title: Red blood cell distribution width levels correlate with liver fibrosis and inflammation: a noninvasive serum marker panel to predict the severity of fibrosis and inflammation in patients with hepatitis B.
abstract: We aimed to study whether red blood cell distribution width (RDW) could be one of the variables determining the extent of liver fibrosis and inflammation in patients with biopsy-proven hepatitis B. A total of 446 hepatitis B virus-infected patients who underwent liver biopsy were divided into 2 groups: absent or mild and moderate-severe according to the severity of liver fibrosis and inflammation. The independent variables that determine the severity of liver fibrosis and inflammation were explored. RDW values increased with progressive liver fibrosis and inflammation. After adjustments for other potent predictors, liver fibrosis (moderate-severe) was independently associated with RDW, platelet, and albumin (odds ratio = 1.121, 0.987, and 0.941, respectively), whereas increased odds ratios of significant inflammation were found for RDW, alanine aminotransferase, albumin, and PLT (odds ratio = 1.146, 1.003, 0.927, and 0.990, respectively). The sensitivity and specificity of model A were 70.0% and 62.9% for detection of significant liver fibrosis [area under the receiver-operating characteristic curve (AUC) = 0.713, P < 0.001]. The sensitivity and specificity of model B were 66.1% and 79.4% for predicting advanced liver inflammation (AUC = 0.765, P < 0.001). Compared with preexisting indicators, model A achieved the highest AUC, whereas model B showed a higher AUC than RDW to platelet ratio (0.670, P < 0.001) and FIB-4 (0.740, P = 0.32). RDW may provide a useful clinical value for predicting liver fibrosis and necroinflammation in hepatitis B-infected patients with other markers.
authors.affiliation: From the First Clinical College (W-HW, S-RL); Department of Laboratory Medicine (W-SX, X-MQ); Genetic Diagnostic Laboratory (Q-SO, CL, J-PL, H-JC, SL, JC); and First Affiliated Hospital of Fujian Medical University, Fuzhou, China.
authors.forename: Wen-Shen
authors.initials: WS
authors.lastname: Xu
authors.forename: Xiao-Ming
authors.initials: XM
authors.lastname: Qiu
authors.forename: Qi-Shui
authors.initials: QS
authors.lastname: Ou
authors.forename: Can
authors.initials: C
authors.lastname: Liu
authors.forename: Jin-Piao
authors.initials: JP
authors.lastname: Lin
authors.forename: Hui-Juan
authors.initials: HJ
authors.lastname: Chen
authors.forename: Sheng
authors.initials: S
authors.lastname: Lin
authors.forename: Wen-Hua
authors.initials: WH
authors.lastname: Wang
authors.forename: Shou-Rong
authors.initials: SR
authors.lastname: Lin
authors.forename: Jing
authors.initials: J
authors.lastname: Chen
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D019540:Area Under Curve; D018450:Disease Progression; D004909:Erythrocyte Indices; D005260:Female; D006509:Hepatitis B / Q000097:blood*; D006801:Humans; D008103:Liver Cirrhosis / Q000097:blood*; D008111:Liver Function Tests; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D012680:Sensitivity and Specificity; D012720:Severity of Illness Index; D055815:Young Adult