A R Subhashree
Professor, Department of Pathology, Sree Balaji Medical College, Bharath University , Chrompet, Chennai, India .
J Clin Diagn Res. 2014 Jun;8(6):FC01-3. doi: 10.7860/JCDR/2014/8349.4431. Epub 2014 Jun 20.
Red cell distribution width (RDW) is a red cell measurement given by fully automated hematology analyzers. It is a measure of heterogeneity in the size of circulating erythrocytes. Studies have shown that it is a prognostic marker in non - anemic diabetic patients with symptomatic cardiovascular disease but its correlation with cardiac failure in diabetics has not been studied so far. Moreover, studies have also shown that a higher RDW may reflect an underlying inflammatory state. Since Diabetes is a pro inflammatory state there is a possibility that it might have an influence on the RDW values even when there is no cardiac failure, but research data on this aspect is lacking. B-type natriuretic peptide (BNP) is a proven marker for cardiac failure whose values are comparable with echo cardio graphic findings in assessing the left ventricular dysfunction.
This study aimed to find out the correlation between RDW% and serum BNP levels in Diabetics with heart failure (cases) when compared to those without failure (controls). Further, we compared the RDW % values of the cases with controls. Settings and Design : The study was approved by institutional ethical and research committee. A cross-sectional study was conducted with patients attending the Diabetes clinic of a tertiary care hospital in Chennai, India, during the period of October to December 2013. Hundred known cases of type II Diabetes mellitus attending Diabetes centre of the Hospital, with clinical and Echo cardio graphic features of cardiac failure were included as cases. Hundred age and gender matched diabetics with negative history of cardiovascular disease and with normal Echo cardio graphic features were included as controls. Informed consent was obtained from all the cases and controls. Demographic data and clinical history were gathered from all the cases and controls by using a standardized self - administered questionnaire. Biochemical and hematological parameters which included Fasting and Postprandial blood sugar, Glycosylated hemoglobin, Complete Blood count including RDW and serum BNP were performed for all the cases and controls.
RESULTS were tabulated and analysed using SPSS 20.0 version
A statistically significant correlation (p<.001) was found between Red cell Distribution Width % and Serum B type Natriuretic Peptide values in the cases. Further, RDW% showed a statistically significant difference between cases and controls.
RDW% can be used as a screening parameter to identify cardiac failure in Diabetic patients similar to non-diabetic cardiac failure. RDW% values are significantly higher in cases of Diabetes with failure in comparison to uncomplicated Diabetes.
红细胞分布宽度（RDW）是全自动血液分析仪给出的一项红细胞测量指标。它是循环红细胞大小异质性的一种度量。研究表明，它是有症状心血管疾病的非贫血糖尿病患者的一项预后标志物，但迄今为止其与糖尿病患者心力衰竭的相关性尚未得到研究。此外，研究还表明，较高的RDW可能反映潜在的炎症状态。由于糖尿病是一种促炎状态，即使没有心力衰竭，它也有可能对RDW值产生影响，但这方面的研究数据尚缺。B型利钠肽（BNP）是已被证实的心力衰竭标志物，其在评估左心室功能障碍方面的值与超声心动图检查结果相当。
本研究旨在找出心力衰竭糖尿病患者（病例组）与无心力衰竭糖尿病患者（对照组）的RDW%与血清BNP水平之间的相关性。此外，我们比较了病例组与对照组的RDW%值。设置与设计：本研究经机构伦理与研究委员会批准。于2013年10月至12月期间，对印度钦奈一家三级护理医院糖尿病门诊的患者进行了一项横断面研究。将100例到医院糖尿病中心就诊的已知II型糖尿病患者纳入病例组，这些患者具有心力衰竭的临床和超声心动图特征。将100例年龄和性别匹配、无心血管疾病病史且超声心动图特征正常的糖尿病患者纳入对照组。所有病例组和对照组均获得了知情同意。通过使用标准化的自填问卷，收集了所有病例组和对照组的人口统计学数据和临床病史。对所有病例组和对照组进行了生化和血液学参数检测，包括空腹和餐后血糖、糖化血红蛋白、全血细胞计数（包括RDW）和血清BNP。
结果进行列表整理，并使用SPSS 20.0版本进行分析。
病例组中红细胞分布宽度%与血清B型利钠肽值之间存在显著的统计学相关性（p<0.001）。此外，病例组与对照组之间的RDW%存在显著的统计学差异。
RDW%可作为一项筛查参数，用于识别糖尿病患者的心力衰竭，类似于非糖尿病性心力衰竭。与无并发症糖尿病患者相比，伴有心力衰竭的糖尿病患者RDW%值显著更高。
