Diagnostic value of red blood cell distribution width for the activity of Crohn′s disease
10.3760/cma.j.cn101480-20230607-00091
- VernacularTitle:红细胞分布宽度对克罗恩病活动性的诊断价值
- Author:
Jiaojie XUE
1
;
Min ZHANG
;
Yitao ZHANG
;
Mao OUYANG
;
Zhichong CHEN
;
Shiyao CHENG
;
Weijie ZENG
Author Information
1. 中山大学附属第六医院心血管内科，广州 510655
- Publication Type:Journal Article
- Keywords:
Crohn′s disease;
Red blood cell distribution width;
Activity;
Diagnostic value
- From:
Chinese Journal of Inflammatory Bowel Diseases
2023;07(4):324-330
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To investigate the relationship between red blood cell distribution width (RDW) and activity of Crohn′s disease (CD), and explore the diagnostic value of RDW for CD activity.Methods:A cross-sectional study was conducted. Clinical data of CD patients treated continuously at the Sixth Affiliated Hospital of Sun Yat-sen University from November 2012 to October 2014 (CD group) were collected, including the first results of routine hematological examinations and C-reactive protein (CRP) levels after admission. Routine hematological examination results were also collected from healthy peoples undergoing regular health check-ups at the same time, who served as the normal control group. CD patients were divided into remission, mild activity, and moderate-severe activity groups based on the Crohn′s disease activity index (CDAI). The levels of routine hematological indicators including RDW and platelet-to-lymphocyte ratio (PLR) were compared between the CD group and the normal control group, as well as among different subgroups of CD patients. The correlations between RDW, PLR and CD activity or CRP were analyzed, and the diagnostic value of RDW for CD activity was evaluated by using ROC curve. Logistic univariate and multivariate regressions were performed to analyze the influencing factors of the activity of CD. Logistic regression equation was constructed to calculate the diagnostic efficacy of the influencing factors.Results:A total of 303 CD patients (216 males, 87 females; mean age 28.6 ± 11.7 years) were assigned to CD group and 293 healthy peoples (190 males, 103 females; mean age 30.1 ± 12.3 years) were assigned to normal control group. There was no significant differences in age and gender between the two groups (both P>0.05), indicating comparability. Among the CD patients, 109 were in remission group, 106 in mild activity group, and 88 in moderate-severe activity group. There was no significant differences in age and gender among the three subgroups (all P>0.05), indicating comparability. Compared with the normal control group, RDW (15.26% ± 2.51% vs. 13.10% ± 1.13%, P<0.001), PLR (245.09 ± 158.69 vs. 119.07 ± 36.52, P<0.001), neutrophil-to-lymphocyte ratio (NLR) [3.22 (2.06, 4.75) vs. 1.76 (1.39, 2.32), P<0.001], white blood cell count [ (7.68 ± 3.30) ×10 9/L vs. (6.52 ± 1.68) × 10 9/L, P<0.001] and platelet count [ (320.69 ± 116.10) × 10 12/L vs. (230.10 ± 51.08) × 10 12/L, P<0.001] were significantly higher in the CD group, while hemoglobin [ (112.8 ± 21.0) g/L vs. (137.1 ± 13.5) g/L, P<0.001] and platelet distribution width (PDW) [ (10.70 ± 1.91) fl vs. (11.89 ± 1.75) fl, P<0.001] were significantly lower. Compared with patients in remission group, the patients in mild activity group had higher RDW and platelet count, and lower hemoglobin (all P<0.05). Compared with the patients in remission and mild activity groups, the patients in moderate-severe activity group had higher RDW, PLR and NLR, and lower hemoglobin (all P<0.05). Correlation analysis showed the positive correlations between RDW, PLR and CD activity ( r = 0.423, P<0.001; r = 0.295, P<0.001), and RDW was positively correlated with CRP ( r = 0.438, P<0.001). The cut-off value of RDW for predicting CD activity was 13.85%, while the area under curve (AUC) was 0.723 (95% CI: 0.664-0.782, P<0.001), sensitivity was 0.784 and specificity was 0.550. Logistic multivariable regression analysis showed that RDW ( OR = 1.532, 95% CI: 1.291-1.818, P<0.001) and PLR ( OR = 1.003, 95% CI: 1.001-1.006, P = 0.013) were independent risk factors. The combination of RDW and PLR in diagnosing CD activity yielded an AUC of 0.730 (95% CI: 0.673-0.787, P<0.001), sensitivity of 0.407, and specificity of 0.927. Conclusions:CD patients with high RDW have more severe activity. RDW is a simple and practical indicator for diagnosing the activity of CD.
