Association of the Red Cell Distribution Width with Red Blood Cell Deformability

  • Kushang V. PatelEmail author
  • Joy G. Mohanty
  • Bindu Kanapuru
  • Charles Hesdorffer
  • William B. Ershler
  • Joseph M. Rifkind
Conference paper
Part of the Advances in Experimental Medicine and Biology book series (AEMB, volume 765)


The red cell distribution width (RDW) is a component of the automated complete blood count (CBC) that quantifies heterogeneity in the size of circulating erythrocytes. Higher RDW values reflect greater variation in red blood cell (RBC) volumes and are associated with increased risk for cardiovascular disease (CVD) events. The mechanisms underlying this association are unclear, but RBC deformability might play a role. CBCs were assessed in 293 adults who were clinically examined. RBC deformability (expressed as the elongation index) was measured using a microfluidic slit-flow ektacytometer. Multivariate regression analysis identified a clear threshold effect whereby RDW values above 14.0% were significantly associated with decreased RBC deformability (β = −0.24; p = 0.003). This association was stronger after excluding anemic participants (β = −0.40; p = 0.008). Greater variation in RBC volumes (increased RDW) is associated with decreased RBC deformability, which can impair blood flow through the microcirculation. The resultant hypoxia may help to explain the previously reported increased risk for CVD events associated with elevated RDW.

Keywords (MeSH)

Ektacytometer Erythrocyte count Erythrocyte deformability Erythrocyte indices 



This research was supported by the Intramural Research Program of the National Institute on Aging, National Institutes of Health.


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Copyright information

© Springer Science+Business Media New York 2013

Authors and Affiliations

  • Kushang V. Patel
    • 1
    Email author
  • Joy G. Mohanty
    • 2
  • Bindu Kanapuru
    • 3
  • Charles Hesdorffer
    • 3
  • William B. Ershler
    • 4
  • Joseph M. Rifkind
    • 2
  1. 1.Laboratory of Epidemiology, Demography, and BiometryNational Institute on Aging/NIHBethesdaUSA
  2. 2.Molecular Dynamics SectionNational Institute on Aging/NIHBethesdaUSA
  3. 3.Clinical Research BranchNational Institute on Aging/NIHBethesdaUSA
  4. 4.Institute for Advanced Studies in AgingGaithersburgUSA

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