Chest
Volume 124, Issue 2, August 2003, Pages 494-500
Journal home page for Chest

Clinical Investigations
PULMONARY FUNCTION TESTS
Relation Between Lung Function and RBC Distribution Width in a Population-Based Study*

https://doi.org/10.1378/chest.124.2.494Get rights and content

Study objectives

Pulmonary function is dependent not only on smoking, but also on nutritional status. Since an increased RBC distribution width (RDW) has been associated with nutritional deficiencies, we postulated that RDW has an inverse relation to pulmonary function. The purpose of this study was to test this hypothesis.

Design and setting

A cross-sectional study was conducted of a random sample of the general population in western New York.

Participants

A total of 1,616 subjects of both genders who were aged 35 to 79 years and were free of respiratory disease.

Interventions

None.

Measurements

Pulmonary function was assessed from FEV1, FVC, height, body weight, total pack-years of smoking, smoking status, hemoglobin concentration, and hematologic indexes, eosinophil count, education, and blood levels of retinol, β-cryptoxanthin, and vitamin E.

Results

We found a direct relation between RDW and the number of pack-years of smoking and smoking status, and an inverse relation between FEV1 and FVC with RDW, even when potentially confounding variables such as smoking were taken into account. When the variability of FEV1 due to smoking was used for comparison, an additional 27% of that variability in FEV1 was explained by variations in antioxidant vitamin levels, and another 24% by RDW.

Conclusions

The results confirmed our hypothesis that there is an inverse relation between RDW and pulmonary function, and raise the possibility that RDW may be a biomarker for as-yet unidentified nutrients that affect pulmonary function.

Section snippets

Study Population

This study was performed in a random sample of the general population from among residents of western New York who were between the ages 35 and 79 years. The details of the study design, random selection of participants, exclusion criteria, laboratory variability, analytical methods, and spirometry have been described previously.15 One thousand six hundred sixteen participants were included in the analysis. The study was approved by the institutional review board of the University at Buffalo.

Data Collection

A

Study Population

Table 1 shows the baseline characteristics of the 1,616 participants by gender. The age of the subjects ranged from 36 to 80 years. More than one third of men (33.9%) and more than half of women (50.9%) had never smoked. The proportions of former and current smokers are shown in (Table 1). The percentages of current smokers among men and women were only 12.2% and 15%, respectively.

Spirometry, Blood Vitamin Levels, and RBC Indexes

Absolute FEV1 and FVC were higher in men, but FEV1 percent predicted was lower in men than in women. Women had

Discussion

The present study examined the relation between RDW and lung function in a sample of individuals from the general population of western New York. The RDW is the width of the frequency distribution curve of the RBC volume (one SD) divided by the mean RBC volume.18 Only increased levels of RDW have been associated with pathologic states. For example, both microcytic and macrocytic anemias have contrasting effects on mean corpuscular volume, but both conditions increase RDW. It has little

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