title: Association of the red cell distribution width with red blood cell deformability.
abstract: The red cell distribution width (RDW) is a component of the automated complete blood count (CBC) that quantifies heterogeneity in the size of circulating erythrocytes. Higher RDW values reflect greater variation in red blood cell (RBC) volumes and are associated with increased risk for cardiovascular disease (CVD) events. The mechanisms underlying this association are unclear, but RBC deformability might play a role. CBCs were assessed in 293 adults who were clinically examined. RBC deformability (expressed as the elongation index) was measured using a microfluidic slit-flow ektacytometer. Multivariate regression analysis identified a clear threshold effect whereby RDW values above 14.0% were significantly associated with decreased RBC deformability (β = -0.24; p = 0.003). This association was stronger after excluding anemic participants (β = -0.40; p = 0.008). Greater variation in RBC volumes (increased RDW) is associated with decreased RBC deformability, which can impair blood flow through the microcirculation. The resultant hypoxia may help to explain the previously reported increased risk for CVD events associated with elevated RDW.
authors.affiliation: Laboratory of Epidemiology, Demography, and Biometry, National Institute on Aging/NIH, 7201 Wisconsin Ave, Suite 3C309, Gateway Building, Bethesda, MD, 20814, USA. patelku@mail.nih.gov.
authors.forename: Kushang V
authors.initials: KV
authors.lastname: Patel
authors.affiliation: Molecular Dynamics Section, National Institute on Aging/NIH, Bethesda, MD, USA.
authors.forename: Joy G
authors.initials: JG
authors.lastname: Mohanty
authors.affiliation: Clinical Research Branch, National Institute on Aging/NIH, Bethesda, MD, USA.
authors.forename: Bindu
authors.initials: B
authors.lastname: Kanapuru
authors.affiliation: Clinical Research Branch, National Institute on Aging/NIH, Bethesda, MD, USA.
authors.forename: Charles
authors.initials: C
authors.lastname: Hesdorffer
authors.affiliation: Institute for Advanced Studies in Aging, Gaithersburg, MD, USA.
authors.forename: William B
authors.initials: WB
authors.lastname: Ershler
authors.affiliation: Molecular Dynamics Section, National Institute on Aging/NIH, Bethesda, MD, USA.
authors.forename: Joseph M
authors.initials: JM
authors.lastname: Rifkind
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000375:Aging / Q000473:pathology*; D002318:Cardiovascular Diseases / Q000209:etiology / Q000401:mortality / Q000473:pathology*; D048429:Cell Size; D004909:Erythrocyte Indices; D004912:Erythrocytes / Q000473:pathology*; D005260:Female; D006801:Humans; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D012307:Risk Factors; D015996:Survival Rate