Evaluation of Red Cell Indices as Biomarkers in Rheumatoid Arthritis Patients
Keywords:
Rheumatoid Arthritis, Red Cell Indices, Biomarkers.Abstract
Inflammatory changes in rheumatological diseases encompass alterations in shape, number, and size of peripheral blood cells. Complete blood cell parameters may be used as an index of inflammation and disease activity. Assess the hematological parameters in rheumatoid arthritis (RA) and identify their relationship with disease activity. 141 patients with rheumatoid arthritis and 100 healthy controls were included in this study. Full medical history, general and musculoskeletal examination, assessment of disease activity using the DAS 28 score, markers of inflammation, rheumatoid factor (RF) titer, anti-cyclic citrullinated peptide (anti-CCP) titer and complete blood picture were done. RA patients had lower RBCs, Hb, MPV, PWD and Hb/RDW% ratio and higher RDW% than controls. Active RA patients had higher WBCs, neutrophils, and NLR. WBCs and neutrophils were positively correlated with DAS score and CRP titer. NLR ratio correlated positively with the DAS score, CRP and Anti CCP titers. Active RA had higher RDW% and lower HCT, Hb, Hb/PLT, RDW%/PLT, Hb/RDW% ratios. RDW% was positively correlated with DAS score, ESR, CRP, RF and Anti CCP titers. The RDW% differentiated active and inactive RA with best cut-off value >12. Active patients had higher platelets and PLR, which were positively correlated with DAS score. Changes in hematological parameters are significantly associated with disease activity in RA patients and they correlate positively with inflammatory markers. RDW%, platelets count and PLR are the most affected hematologic parameters in relation to DAS score and parameters of disease activity.
Downloads
References
Horta Baas G, Romero Figueroa MdS. Clinical utility of red blood cell
distribution width in inflammatory and non inflammatory joint diseases.
International journal of rheumatic diseases. 2019;22(1):47-54.
Johnson TM, Register KA,Schmidt CM, O'Dell JR, Mikuls TR, Michaud K, et al.
Correlation of the Multi Biomarker disease activity score with rheumatoid
arthritis disease activity measures: a systematic review and Meta Analysis.
Arthritis care & research. 2019;71(11):1459-72.
Sawateeva E, Smoldovskaya O, Feyzkhanova G, Rubina A. Multiple
biomarker approach for the diagnosisand therapyof rheumatoid arthritis.
Critical Reviews in Clinical Laboratory Sciences. 2021;58(1):17-28.
Gasparyan AY, Ayvazyan L, Mukanova U, Yessirkepov M, Kitas GD. The
platelet-to-lymphocyte ratio as an inflammatory marker in rheumatic
diseases. Annals of laboratory medicine. 2019;39(4):345.
Myngbay A, Bexeitov Y, Adilbayeva A, Assylbekov Z, Yevstratenko BP,
Aitzhanova RM, et al.CTHRC1:a newcandidate biomarker for improved
rheumatoid arthritis diagnosis. Frontiers in Immunology. 2019;10:1353.
Luo Q, Liu J, Fu B, Zhang L, Guo Y, Huang Z, et al. Circular RNAs
Hsa_circ_0002715 and Hsa_circ_0035197 in peripheral blood are
novel potential biomarkers for new-onset rheumatoid arthritis.
Disease markers. 2019;2019.
Al-Rawi ZS, Gorial FI, Al-Bayati AA. Red cell distribution width in
rheumatoid arthritis. Mediterranean Journal of Rheumatology.
;29(l):38-42.
Lin F, Wang X, Liang Y, Liu D, Zhang Y, Zhong R, et al. Red blood cell distribution width in rheumatoid arthritis, ankylosing spondylitis
and osteoarthritis: true inflammatory index or effect of anemia?
Annals of Clinical & Laboratory Science. 2018;48(3):301-7.
Atwa ET, Omar HM, Amin A, Hammad M. Red cell distribution width and
mean platelet volume in rheumatoid arthritis patients: Its association with
disease activity. Reumatologia clinica. 2022;18(7):399-405.
Remalante PPM, Salido EO, Penserga EG, Gauiran DTV. Red cell
distribution width and neutrophil-lymphocyte ratio in rheumatoid
arthritis. Rheumatology International. 2020;40(10):1631-7.
Xue L, Tao L,Sun H, Wang Y, Zhang Y, Lei N, et al.Association between blood PLT
and RBC related indices and disease activity in patients with rheumatoid
arthritis. InternationalJournal of General Medicine. 2022:573-81.
Aletaha D, Neogi T, Silman AJ, Funovits J, Felson DT, Bingham III CO, et
al. 2010 rheumatoid arthritis classification criteria: an American
College of Rheumatology/European League Against Rheumatism
collaborative initiative. Arthritis & rheumatism. 2010;62(9):2569-81.
Tecer D, Sezgin M, Kamk A, Incel NA, Qimen OB, Bicker A, et al. Can
mean platelet volume and red blood cell distribution width show
disease activity in rheumatoid arthritis? Biomarkers in Medicine.
;10(9):967-74.
Cakir L, Aktas G, Mercimek OB, Enginyurt O, Kaya Y, Mercimek K. Are
red cell distribution width and mean platelet volume associated with
rheumatoid arthritis. Biomed Res. 2016;27(2):292-4.
