Large variability in the size of red blood cells are associated with increased risk of venous thromboembolism, shows Trygve Sølberg Ellingsen‘s PhD thesis.

MAIN RESULTS:

1. High red cell distribution width is linked to increased risk of venous thromboembolism.
2. The association is not explained by increased risk of cancer, myocardial infarction or ischemic stroke in people with high distribution width.
3. Iron deficiency does not explain the association between red cell distribution width and venous thromboembolism.

THESIS DEFENCE:

Thesis:  Red cell distribution width and risk of venous thromboembolism
Candidate: Trygve Sølberg Ellingsen
Time: June 11. 2018 at 12:15
Place: UiT The Arctic University of Norway, Farmasibygget: Tabletten
Link to university website (in Norwegian)

SUMMARY:

(1) A higher distribution width of red blood cells is associated with incident venous thromboembolism. Red cell distribution width is a measure of the variability in size of circulating red blood cells.

26 000 participants in the Tromsø Study were followed for up to 17 years. The association was independent of traditional cardiovascular risk factors.

(2) Red cell distribution width is also associated with incident cancer in men and postmenopausal women.

(3) Increased red cell distribution width is a risk factor for venous thromboembolism independent of cancer, myocardial infarction and stroke. Large variation in the size of red blood cells increases the risk of cancer and cardiovascular disease, which is also linked to increased risk of venous thromboembolism. But the association between red cell distribution width and venous thromboembolism was still significant after excluding participants with cancer, myocardial infarction and stroke from the analysis.

(4) Hepidicin, a marker of iron stores in the body, was associated with increased risk of venous thromboembolism. Thus, iron deficiency does not explain the association between red cell distribution width and risk of venous thromboembolism. Hepidicin was measured in plasma from 400 cases with venous thromboembolism, and compared to 800 healthy controls.

REFERENCES:

(1) Ellingsen, T. S., Lappegård, J., Skjelbakken, T., Brækkan, S. K., & Hansen, J. B. (2015). Red cell distribution width is associated with incident venous thromboembolism (VTE) and case-fatality after VTE in a general population. Thromb Haemost, 113(1), 193-200.

(2) Ellingsen, T. S., Lappegård, J., Skjelbakken, T., Brækkan, S. K., & Hansen, J. B. (2015). Impact of red cell distribution width on future risk of cancer and all-cause mortality among cancer patients–the Tromsø Study. haematologica, 100(10), e387-e389.

(3) Ellingsen, T. S., Lappegård, J., Skjelbakken, T., Mathiesen, E. B., Njølstad, I., Brækkan, S. K., & Hansen, J. B. (2018). The association between red cell distribution width and venous thromboembolism is not explained by myocardial infarction, stroke, or cancer. Research and Practice in Thrombosis and Haemostasis.

(4) Ellingsen, T. S., Lappegård, J., Ueland, T., Aukrust, P., Brækkan, S. K., & Hansen, J. B. (2018). Plasma hepcidin is associated with future risk of venous thromboembolism. Blood advances, 2(11), 1191-1197.