Institutional members access full text with Ovid®

Share this article on:

High red blood cell distribution width is closely associated with nonalcoholic fatty liver disease

Yang, Wen; Huang, Haiyan; Wang, Yuzhu; Yu, Xiaohong; Yang, Zhijian

European Journal of Gastroenterology & Hepatology: February 2014 - Volume 26 - Issue 2 - p 174–178
doi: 10.1097/MEG.0b013e328365c403
Original Articles: Metabolic Liver Disease

Background The red blood cell distribution width (RDW) has been reported to be a risk marker of morbidity and mortality for cardiovascular diseases in various study populations. Nonalcoholic fatty liver disease (NAFLD) is also a risk factor for cardiovascular diseases. However, the relationship between RDW and NAFLD is less certain.

Patients and methods RDW was determined using a Coulter counter together with the hemoglobin level in 1637 normal control individuals and 619 NAFLD patients who were consecutively referred by general practitioners for routine medical check-up. The total plasma cholesterol, plasma triglyceride, and fasting glucose were determined using a multichannel analyzer, and BMI, systolic blood pressure (SBP), diastolic blood pressure (DBP), and the incidence of hypertension and coronary artery disease were measured using statistical analysis.

Results Patients with NAFLD had a higher RDW, BMI, waist to hip ratio, SBP and DBP, fasting glucose, triglycerides, and hypertension incidence (P<0.01), and were also younger (P<0.01). NAFLD was considered as a dependent variable, whereas age, sex, BMI, waist to hip ratio, RDW, hemoglobin, SBP and DBP, fasting glucose, total cholesterol, triglyceride, and hypertension were considered as covariate variables. We found that age (β=−0.031, P<0.01), BMI (β=0.265, P<0.01), waist to hip ratio (β=6.166, P<0.01), RDW (β=0.154, P<0.01), fasting plasma glucose (β=0.301, P<0.01), and triglyceride (β=0.222, P<0.01) were significantly associated with the risk for NAFLD, analyzed by binary logistic regression analysis.

Conclusion Patients with NAFLD were more likely to have high levels of RDW. Moreover, NAFLD was associated with age, BMI, RDW, fasting plasma glucose, and triglyceride. If confirmed in future follow-up studies, this association might provide a rationale to introduce the easy, inexpensive RDW in algorithms for NAFLD risk prediction.

Geriatric Digestive System Department, Navy General Hospital, Beijing, China

Correspondence to Wen Yang, MSc, Geriatric Digestive System Department, Navy General Hospital, No 6 Fuchenglu Road, Beijing 100048, China Tel: +86 186 0031 0319; fax: +86 010 6695 8471; e-mail:

Received July 14, 2013

Accepted August 12, 2013

© 2014 Wolters Kluwer Health | Lippincott Williams & Wilkins