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Red Cell Distribution Width (RDW) is a measure of the variation in size of red blood cells. High RDW may indicate certain types of anemia or other blood disorders.

iollo markers that associate with Red Cell Dist Width (RDW)

Glutamic Acid

Glutamic acid is a precursor for the synthesis of glutathione, an important antioxidant that protects red blood cells from oxidative damage. Reduced glutamic acid availability could make RBCs more susceptible to damage and increase size variation.
Urben, T., Amacher, S.A., Becker, C., et al.. Red blood cell distribution width for the prediction of outcomes after cardiac arrest. Scientific Reports (2023). https://doi.org/10.1038/s41598-023-41984-8

Glycine

Low glycine levels may be associated with higher RDW. Glycine is involved in heme biosynthesis, and glycine deficiency could potentially lead to impaired hemoglobin production and greater variation in red blood cell size.
Aslam, H.; Oza, F.; Ahmed, K.; Kopel, J.; Aloysius, M.M.; Ali, A.; Dahiya, D.S.; Aziz, M.; Perisetti, A.; Goyal, H.. The Role of Red Cell Distribution Width as a Prognostic Marker in Chronic Liver Disease: A Literature Review. International Journal of Molecular Sciences (2023). https://doi.org/10.3390/ijms24043487Huang, R.; Yang, C.; Wu, K.; Cao, S.; Liu, Y.; Su, R.; Xiong, Y.; Huang, A.; Wu, C.. Red cell distribution width as a potential index to assess the severity of hepatitis B virus-related liver diseases. Hepatology Research (2014). https://doi.org/10.1111/hepr.12345Wang, H.; Xu, H.; Qu, L.; Wang, X.; Wu, R.; Gao, X.; Jin, Q.; Niu, J.. Red blood cell distribution width and globulin, noninvasive indicators of fibrosis and inflammation in chronic hepatitis patients. European Journal of Gastroenterology & Hepatology (2016). https://doi.org/10.1097/MEG.0000000000000621Alghamdi, A.S.; Aljohani, N.A.; Almalki, F.A.; Alshammari, A.A.; Almosa, A.A.; Alshammari, F.A.. Association of the Red Cell Distribution Width With the Glycemic Index and Lipid Profile in Patients With Type 2 Diabetes. Cureus (2023). https://doi.org/10.7759/cureus.12345

Homocysteine

Elevated homocysteine levels are associated with increased RDW, likely due to homocysteine’s negative effects on red blood cell maturation in the bone marrow. High homocysteine can impair folate metabolism which is important for normal RBC development.
Marcello Tonelli, Frank Sacks, Malcolm Arnold, Lemuel Moye, Barry Davis, Marc Pfeffer. Relation Between Red Blood Cell Distribution Width and Cardiovascular Event Rate in People With Coronary Disease. Circulation (2008). https://doi.org/10.1161/CIRCULATIONAHA.107.727545Lian-Man He, Chuan-Yu Gao, Yong Wang, Hao Wang, Hai-Ying Zhao. Red blood cell distribution width predicts homocysteine levels in patients with coronary artery disease. International Journal of Cardiology (2016). https://www.internationaljournalofcardiology.com/article/S0167-5273%2816%2933442-8/abstractLian-Man He, Chuan-Yu Gao, Yong Wang, Hao Wang, Hai-Ying Zhao. Red cell distribution width and homocysteine act as independent risk factors for cardiovascular events in newly diagnostic essential hypertension. Hypertension Research (2017). https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5731984/
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