Department of Endocrinology, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan, Shandong, China.
Shandong Key Laboratory of Endocrinology and Lipid Metabolism, Jinan, Shandong, China.
Cell Biol Int. 2023 Jul;47(7):1161-1169. doi: 10.1002/cbin.12029. Epub 2023 Apr 24.
Many indicators, including red cell distribution width (RDW) and iron metabolism, are sensitive to a variety of risk factors, and are associated with the pathological alterations and disease onset. RDW reflects the degree of heterogeneous volumes of peripheral red blood cells (RBCs). It has been well-known that increased RDW indicates iron deficiency anemia, hemolytic anemia, ineffective erythropoiesis, and shorten lifespan of RBCs. Increased RDW is also prevalent in various non-anemic pathological conditions and diseases. We here review the factors affecting RDW, particularly disordered iron metabolism, chronic inflammation, and oxidative stress, and recapitulate the interplays among these factors. Furthermore, we review the application of increased RDW together with disordered iron homeostasis and the deregulations of hepcidin expression and ferritin levels in the diagnoses and prognosis of anemic and nonanemic diseases. RDW is inexpensive and readily available and may be valuable in adding to the diagnosis and monitoring of many pathological conditions. RDW combined with other indicators, for example, hepcidin and ferritin levels, should be utilized more frequently in clinical practice.
许多指标，包括红细胞分布宽度（RDW）和铁代谢，对各种危险因素敏感，与病理改变和疾病发生有关。RDW 反映外周血红细胞（RBC）体积的异质性程度。众所周知，RDW 增加表明缺铁性贫血、溶血性贫血、无效性红细胞生成和 RBC 寿命缩短。RDW 增加也常见于各种非贫血性病理状况和疾病中。我们在此回顾了影响 RDW 的因素，特别是铁代谢紊乱、慢性炎症和氧化应激，并总结了这些因素之间的相互作用。此外，我们还回顾了 RDW 增加与铁稳态紊乱、hepcidin 表达和铁蛋白水平失调在贫血和非贫血性疾病诊断和预后中的应用。RDW 价格低廉，易于获得，可能对许多病理状况的诊断和监测具有重要价值。RDW 应与其他指标（例如 hepcidin 和铁蛋白水平）联合使用，以更频繁地应用于临床实践中。
