Red Blood Cell Distribution Width Levels Correlate With Liver Fibrosis and Inflammation

We aimed to study whether red blood cell distribution width (RDW) could be one of the variables determining the extent of liver fibrosis and inflammation in patients with biopsy-proven hepatitis B. A total of 446 hepatitis B virus-infected patients who underwent liver biopsy were divided into 2 groups: absent or mild and moderate– severe according to the severity of liver fibrosis and inflammation. The independent variables that determine the severity of liver fibrosis and inflammation were explored. RDW values increased with progressive liver fibrosis and inflammation. After adjustments for other potent predictors, liver fibrosis (moderate–severe) was independently associated with RDW, platelet, and albumin (odds ratio1⁄4 1.121, 0.987, and 0.941, respectively), whereas increased odds ratios of significant inflammation were found for RDW, alanine aminotransferase, albumin, and PLT (odds ratio1⁄4 1.146, 1.003, 0.927, and 0.990, respectively). The sensitivity and specificity of model A were 70.0% and 62.9% for detection of significant liver fibrosis [area under the receiver-operating characteristic curve (AUC)1⁄4 0.713, P<0.001]. The sensitivity and specificity of model B were 66.1% and 79.4% for predicting advanced liver inflammation (AUC1⁄4 0.765, P<0.001). Compared with preexisting indicators, model A achieved the highest AUC, whereas model B showed a higher AUC than RDW to platelet ratio (0.670, P<0.001) and FIB-4 (0.740, P1⁄40.32). RDW may provide a useful clinical value for predicting liver fibrosis and necroinflammation in hepatitis B-infected patients with other markers. u, PhD, Can Liu o Lin, PhD, S, MM, Shou-Rong Lin, MM, and Jing Chen, MM area under the receiver operating characteristics curve, BMI = body mass index, CHBc = hronic hepatitis B, CIV = type IV collagen, HA = hyaluronic acid, HBeAg = hepatitis B e antigen, HBV = hepatitis B virus, LN = laminin, MCV = mean corpuscular volume, NAFLD = nonalcoholic fatty liver disease, NASH = nonalcoholic steatohepatitits, NPV = negative predictive value, PBC = primary biliary cirrhosis, PIIINP = N-terminal peptide of type III procollagen, PPV = positive predictive value, RDW = red blood RPR = RDW to platelet ratio, TBIL = total bilirubin, WBC = white