Is increased red cell distribution width an indicating marker of nonalcoholic steatohepatitis and fibrotic stage?

Table 1 Demographic and laboratory features of non-alcoholic steatohepatitis, simple steatosis and healthy control groups

Factor	NASH group (n = 62)	Steatosis group (n = 32)	Healthy control group (n = 30)	P-value
Age mean ± SD	48.81 ± 12.21	47.25 ± 12.58	48.03 ± 9.54	NS
Gender (male)	30 (48.3)	18 (56.2)	18 (60)	NS
BMI (kg/m2)	27.13 ± 0.37	25.97 ± 0.67	24.22 ± 0.45	< 0.01
Hemoglobin (g/dL)	14.10 ± 0.16	14.51 ± 0.28	13.91 ± 0.11	NS
Platelet (× 103/mL)	245.5 ± 34.73	244.5 ± 13.8	260 ± 4.47	NS
WBC (k/UL)	6950 ± 319	7250 ± 330	7350 ± 146	NS
Neutrophil ratio	59.39% ± 1.20%	59.87% ± 1.20%	59% ± 1.1%	NS
Lymphocyte ratio	31.29% ± 1.09%	29.88% ± 1.10%	32% ± 0.78%	NS
RDW	14.28% ± 0.25%	13.37% ± 0.12%	12.96% ± 0.14%	< 0.01
MPV (fL)	8.63 ± 1.30	8.49 ± 1.06	8.20 ± 0.59	NS
MCV (fL)	86.34 ± 0.88	87.98 ± 1.37	85.5 ± 0.82	NS
ALT (IU/L)	54 ± 8.1	45 ± 3.97	32.5 ± 1.49	< 0.01
AST (IU/L)	40.05 ± 6.04	40.05 ± 3.01	24 ± 1.39	< 0.01
ALP (IU/L)	87.5 ± 9.09	81.5 ± 3.91	61 ± 1.87	< 0.01
GGT (IU/L)	61 ± 13.4	32 ± 3.4	27 ± 2.5	< 0.01
Albumin (g/dL)	4.36 ± 0.73	4.5 ± 0.42	4.9 ± 0.75	< 0.01
Creatinine	0.78 ± 0.033	0.79 ± 0.023	0.72 ± 0.014	NS
BUN (mg /dL)	12.25 ± 0.85	14.2 ± 0.67	13.46 ± 0.71	NS
Diabetes mellitus	19 (30.6)	9 (28.1)	0 (0)	NS
Hypertension	22 (35.4)	7 (21.8)	0 (0)	NS

Values are presented as n (%) frequencies, median ± SE for skewed distributed variables. BMI: Body-mass index; RDW: Red cell distribution width; MPV: Mean platelet volume; NS: Not significant; ALT: Alanine aminotransaminase; AST: Aspartate aminotransferase; ALP: Alkaline phosphatase; GGT: γ glutamyl transferase; WBC: White blood cell; MCV: Mean corpuscle volume; BUN: Blood urine nitrogen.

Table 2 Red cell distribution width correlated with clinical characteristics and histological features of non-alcoholic steatohepatitis

Factor	r-value	P-value
Age (yr)	0.245	< 0.01
BMI (kg/m2)	0.131	NS
Gender	-0.251	< 0.01
Fibrosis	0.579	< 0.01
Inflammation	0.207	NS
Steatosis	0.121	NS
Ballooning	0.175	NS
NASH	0.217	NS

BMI: Body mass index; RDW: Red cell distribution width; NASH: non-alcoholic steatohepatitis; NS: Not significant.

Table 3 Univariate analyses for predicting liver fibrosis

	OR	95%CI	P-value
Age	1.05	1.004-1.109	< 0.05
Gender	1.46	0.516-4.171	NS
Platelet	0.98	0.988-0.996	< 0.01
ALT	1.08	0.976-1.004	NS
AST	0.98	0.963-1.007	NS
ALP	1.015	1.002-1.028	< 0.05
GGT	1.002	0.998-1.007	NS
RDW	1.73	1.242-2.409	< 0.01
Albumin	0.418	0.158-1.105	NS
BMI	1.012	0.847-1.209	NS

ALT: Alanine aminotransferase; AST: Aspartate aminotransferase; ALP: Alkaline phosphatase; GGT: γ glutamyl aminotransferase; RDW: Red cell distribution width; BMI: Body mass index; NS: Not significant.

Table 4 Multivariate analyses for advanced liver fibrosis

	OR	95%CI	P-value
ALP	1.005	0.993-1.018	NS
RDW	1.75	1.129-2.711	< 0.05
Age	1.02	0.957-1.086	NS
Platelet	0.991	0.981-1.001	NS
Albumin	1.016	0.291-3.545	NS

ALP: Alkaline phosphatase; RDW: Red cell distribution width; NS: Not significant.