Department of Coronary Disease and Heart Failure, Institute of Cardiology, Jagiellonian University Medical College, John Paul II Hospital, Kraków, Poland
Department of Cardiology, School of Health Sciences, Medical University of Silesia, Katowice, Poland
Kardiol Pol. 2020 May 25;78(5):420-428. doi: 10.33963/KP.15257. Epub 2020 Mar 24.
Previous studies have shown that red blood cell distribution width (RDW) is an independent predictor of poor prognosis in type 2 diabetes (T2D) and atherosclerotic cardiovascular disease (ASCVD). The mechanisms underlying increased anisocytosis in patients with T2D and confirmed ASCVD remain poorly understood.
We sought to evaluate the relationship among the leptin-to-adiponectin ratio, systemic low -grade inflammation, and RDW in optimally treated patients with T2D and established ASCVD.
A total of 68 patients, aged 47 to 85 years (mean [SD], 65.3 [6.8] years) and including 21 women (30.9%), were enrolled and grouped according to median RDW into those with RDW <13.5% (n = 33) and those with RDW ≥13.5% (n = 35).
Patients with RDW ≥13.5% had a significantly higher median (interquartile range [IQR]) serum leptin-to-adiponectin ratio (1.7 [0.49-2.3] ng/μg vs 0.66 [0.31-1.25] ng/μg; P = 0.04) and median (IQR) tumor necrosis factor α levels (1.58 [1.42-1.97] pg/ml vs 1.39 [1.18-1.57] pg/ml; P = 0.02). There were no significant differences in the concentrations of other inflammatory markers. The leptin-to-adiponectin ratio (r = 0.25; P = 0.04) and levels of tumor necrosis factor α (r = 0.32; P = 0.01) and soluble intercellular adhesion molecule 1 (r = 0.31; P = 0.01) were positively correlated with RDW, which was confirmed by univariate linear regression analysis. A multivariable regression model, which included demographic, clinical, and laboratory data, showed that white blood cell count (β = 0.25; 95% CI, 0.05-0.45; P = 0.01), soluble intercellular adhesion molecule 1 levels (β = 0.21; 95% CI, 0.02-0.41; P = 0.03), and mean corpuscular hemoglobin concentration (MCHC), (β = -0.48; 95% CI, 0.67 to -0.28; P < 0.001) were independent predictors of RDW in our patients.
In well-controlled patients with T2D and ASCVD, the RDW values are associated with leptin-to-adiponectin imbalance and selected inflammatory markers.
先前的研究表明，红细胞分布宽度（RDW）是 2 型糖尿病（T2D）和动脉粥样硬化性心血管疾病（ASCVD）不良预后的独立预测因子。T2D 患者红细胞体积分布异质性增加的机制仍知之甚少，并已确诊 ASCVD。
我们旨在评估最佳治疗的 T2D 合并已确诊 ASCVD 患者中瘦素与脂联素比值、全身低度炎症与 RDW 之间的关系。
共纳入 68 例年龄 47 至 85 岁（平均[标准差]65.3[6.8]岁）的患者，包括 21 名女性（30.9%），根据 RDW 的中位数将其分为 RDW＜13.5%（n=33）和 RDW≥13.5%（n=35）。
RDW≥13.5%的患者血清瘦素与脂联素比值（中位数[四分位距]：1.7[0.49-2.3]ng/μg比 0.66[0.31-1.25]ng/μg；P=0.04）和肿瘤坏死因子-α水平（中位数[四分位距]：1.58[1.42-1.97]pg/ml比 1.39[1.18-1.57]pg/ml；P=0.02）明显更高。其他炎症标志物的浓度无显著差异。瘦素与脂联素比值（r=0.25；P=0.04）和肿瘤坏死因子-α（r=0.32；P=0.01）和可溶性细胞间黏附分子 1（r=0.31；P=0.01）与 RDW 呈正相关，这在单变量线性回归分析中得到了证实。一个包含人口统计学、临床和实验室数据的多变量回归模型显示，白细胞计数（β=0.25；95%置信区间，0.05-0.45；P=0.01）、可溶性细胞间黏附分子 1 水平（β=0.21；95%置信区间，0.02-0.41；P=0.03）和平均红细胞血红蛋白浓度（MCHC）（β=-0.48；95%置信区间，0.67-0.28；P＜0.001）是我们患者 RDW 的独立预测因子。
在 T2D 和 ASCVD 得到良好控制的患者中，RDW 值与瘦素与脂联素失衡和选定的炎症标志物有关。
