Elevated red cell distribution width is associated with advanced fibrosis in NAFLD.

Area of Science:

• Hepatology
• Clinical Biochemistry
• Cardiovascular Disease Risk Stratification

Background:

• Red-blood-cell distribution width (RDW) is an emerging risk marker in cardiovascular disease.
• The association between RDW and liver fibrosis in nonalcoholic fatty liver disease (NAFLD) remains underexplored.

Purpose of the Study:

• To investigate the relationship between RDW values and the degree of liver fibrosis in NAFLD patients.
• To assess RDW as a potential indicator of advanced fibrosis using BARD and FIB-4 scoring systems.

Main Methods:

• Retrospective analysis of 24,547 NAFLD patients diagnosed via ultrasonography and alcohol consumption questionnaires.
• Liver fibrosis staging determined using established BARD and FIB-4 scores.
• Statistical analysis to assess the association between RDW levels and fibrosis scores, with adjustments for confounding factors.

Main Results:

• Adjusted RDW values showed a significant increase with higher BARD and FIB-4 fibrosis scores (P<0.05).
• Prevalence of advanced fibrosis (BARD ≥ 2, FIB-4 ≥ 1.3) increased across RDW quartiles (P<0.001).
• Individuals in the highest RDW quartile (Q4) had significantly higher odds of advanced fibrosis compared to the lowest quartile (Q1) (OR 1.76 for BARD, OR 1.69 for FIB-4).

Conclusions:

• Elevated RDW is independently associated with advanced liver fibrosis in NAFLD patients.
• RDW may serve as a valuable, non-invasive biomarker for identifying advanced fibrosis in NAFLD.