title: Is increased red cell distribution width an indicating marker of nonalcoholic steatohepatitis and fibrotic stage?
abstract: OBJECTIVE
  To evaluate the red cell distribution width (RDW) as an indicator of the presence of non-alcoholic steatohepatitis (NASH) and its association with fibrotic scores.
  
  
  METHODS
  A retrospective study was carried out that included sixty-two biopsy proven NASH, 32 simple steatosis patients and 30 healthy controls. The correlation between the clinical and histopathological features of NASH patients and RDW values was evaluated. Liver fibrosis scores were measured using a 0 to 4 point scale and were divided in to two groups; fibrosis scores 0-1 were termed mild and fibrosis scores 2-4 were termed advanced fibrosis. RDW values were compared between NASH, simple steatosis and healthy controls. Univariate and multivariate analyses were performed to evaluate the independent predicting factors for the presence of liver fibrosis caused by NASH.
  
  
  RESULTS
  Patients with NASH had higher RDW values compared with simple steatosis and healthy control groups [14.28% ± 0.25% vs 13.37% ± 0.12%, 12.96% ± 0.14% (P < 0.01), respectively]. Patients with advanced fibrosis had higher RDW values than the mild fibrosis group (15.86% ± 0.4% vs 13.63% ± 0.67%, P < 0.01, respectively). RDW also correlated with fibrotic scores (r = 0.579 and P < 0.01). The variables that were significant in the univariate analysis were evaluated in multivariate logistic regression analysis, and RDW was an independent predicting factor of NASH (OR = 1.75, 95%CI: 1.129-2.711, P < 0.05).
  
  
  CONCLUSIONS
  RDW a new non-invasive marker that can be used to demonstrate the presence of NASH and indicate advanced fibrotic scores.
authors.affiliation: Mustafa Cengiz, Seren Ozenirler, Department of Gastroenterology, Gazi University Faculty of Medicine, 06500 Ankara, Turkey.
authors.forename: Mustafa
authors.initials: M
authors.lastname: Cengiz
authors.forename: Burcu Aslan
authors.initials: BA
authors.lastname: Candır
authors.forename: Güldal
authors.initials: G
authors.lastname: Yılmaz
authors.forename: Gülen
authors.initials: G
authors.lastname: Akyol
authors.forename: Seren
authors.initials: S
authors.lastname: Ozenirler
mesh_terms: D000328:Adult; D000368:Aged; D001706:Biopsy; D016009:Chi-Square Distribution; D004909:Erythrocyte Indices; D005234:Fatty Liver / Q000097:blood / Q000150:complications / Q000175:diagnosis* / Q000473:pathology; D005260:Female; D006801:Humans; D008099:Liver / Q000473:pathology*; D008103:Liver Cirrhosis / Q000097:blood / Q000175:diagnosis* / Q000209:etiology / Q000473:pathology; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D065626:Non-alcoholic Fatty Liver Disease; D016017:Odds Ratio; D011237:Predictive Value of Tests; D011379:Prognosis; D012189:Retrospective Studies; D012307:Risk Factors; D012720:Severity of Illness Index; D055815:Young Adult
keywords: Liver biopsy; Liver fibrosis; Non-alcoholic steatohepatitis; Non-invasive marker; Red cell distribution width; Simple steatosis