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RESEARCH PRODUCT

Reply to "The association of red blood cell distribution width and morbid obesity" by Aydin et al.

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We thank Aydin & cols. for their comments about our recently published paper “Red blood cell distribution width is not related with inflammatory parameters in morbidly obese patients” in Clinical Biochemistry Journal [1]. The authors show their concern about the clinical interpretation of our findings since we did not report folate and B12 vitamin levels. Moreover, they state that we should demonstrate the elimination of thrombocytopenic diseases by showing platelet count data. Aswe state in the paper, exclusion criteria for obese patients included “organic, malignant, hematological, infectious or inflammatory disease”. Therefore, any case of thrombocytopenic disease was not included. Moreover, obese patients showed higher levels of platelets (control: 225±45×10/μL, obese: 258±55×10/μL, p b 0.001) althoughwithin normal range and congruent with amild inflammatory status. Obese patients showed a discrete lowered folate (control: 9.26 ± 4.61 ng/mL, obese: 5.71 ± 2.59 ng/mL, p b 0.001) and B12 vitamin (control: 534 ± 192 pg/mL, obese: 429 ± 177 pg/mL, p = 0.001), which might indicate nutritional deficiencies. But when these variables were included in the multivariate logistic regression analysis, no effect on the reported model was observed. This data further reinforce our conclusion that hyposideremia, rather than inflammatory parameters, is related with higher RDW in these patients. However, the role of nutritional deficiencies in this clinical setting should be taking into account when hematological parameters are explored.