2025年 新着論文 45 糖尿病診療分野から論文が発表されました

Red blood cell distribution width is associated with renal tubular injury in individuals with type 2 diabetes

J Diabetes Investig. 2025 Sep 29. doi: 10.1111/jdi.70149. Online ahead of print.

Authors

Kohsuke Miyataka  1 Yousuke Kaneko  1   2 Taiki Hori  1 Yuki Yamaguchi  3 Seijiro Tsuji  4 Tomoyo Hara  1 Hiroki Yamagami  1 Sumiko Yoshida  4 Toshiki Otoda  5 Tomoyuki Yuasa  5 Akio Kuroda  6 Takeshi Harada  1 Hirokazu Miki  7 Shingen Nakamura  5 Itsuro Endo  8 Munehide Matsuhisa  6 Ken-Ichi Matsuoka  1 Ken-Ichi Aihara  5   9

Affiliations

  • 1 Department of Hematology, Endocrinology and Metabolism, Graduate School of Biomedical Sciences, Tokushima University, Tokushima, Japan.
  • 2 Department of Internal Medicine, Tokushima Prefectural Kaifu Hospital, Tokushima, Japan.
  • 3 Department of Internal Medicine, Takamatsu Municipal Hospital, Takamatsu, Kagawa, Japan.
  • 4 Department of Endocrinology and Metabolism, Shikoku Medical Center for Children and Adults Hospital, Zentsuji, Kagawa, Japan.
  • 5 Department of Community Medicine and Medical Science, Graduate School of Biomedical Sciences, Tokushima University, Tokushima, Japan.
  • 6 Diabetes Therapeutics and Research Center, Institute of Advanced Medical Sciences, Tokushima University, Tokushima, Japan.
  • 7 Division of Transfusion Medicine and Cell Therapy, Tokushima University Hospital, Tokushima, Japan.
  • 8 Department of Bioregulatory Sciences, Graduate School of Biomedical Sciences, Tokushima University, Tokushima, Japan.
  • 9 Department of Internal Medicine, Anan Medical Center, Anan, Tokushima, Japan.

Free article

Abstract

Aims/introduction: Red blood cell distribution width (RDW) is a parameter of erythrocyte volume heterogeneity that has been traditionally used as an indicator of anemia and other hematopoietic abnormalities. Although the RDW-coefficient of variation (RDW-CV) increases in individuals with diabetes, its clinical significance in diabetic kidney disease (DKD), including glomerular and tubular injury, is unclear. Therefore, we aimed to clarify the relationship between RDW-CV and DKD indices in individuals with type 2 diabetes.

Materials and methods: This was a multicenter, retrospective, cross-sectional study. In 490 Japanese individuals with type 2 diabetes (309 men and 181 women), multiple regression analysis was performed to examine the degree of association between DKD indices (estimated glomerular filtration rate (eGFR), urinary albumin-to-creatinine ratio (uACR), log-transformed uACR (Log-uACR), urinary liver-type fatty acid-binding protein (uL-FABP)-to-creatinine ratio (uL-FABPCR), and log-transformed uL-FABPCR (Log-uL-FABPCR)) and clinical confounding factors, including RDW-CV.

Results: No significant associations were identified between RDW-CV and eGFR, uACR, or Log-uACR in either the simple or multiple linear regression analyses. However, significant and independent positive associations between RDW-CV and both uL-FABPCR and Log-uL-FABPCR were identified in multiple regression analyses (P = 0.002 and P = 0.034, respectively). Additionally, logistic regression analysis showed that RDW-CV was an aggravating factor for the incidence of advanced tubular injury [odds ratio, 1.241 (95% confidence interval: 1.010-1.520), P = 0.037].

Conclusions: RDW-CV was independently and positively correlated with urinary excretion of L-FABP. Therefore, RDW-CV may be a simple and useful biomarker for detecting renal tubular injury in individuals with type 2 diabetes.

Keywords: Red blood cell distribution width; Renal tubular injury; Type 2 diabetes.

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