Zinellu Angelo, Mangoni Arduino A
Department of Biomedical Sciences, University of Sassari, 07100 Sassari, Italy.
Discipline of Clinical Pharmacology, College of Medicine and Public Health, Flinders University, Sturt Road, Bedford Park, SA 5042, Australia.
Diagnostics (Basel). 2022 Oct 30;12(11):2633. doi: 10.3390/diagnostics12112633.
Alterations in the volume of platelets (mean platelet volume, MPV; platelet distribution width, PDW) and erythrocytes (red blood cell distribution width, RDW) have been reported in rheumatoid arthritis (RA) and might serve as diagnostic biomarkers. We conducted a systematic review and meta-analysis of the MPV, PDW, and RDW in RA patients and healthy controls. Relevant articles were searched in PubMed, Web of Science, Scopus, and Google Scholar from inception to June 2022. Risk of bias was assessed using the Joanna Briggs Institute Critical Appraisal Checklist and certainty of evidence was assessed using GRADE. In 23 studies (2194 RA patients and 1565 healthy controls), the RDW, but not MPV or PDW, was significantly higher in RA patients (standardized mean difference, SMD = 0.96, 95% CI 0.78 to 1.15, p < 0.001; moderate certainty of evidence). The substantial heterogeneity observed (I2 = 75.1%, p < 0.001) was virtually removed in a subgroup of prospective studies. In sensitivity analysis, the magnitude of the effect size was not substantially modified by sequentially removing individual studies. There was no significant publication bias. No significant associations were observed between the effect size and pre-defined study or patient characteristics. The results of our study suggest that the RDW might be a useful biomarker for the diagnosis of RA, and complement the clinical information provided by other patient characteristics and laboratory parameters (PROSPERO registration number: CRD42022349432).
类风湿关节炎（RA）患者的血小板体积（平均血小板体积，MPV；血小板分布宽度，PDW）和红细胞体积（红细胞分布宽度，RDW）已被报道发生改变，这些指标可能作为诊断生物标志物。我们对RA患者和健康对照者的MPV、PDW和RDW进行了系统评价和荟萃分析。从数据库建库至2022年6月，在PubMed、Web of Science、Scopus和谷歌学术中检索相关文章。使用乔安娜·布里格斯研究所批判性评价清单评估偏倚风险，使用GRADE评估证据的确定性。在23项研究（2194例RA患者和1565例健康对照者）中，RA患者的RDW显著高于健康对照者，而MPV和PDW无显著差异（标准化均数差，SMD = 0.96，95%CI 0.78至1.15，p < 0.001；证据确定性为中等）。在前瞻性研究亚组中，观察到的显著异质性（I2 = 75.1%，p < 0.001）几乎被消除。在敏感性分析中，依次剔除个别研究后，效应量大小未发生实质性改变。未观察到显著的发表偏倚。效应量与预先定义的研究或患者特征之间未观察到显著关联。我们的研究结果表明，RDW可能是诊断RA的有用生物标志物，并可补充其他患者特征和实验室参数提供的临床信息（国际前瞻性系统评价注册库注册号：CRD42022349432）。
