Association of the red cell distribution width with red blood cell deformability

Kushang V. Patel, Joy G. Mohanty, Bindu Kanapuru, Charles Hesdorffer, William B. Ershler, Joseph M. Rifkind

Research output: Chapter in Book/Report/Conference proceedingConference contribution


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.

Original languageEnglish (US)
Title of host publicationOxygen Transport to Tissue XXXIV
EditorsWilliam J. Welch, Fredrik Palm, Duane F. Bruley, David K. Harrison
PublisherSpringer Science and Business Media, LLC
Number of pages6
ISBN (Print)9781461447719
StatePublished - 2013
Externally publishedYes

Publication series

NameAdvances in Experimental Medicine and Biology
ISSN (Print)0065-2598


  • Erythrocyte count
  • Erythrocyte deformability
  • Erythrocyte indices
  • Keywords (MeSH): Ektacytometer

ASJC Scopus subject areas

  • Biochemistry, Genetics and Molecular Biology(all)


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