Premium
Red cell distribution width, haemoglobin A 1c and incidence of diabetes mellitus
Author(s) -
Engström G.,
Smith J. G.,
Persson M.,
Nilsson P. M.,
Melander O.,
Hedblad B.
Publication year - 2014
Publication title -
journal of internal medicine
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 2.625
H-Index - 160
eISSN - 1365-2796
pISSN - 0954-6820
DOI - 10.1111/joim.12188
Subject(s) - red blood cell distribution width , medicine , diabetes mellitus , hazard ratio , mean corpuscular volume , incidence (geometry) , quartile , confidence interval , gastroenterology , population , triglyceride , endocrinology , hemoglobin , cholesterol , physics , environmental health , optics
Objective Hyperglycaemia has multiple effects on the red blood cell ( RBC ), including glycation of haemoglobin, reduced deformability and reduced lifespan. Red cell distribution width ( RDW ) is a measure of the heterogeneity of erythrocyte volumes. The aim of this study was to explore the relationships between RDW and glucose, haemoglobin A 1c ( H bA1c) and incidence of diabetes mellitus ( DM ). Design, setting and subjects RDW and mean corpuscular volume were measured in 26 709 non‐diabetic participants (aged 45–73 years) from the population‐based M almö D iet and C ancer cohort. HbA1c and fasting venous blood glucose levels were measured in 4845 subjects. Main outcome measure Incidence of DM ( n = 2944) over 14 years of follow‐up was studied by linkage with national and local DM registers. Results Individuals with low RDW had significantly higher risk of developing DM [adjusted hazard ratio ( HR ) 1.48, 95% confidence interval ( CI ) 1.29–1.70, for 1st vs. 4th quartile], especially in subjects with impaired fasting glucose ( n = 416) ( HR 2.15, 95% CI 1.12–4.14). Low RDW was also associated with significantly higher waist circumference and glucose, insulin and triglyceride concentrations. By contrast, RDW was significantly and positively associated with HbA1c, corresponding an increase in HbA1c of 0.10% per 1 SD increase in RDW . Conclusion Low RDW is associated with increased incidence of DM independently of other risk factors. We propose that low RDW could be a surrogate marker of reduced RBC survival, with lower HbA1c due to shorter duration of glucose exposure. RDW is a biomarker that could improve risk assessment for individuals at risk of developing DM .