Zinellu A, Paliogiannis P, Sotgiu E, Mellino S, Mangoni AA, Zinellu E, et
al. Blood cell count derived inflammation indexes in patients with
idiopathic pulmonary fibrosis. Lung. 2020;198:821-7.
Orange DE, Yao V, Sawicka K, Fak J, Frank MO, Parveen S, et al. RNA
identification of PRIME cells predicting rheumatoid arthritis flares.
New England Journal of Medicine. 2020;383(3):218-28.
Mellors T, Withers JB, Ameli A, Jones A, Wang M, Zhang L, et al. Clinical
validation of a blood-based predictive test for stratification of
response to tumor necrosis factor inhibitor therapies in rheumatoid
arthritis patients. Network and Systems Medicine. 2020;3(1):91-104.
Ustaoglu M, Aktas G, Avcioglu U, Bas B, Bahceci BK. Elevated platelet
distribution width and red cell distribution width are associated with
autoimmune liver diseases. European journal of gastroenterology &
hepatology. 2021;33(lS):e905-e8.
Khaled SA, NasrEldin E, Makarem YS, Mahmoud HF. Value of platelet
distribution width and mean platelet volume in Disease Activity Score of
rheumatoid arthritis.Journal of inflammation research. 2020:595-606.
Bellan M, Soddu D, Zecca E, Croce A, Bonometti R, Pedrazzoli R, et al.
Association between red cell distribution width and response to
methotrexate in rheumatoid arthritis. Reumatismo. 2020;72(l):16-20.
Conic RR, Damiani G, Schrom KP, Ramser AE, Zheng C, Xu R, et al.
Psoriasis and psoriatic arthritis cardiovascular disease endotypes
identified by red blood cell distribution width and mean platelet
volume. Journal of clinical medicine. 2020;9(l):186.
Deng J, Xu S, Gao X, Xu S, Shuai Z, Pan F. Red cell distribution width and
mean platelet volume in patients with ankylosing spondylitis: a
systematic review and meta-analysis. JCR: Journal of Clinical
Rheumatology. 2021;27(7):292-7.
Song GG, Lee YH. Red cell distribution width, platelet-to-lymphocyte
ratio, and mean platelet volume in ankylosing spondylitis and their
correlations with inflammation: A meta-analysis. Modern
Rheumatology. 2020;30(5):894-9.
Ozisler C, Sandikci SC. Evaluation of red blood cell distribution width in
patients with psoriatic arthritis. The Egyptian Rheumatologist.
;42(4):309-12.
AlghamdiM. Red Blood Cell Distribution Width: A Potential Inexpensive Marker
for Disease Activity in Patients with Rheumatic Diseases; Scoping Review.
Open Access Rheumatology: Research and Reviews. 2023:173-80.
Mohamed OSD, Azmy GJ, Elfadl EMA. Clinical significance of red blood
cell distribution width in systemic lupus erythematosus patients.
Egyptian Rheumatology and Rehabilitation. 2020;47:1-8.
Lange A, Kostadinova L, Damjanovska S, Gad I, Syed S, Siddiqui H, et al.
Red Cell Distribution Width and Absolute Lymphocyte Count
Associate With Biomarkers of Inflammation and Subsequent
Mortality in Rheumatoid Arthritis. The Journal of Rheumatology.
;50(2):166-74.
Farrukh S, Khan F, Aziz W, Rasheed U, Zammarrud S. Red Blood Cell
Distribution Width as a Surrogate Marker of Disease Activity in
Patients with Rheumatoid Arthritis. Annals of PIMS-Shaheed
Zulfiqar Ali Bhutto Medical University. 2021;17(3):206-10.
Wang G, Liu Z. The relationship between red cell distribution width,
absolute lymphocyte count, and rheumatoid arthritis. The Journal of
Rheumatology. 2023;50(10):1355-.
Tekin YK, Tekin G. Mean platelet volume-to-platelet count ratio, mean
platelet volume-to-lymphocyte ratio, and red blood cell distribution
width-platelet count ratio as markers of inflammation in patients
with ascending thoracic aortic aneurysm. Brazilian journal of
cardiovascular surgery. 2020;35:175-80.
Gisondi P, Geat D, Lippi G, Montagnana M, Girolomoni G. Increased red
blood cell distribution width in patients with plaque psoriasis.
Journal of Medical Biochemistry. 2021;40(2):199.
Yi P, Jiang J, Wang Z, Wang X, Zhao M, Wu H, et al. Comparison of mean
platelet volume (MPV) and red blood cell distribution width (RDW)
between psoriasis patients and controls: A systematic review and
meta-analysis. Pios one. 2022;17(2): e0264504.
Downloads
Published
Issue
Section
License
You are free to:
- Share — copy and redistribute the material in any medium or format for any purpose, even commercially.
- Adapt — remix, transform, and build upon the material for any purpose, even commercially.
- The licensor cannot revoke these freedoms as long as you follow the license terms.
Under the following terms:
- Attribution — You must give appropriate credit , provide a link to the license, and indicate if changes were made . You may do so in any reasonable manner, but not in any way that suggests the licensor endorses you or your use.
- No additional restrictions — You may not apply legal terms or technological measures that legally restrict others from doing anything the license permits.
Notices:
You do not have to comply with the license for elements of the material in the public domain or where your use is permitted by an applicable exception or limitation .
No warranties are given. The license may not give you all of the permissions necessary for your intended use. For example, other rights such as publicity, privacy, or moral rights may limit how you use the material.
