• Chang Seok Song, Dong Il Park, Min Yong Yoon, Hyo Sun Seok, Jung Ho Park, Hong Joo Kim, Yong Kyun Cho, Chong Il Sohn, Woo Kyu Jeon, and Byung Ik Kim.
• Department of Internal Medicine, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, 108, Pyung-Dong, Jongro-Ku, Seoul 110-746, Korea. md.song@samsung.com
• Dig. Dis. Sci. 2012 Apr 1; 57 (4): 1033-8.

BackgroundRecent studies have suggested that a higher red blood cell distribution width (RDW) is associated with disease activity in patients with inflammatory bowel disease (IBD). However, the RDW in IBD patients without anemia has not been investigated.AimThis study aimed to determine whether or not RDW could be used for the assessment of disease activity in IBD patients with and without anemia.MethodsThe serum C-reactive protein (CRP) level, erythrocyte sedimentation rate (ESR), hemoglobin concentration, platelet and white blood cell counts, and RDW were assessed in 221 IBD patients, comprised of 120 patients with ulcerative colitis (UC) and 101 patients with Crohn's disease (CD). Disease activity was determined for UC and CD with the Mayo score and the Crohn's disease activity index, respectively.ResultsThe CRP level, ESR, hemoglobin concentration, hematocrit, and RDW increased according to disease activity in patients with and without anemia (all P < 0.05). Multivariate analysis demonstrated that RDW was the best independent indicator for predicting disease activity in CD patients without anemia [odd ratios (OR), 1.702; 95% confidence interval (CI), 1.185-2.445; P = 0.004] and UC patients without anemia (OR, 4.921; 95% CI, 2.281-10.615; P < 0.001). Also, ROC curve analysis showed the RDW to be the most significant indicator of non-anemic active IBD [area under curve (AUC) in CD, 0.852, P < 0.001; AUC in UC, 0.827, P < 0.001].ConclusionThe association between increased RDW and active IBD was evident in IBD patients with and without anemia.

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