Sun Xiaodong, Liu Yang, Liu Yanyan, Wang Hui, Liu Bo, Shi Lin
Capital Institute of Pediatrics, Beijing, China.
Department of Cardiology, Children's Hospital, Capital Institute of Pediatrics, Beijing, China.
Front Pediatr. 2023 Feb 2;11:1088535. doi: 10.3389/fped.2023.1088535. eCollection 2023.
Left ventricular hypertrophy (LVH) is one of the most common types of target organ damage in hypertension. The red blood cell distribution width (RDW) is closely related to many cardiovascular diseases, including hypertension. The aim of this study was to analyze the relationship between the RDW level and LVH in pediatric essential hypertension.
A total of 429 untreated children and adolescents with essential hypertension were recruited and divided into an LVH group ( = 114) and non-LVH group ( = 315) according to left ventricular mass index (LVMI) and relative wall thickness (RWT) by color Doppler ultrasound. Spearman correlation analysis was used to determine the relationship between RDW and LVMI, RWT. The effect of RDW on LVH was determined using a multivariate logistic regression analysis. To assess the predictive value of RDW on LVH, the receiver operating characteristic (ROC) curve was used.
The level of RDW in children with hypertension in the LVH group was significantly higher than that in the non-LVH group (13.0 [12.0, 13.0] vs. 12.4 [12.0, 13.0] %, = 0.001). The incidence of low and high quantiles of LVH was 21.0% and 32.0%, respectively. Spearman correlation analysis showed that RDW was positively correlated with C-reactive protein (CRP), LVMI, RWT, and red blood cell (RBC) count ( all < 0.05), and negatively correlated with hemoglobin (HGB) level, mean corpuscular volume (MCV), mean corpuscular hemoglobin (MCH), and mean corpuscular hemoglobin concentration (MCHC) ( all < 0.05). After adjusting for various confounding factors, a multivariate logistic regression model revealed that RDW was an independent risk factor for LVH (OR = 1.946, 95% CI: 1.324-2.861, = 0.001). The area under the ROC curve of RDW predicting centripetal hypertrophy was 0.700 (95% CI: 0.541-0.859, < 0.05) in pediatric essential hypertension.
Increased RDW levels are an independent risk factor for LVH in pediatric essential hypertension, and RDW may be a predictor of LVH in untreated pediatric essential hypertension.
左心室肥厚（LVH）是高血压最常见的靶器官损害类型之一。红细胞分布宽度（RDW）与包括高血压在内的多种心血管疾病密切相关。本研究旨在分析小儿原发性高血压中RDW水平与LVH之间的关系。
共纳入429例未经治疗的小儿原发性高血压患者，根据彩色多普勒超声测得的左心室质量指数（LVMI）和相对室壁厚度（RWT）分为LVH组（n = 114）和非LVH组（n = 315）。采用Spearman相关性分析确定RDW与LVMI、RWT之间的关系。使用多因素logistic回归分析确定RDW对LVH的影响。为评估RDW对LVH的预测价值，采用受试者工作特征（ROC）曲线。
LVH组高血压患儿的RDW水平显著高于非LVH组（13.0 [12.0, 13.0]% 对 12.4 [12.0, 13.0]%，P = 0.001）。LVH低、高分位数的发生率分别为21.0%和32.0%。Spearman相关性分析显示，RDW与C反应蛋白（CRP）、LVMI、RWT和红细胞（RBC）计数呈正相关（均P < 0.05），与血红蛋白（HGB）水平、平均红细胞体积（MCV）、平均红细胞血红蛋白（MCH）和平均红细胞血红蛋白浓度（MCHC）呈负相关（均P < 0.05）。在调整各种混杂因素后，多因素logistic回归模型显示RDW是LVH的独立危险因素（OR = 1.946，95%CI：1.324 - 2.861，P = 0.001）。在小儿原发性高血压中，RDW预测向心性肥厚的ROC曲线下面积为0.700（95%CI：0.541 - 0.859，P < 0.05）。
RDW水平升高是小儿原发性高血压LVH的独立危险因素，且RDW可能是未经治疗的小儿原发性高血压LVH的预测指标。
