title: Association between red cell distribution width and disease activity in patients with inflammatory bowel disease.
abstract: BACKGROUND
  Recent studies have suggested that a higher red blood cell distribution width (RDW) is associated with disease activity in patients with inflammatory bowel disease (IBD). However, the RDW in IBD patients without anemia has not been investigated.
  
  
  OBJECTIVE
  This study aimed to determine whether or not RDW could be used for the assessment of disease activity in IBD patients with and without anemia.
  
  
  METHODS
  The serum C-reactive protein (CRP) level, erythrocyte sedimentation rate (ESR), hemoglobin concentration, platelet and white blood cell counts, and RDW were assessed in 221 IBD patients, comprised of 120 patients with ulcerative colitis (UC) and 101 patients with Crohn's disease (CD). Disease activity was determined for UC and CD with the Mayo score and the Crohn's disease activity index, respectively.
  
  
  RESULTS
  The CRP level, ESR, hemoglobin concentration, hematocrit, and RDW increased according to disease activity in patients with and without anemia (all P < 0.05). Multivariate analysis demonstrated that RDW was the best independent indicator for predicting disease activity in CD patients without anemia [odd ratios (OR), 1.702; 95% confidence interval (CI), 1.185-2.445; P = 0.004] and UC patients without anemia (OR, 4.921; 95% CI, 2.281-10.615; P < 0.001). Also, ROC curve analysis showed the RDW to be the most significant indicator of non-anemic active IBD [area under curve (AUC) in CD, 0.852, P < 0.001; AUC in UC, 0.827, P < 0.001].
  
  
  CONCLUSIONS
  The association between increased RDW and active IBD was evident in IBD patients with and without anemia.
authors.affiliation: Department of Internal Medicine, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, 108, Pyung-Dong, Jongro-Ku, Seoul 110-746, Korea. md.song@samsung.com
authors.forename: Chang Seok
authors.initials: CS
authors.lastname: Song
authors.forename: Dong Il
authors.initials: DI
authors.lastname: Park
authors.forename: Min Yong
authors.initials: MY
authors.lastname: Yoon
authors.forename: Hyo Sun
authors.initials: HS
authors.lastname: Seok
authors.forename: Jung Ho
authors.initials: JH
authors.lastname: Park
authors.forename: Hong Joo
authors.initials: HJ
authors.lastname: Kim
authors.forename: Yong Kyun
authors.initials: YK
authors.lastname: Cho
authors.forename: Chong Il
authors.initials: CI
authors.lastname: Sohn
authors.forename: Woo Kyu
authors.initials: WK
authors.lastname: Jeon
authors.forename: Byung Ik
authors.initials: BI
authors.lastname: Kim
mesh_terms: D000328:Adult; D000740:Anemia / Q000150:complications; D015415:Biomarkers / Q000097:blood; D001799:Blood Sedimentation; D002097:C-Reactive Protein / Q000032:analysis; D003093:Colitis, Ulcerative / Q000097:blood* / Q000150:complications / Q000473:pathology; D003424:Crohn Disease / Q000097:blood* / Q000150:complications / Q000473:pathology; D004909:Erythrocyte Indices; D005260:Female; D006454:Hemoglobins / Q000032:analysis; D006801:Humans; D007249:Inflammation; D007958:Leukocyte Count; D008297:Male; D008875:Middle Aged; D012680:Sensitivity and Specificity
chemical_list: D015415:Biomarkers; D006454:Hemoglobins; D002097:C-Reactive Protein