Elevated red cell distribution width is associated with advanced fibrosis in NAFLD

• Published in: Clinical and molecular hepatology Vol. 19; no. 3; pp. 258 - 265
• Main Authors: Kim, Hwa Mok, Kim, Bum Soo, Cho, Yong Kyun, Kim, Byung Ik, Sohn, Chong Il, Jeon, Woo Kyu, Kim, Hong Joo, Park, Dong Il, Park, Jung Ho, Joo, Kwan Joong, Kim, Chang Joon, Kim, Yong Sung, Heo, Woon Je, Choi, Won Seok
• Format: Journal Article
• Language: English
• Published: Korea (South) Korean Association for the Study of the Liver 01-09-2013; The Korean Association for the Study of the Liver; 대한간학회
• Subjects: Abdomen; Adult; Alcohol Drinking; Antigens; BARD score; Blood; Blood platelets; Body mass index; C-Reactive Protein - analysis; Cholesterol; Diabetes; Diabetes Mellitus - pathology; Erythrocyte Indices; Fatty Liver - complications; Fatty Liver - diagnosis; Fatty Liver - diagnostic imaging; Female; FIB-4 score; Hemoglobin; Hepatitis C; High density lipoprotein; Humans; Hypertension; Hypertension - pathology; Liver cirrhosis; Liver Cirrhosis - diagnosis; Liver Cirrhosis - epidemiology; Liver Cirrhosis - etiology; Male; Middle Aged; Mortality; Non-alcoholic Fatty Liver Disease; Nonalcoholic fatty liver disease; Odds Ratio; Original; Oxidative stress; Prevalence; Red-blood-cell distribution width; Severity of Illness Index; Statistical analysis; Surveys and Questionnaires; Ultrasonic imaging; Ultrasonography; Variance analysis; 내과학; United States > US; Nonalcoholic fatty liver disease; FIB-4 score; BARD score; Red-blood-cell distribution width
• ISSN: 2287-2728; 2287-285X
• DOI: 10.3350/cmh.2013.19.3.258

The red-blood-cell distribution width (RDW) is a newly recognized risk marker in patients with cardiovascular disease, but its role in nonalcoholic fatty liver disease (NAFLD) has not been well defined. The aim of the present study was to determine the association between RDW values and the level of fibrosis in NAFLD according to BARD and FIB-4 scores.
This study included 24,547 subjects who had been diagnosed with NAFLD based on abdominal ultrasonography and questionnaires about alcohol consumption. The degree of liver fibrosis was determined according to BARD and FIB-4 scores. The association between RDW values and the degree of fibrosis in NAFLD was analyzed retrospectively.
After adjusting for age, hemoglobin level, mean corpuscular volume, history of hypertension, history of diabetes, and high-sensitivity C-reactive protein, the RDW values were 12.61±0.41% (mean±SD), 12.70±0.70%, 12.77±0.62%, 12.87±0.82%, and 13.25±0.90% for those with BARD scores of 0, 1, 2, 3, and 4, respectively, and 12.71±0.72%, 12.79±0.66%, and 13.23±1.52% for those with FIB-4 scores of <1.30, 1.31-2.66, and ≥2.67, respectively (P<0.05). The prevalence of advanced fibrosis (BARD score of 24 and FIB-4 score of ≥1.3) increased with the RDW [BARD score: 51.1% in quartile 1 (Q1) vs. 63.6% in Q4; FIB-4 score: 6.9% in Q1 vs. 10.5% in Q4; P<0.001]. After adjustments, the odds ratio of having advanced fibrosis for those in Q4 compared to Q1 were 1.76 (95%CI=1.55-2.00, P<0.001) relative to BARD score and 1.69 (95%CI=1.52-1.98, P<0.001) relative to FIB-4 score.
Elevated RDW is independently associated with advanced fibrosis in NAFLD.