.
  9. Williams L. Third report of the National Cholesterol Education Program (NCEP) expert panel on detection, evaluation, and treatment of high blood cholesterol in adults (Adult Treatment Panel III) final report. Circulation. 2002; 106(25):3143-.
  10. Alberti KG, Eckel RH, Grundy SM, Zimmet PZ, Cleeman JI, Donato KA, Fruchart JC, James WPT, Loria CM, Smith Jr SC; International Diabetes Federation Task Force on Epidemiology and Prevention; Hational Heart, Lung, and Blood Institute; American Heart Association; World Heart Federation; International Atherosclerosis Society; International Association for the Study of Obesity. Harmonizing the metabolic syndrome: a joint interim statement of the International Diabetes Federation Task Force on Epidemiology and Prevention; National Heart, Lung, and Blood Institute; American Heart Association; World Heart Federation; International Atherosclerosis Society; and International Association for the Study of Obesity. Circulation. 2009; 120(16):1640-5.
  11. Grundy SM, Cleeman JI, Daniels SR, Donato KA, Eckel RH, Franklin BA, Gordon DJ, Krauss RM, Savage PJ, Smith Jr SC, Spertus JA, Costa F; American Heart Association; National Heart, Lung, and Blood Institute. Diagnosis and management of the metabolic syndrome. Circulation. 2005; 112(17):2735-52.
  12. Wiewiora M, Slowinska-Lozynska L, Glück M, Piecuch J, Sosada K, Monkos K. Association between hemorheological alteration and clinical diagnosis of metabolic syndrome among patients qualified for bariatric surgery. Clin Hemorheol Microcirc 2014; 56(2):101-9.
  13. Ozcan F, Turak O, Durak A, Isleyen A, Ucar F, Ginis Z, Uçar F, Başar FN, Aydoğdu. Red cell distribution width and inflammation in patients with non-dipper hypertension. Blood Press. 2013; 22(2):80-5.
  14. Tsuboi S, Miyauchi K, Kasai T, Ogita M, Dohi T, Miyazaki T, Yokoyama T, Kojima T, Yokoyama K, Kurata T, Daida H. Impact of red blood cell distribution width on long-term mortality in diabetic patients after percutaneous coronary intervention. Circulation journal: official journal of the Japanese Circulation Society. 2013; 77(2):456-61.
  15. Zhang Z, Zhou W, Wu S, Yang J, Peng Y, Xiang J, Chen C, Tu J. The relationship between red blood cell distribution width and metabolic syndrome in patients with impaired glucose tolerance. Journal of Chinese Physician. 2021:525-8.
  16. Yan Z, Fan Y, Meng Z, Huang C, Liu M, Zhang Q. The relationship between red blood cell distribution width and metabolic syndrome in elderly Chinese: a cross-sectional study. Lipids in health and disease. 2019; 18(1):1-9.
  17. Huang LL, Dou D-M, Liu N, Wang XX, Fu L-Y, Wu X, Wang P. Association of erythrocyte parameters with metabolic syndrome in the Pearl River Delta region of China: a cross sectional study. BMJ open. 2018; 8(1):e019792.
  18. Vaya A, Alis R, Suescun M, Rivera L, Murado J, Romagnoli M, Solá E, Hernandez-Mijares A. Association of erythrocyte deformability with red blood cell distribution width in metabolic diseases and thalassemia trait. Clin Hemorheol Microcirc. 2015; 61(3):407-15.
  19. Tsuda K, Kinoshita Y, Nishio I, Masuyama Y. Hyperinsulinemia is a determinant of membrane fluidity of erythrocytes in essential hypertension. American journal of hypertension. 2001; 14(5 Pt 1):419-23.
  20. Sanchez-Chaparro MA, Calvo-Bonacho E, Gonzalez-Quintela A, Cabrera M, Sainz JC, Fernandez-Labandera C, Aguado LQ, Meseguer AF, Valdivielso P, Román-García J; Ibermutuamur CArdiovascular RIsk Assessment Study Group. Higher red blood cell distribution width is associated with the metabolic syndrome: results of the Ibermutuamur CArdiovascular RIsk assessment study. Diabetes Care. 2010; 33(3):e40.
  21. Arbel Y, Havakuk O, Halkin A, Revivo M, Berliner S, Herz I, Weiss-Meilik A, Sagy Y, Keren G, Finkelstein A, Banai S. Relation of metabolic syndrome with long-term mortality in acute and stable coronary disease. Am J Cardiol. 2015; 115(3):283-7.
  22. Hoffmann R, Stellbrink E, Schröder J, Grawe A, Vogel G, Blindt R, Kelm M, Radke PW. Impact of the metabolic syndrome on angiographic and clinical events after coronary intervention using bare-metal or sirolimus-eluting stents. Am J Cardiol 2007; 100(9):1347-52.
  23. Uchida Y, Ichimiya S, Ishii H, Kanashiro M, Watanabe J, Yoshikawa D, Takeshita K, Sakai S, Amano T, Matsubara T, Murohara T. Impact of metabolic syndrome on various aspects of microcirculation and major adverse cardiac events in patients with ST-segment elevation myocardial infarction. Circulation journal: official journal of the Japanese Circulation Society. 2012; 76(8):1972-9.
  24. Marso SP, Mercado N, Maehara A, Weisz G, Mintz GS, McPherson J, Schiele F, Dudek D, Fahy M, Xu K, Lansky A, Templin B, Zhang Z, Bruyne BD, Serruys PW, Stone GW. Plaque composition and clinical outcomes in acute coronary syndrome patients with metabolic syndrome or diabetes. JACC Cardiovascular imaging. 2012; 5(3 Suppl):S42-52.
  25. Wen Y. High red blood cell distribution width is closely associated with risk of carotid artery atherosclerosis in patients with hypertension. Exp Clin Cardiol. 2010; 15(3):37.
International Journal of Pediatrics
Volume 11, Issue 2
February 2023
Pages 17416-17427
Files
Share
How to cite
Statistics