title: Clinical usefulness of measuring red blood cell distribution width in patients with systemic sclerosis.
abstract: OBJECTIVE
  Red blood cell distribution width (RDW) is a biomarker quantifying the variability of red blood cell size in peripheral blood. Elevated RDW has been found to be an independent prognostic factor for cardiovascular events. SSc is characterized by generalized micro- and macroangiopathy. Our aim was to investigate RDW as a potential biomarker for the assessment of the severity of vascular involvement.
  
  
  METHODS
  One hundred and sixty-eight consecutive SSc patients--62 with dcSSc and 106 with lcSSc--were investigated at baseline and after 1-year of follow-up. Measurements in 93 patients with primary RP and 40 healthy subjects served as controls.
  
  
  RESULTS
  The median RDW value of patients with SSc was higher [14.2% (25th-75th percentiles 13.5-14.8%) compared with the group of primary RP patients [13.9% (13.4-14.4%); P < 0.05) and healthy volunteers [13.6% (13.2-13.8%; P < 0.01]. dcSSc and anti-topoisomerase antibody-positive cases showed elevated RDW values compared with lcSSc and anti-topoisomerase antibody-negative cases (P < 0.05). RDW showed a positive correlation with inflammatory markers, including ESR (P < 0.05) and CRP (P < 0.05), and a negative correlation with forced vital capacity (P < 0.05) and diffusing capacity of the lung for carbon monoxide (DLCO) (P < 0.05) during the follow-up. An increase in RDW of >5% during follow-up was associated with an average 8.9% decrease in left ventricular ejection fraction (LVEF) and 7% in DLCO and these associations were independent of each other.
  
  
  CONCLUSIONS
  RDW in SSc may represent an integrative measure of multiple pathological processes including extensive vasculopathy, fibrosis or ongoing inflammation. An increase in RDW may indicate an impairment of cardiorespiratory function.
authors.affiliation: Institute of Bioanalysis, Institute of Family Medicine, Department of Rheumatology and Immunology, University of Pécs, Pécs and Third Department of Internal Medicine, Semmelweis University, Research Laboratory, Budapest, Hungary.
authors.forename: Nelli
authors.initials: N
authors.lastname: Farkas
authors.affiliation: Institute of Bioanalysis, Institute of Family Medicine, Department of Rheumatology and Immunology, University of Pécs, Pécs and Third Department of Internal Medicine, Semmelweis University, Research Laboratory, Budapest, Hungary.
authors.forename: Andrea
authors.initials: A
authors.lastname: Szabó
authors.affiliation: Institute of Bioanalysis, Institute of Family Medicine, Department of Rheumatology and Immunology, University of Pécs, Pécs and Third Department of Internal Medicine, Semmelweis University, Research Laboratory, Budapest, Hungary.
authors.forename: Veronika
authors.initials: V
authors.lastname: Lóránd
authors.affiliation: Institute of Bioanalysis, Institute of Family Medicine, Department of Rheumatology and Immunology, University of Pécs, Pécs and Third Department of Internal Medicine, Semmelweis University, Research Laboratory, Budapest, Hungary.
authors.forename: Donát Péter
authors.initials: DP
authors.lastname: Sarlós
authors.affiliation: Institute of Bioanalysis, Institute of Family Medicine, Department of Rheumatology and Immunology, University of Pécs, Pécs and Third Department of Internal Medicine, Semmelweis University, Research Laboratory, Budapest, Hungary.
authors.forename: Tünde
authors.initials: T
authors.lastname: Minier
authors.affiliation: Institute of Bioanalysis, Institute of Family Medicine, Department of Rheumatology and Immunology, University of Pécs, Pécs and Third Department of Internal Medicine, Semmelweis University, Research Laboratory, Budapest, Hungary.
authors.forename: Zoltán
authors.initials: Z
authors.lastname: Prohászka
authors.affiliation: Institute of Bioanalysis, Institute of Family Medicine, Department of Rheumatology and Immunology, University of Pécs, Pécs and Third Department of Internal Medicine, Semmelweis University, Research Laboratory, Budapest, Hungary.
authors.forename: László
authors.initials: L
authors.lastname: Czirják
authors.affiliation: Institute of Bioanalysis, Institute of Family Medicine, Department of Rheumatology and Immunology, University of Pécs, Pécs and Third Department of Internal Medicine, Semmelweis University, Research Laboratory, Budapest, Hungary. varju.cecilia@pte.hu.
authors.forename: Cecília
authors.initials: C
authors.lastname: Varjú
mesh_terms: D000328:Adult; D000368:Aged; D015415:Biomarkers / Q000097:blood; D048429:Cell Size; D004909:Erythrocyte Indices; D004912:Erythrocytes; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D012595:Scleroderma, Systemic / Q000097:blood*
chemical_list: D015415:Biomarkers
keywords: RDW; inflammation; left ventricular ejection fraction; lung fibrosis; red blood cell distribution width; systemic sclerosis; vasculopathy