title: Red cell distribution width and carotid atherosclerosis progression. The Tromsø Study.
abstract: Red cell distribution width (RDW), a measure of the size variability of circulating erythrocytes, is associated with cardiovascular morbidity and mortality. We aimed to investigate whether RDW was associated with progression of atherosclerotic plaques in subjects recruited from the general population. Baseline characteristics, including RDW, were collected from 4677 participants in the fourth survey of the Tromsø Study conducted in 1994/95. Prevalence of carotid plaques and total plaque area (TPA) were assessed by ultrasonographic imaging at baseline and after seven years of follow-up. Generalised linear models were used to analyse change in TPA across tertiles of RDW. Change in TPA was significantly higher across tertiles of RDW in crude analysis and in multivariable analysis adjusted for cardiovascular risk factors. The mean change in TPA increased from 5.6 mm² (4.9-6.4) in tertile 1 (RDW ≤ 12.6 %) to 6.7 mm² (5.9-7.6) in tertile 3 (RDW ≥ 13.3) in multivariable analysis adjusted for body mass index, total cholesterol, HDL cholesterol, systolic blood pressure, self-reported diabetes, smoking status, platelet count, white blood cell count, and hs-CRP levels (p for trend 0.003). A 1 % increase in RDW was associated with 0.6 mm² (0.1-1.2) increase in TPA in multivariable analysis (p=0.03). RDW was associated with progression of atherosclerosis after adjustments for traditional atherosclerotic risk factors. Our findings suggest that the link between RDW and cardiovascular morbidity and mortality may be explained by atherosclerosis.
authors: Jostein Lappegård, K. G.Jebsen Thrombosis Research and Expertise Centre, Department of Clinical Medicine, University of Tromsø, Tromsø, Norway, Tel.: +47 90568257, E-mail: jostein.lappegard@uit.no.
authors: Jostein
authors: J
authors: Lappegård
authors: Trygve S
authors: TS
authors: Ellingsen
authors: Anders
authors: A
authors: Vik
authors: Tove
authors: T
authors: Skjelbakken
authors: Jan
authors: J
authors: Brox
authors: Ellisiv B
authors: EB
authors: Mathiesen
authors: Stein Harald
authors: SH
authors: Johnsen
authors: Sigrid K
authors: SK
authors: Brækkan
authors: John-Bjarne
authors: JB
authors: Hansen
mesh_terms: D000368:Aged; D002339:Carotid Arteries / Q000000981:diagnostic imaging; D002340:Carotid Artery Diseases / Q000097:blood* / Q000000981:diagnostic imaging / Q000453:epidemiology*; D048429:Cell Size; D018450:Disease Progression; D004909:Erythrocyte Indices; D004912:Erythrocytes / Q000473:pathology*; D005260:Female; D006801:Humans; D016014:Linear Models; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D009664:Norway / Q000453:epidemiology; D058226:Plaque, Atherosclerotic; D011237:Predictive Value of Tests; D015995:Prevalence; D011446:Prospective Studies; D012307:Risk Factors; D012720:Severity of Illness Index; D018615:Ultrasonography, Doppler, Color; D018617:Ultrasonography, Doppler, Pulsed
keywords: Atherosclerosis; cardiovascular disease; cohort studies; epidemiology; erythrocyte indices