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. 2020 Jun 26;19(1):154.
doi: 10.1186/s12944-020-01308-5.

A structural equation model to assess the pathways of body adiposity and inflammation status on dysmetabolic biomarkers via red cell distribution width and mean corpuscular volume: a cross-sectional study in overweight and obese subjects

Mariangela Rondanelli  1   2 , Simone Perna  3 , Tariq A Alalwan  3 , Roberta Cazzola  4 , Clara Gasparri  5 , Vittoria Infantino  6 , Federica Perdoni  7 , Giancarlo Iannello  8 , Daniele Pepe  9 , Davide Guido  10   11
Affiliations

A structural equation model to assess the pathways of body adiposity and inflammation status on dysmetabolic biomarkers via red cell distribution width and mean corpuscular volume: a cross-sectional study in overweight and obese subjects

Mariangela Rondanelli et al. Lipids Health Dis. .

Abstract

Background: A study has been performed in overweight and obese subjects to assess the effects of adiposity and inflammation indicators on dysmetabolic biomarkers via red cell distribution width (RDW) and mean corpuscular volume (MCV), taking into account pro-antioxidant balance.

Methods: Data from 166 overweight subjects were analyzed by a path analysis model using structural equation modelling (SEM) to evaluate the direct and indirect pathway effects of adiposity, measured by body mass index (BMI) and waist circumference (WC), and inflammation status, measured by pro-antioxidant balance [reactive oxygen species (ROS)], lag-time and slope and C-reactive protein (CRP) values on dysmetabolic biomarkers, via RDW and MCV.

Results: BMI was strongly linked to CRP and ROS levels. Moreover, there was a significant negative decrease of MCV (1.546 femtoliters) linked to BMI indirectly via high CRP levels. Furthermore, WC affected RDW, indicating a possible mediatory role for RDW in relation to the relationship between WC and homeostatic model assessment (HOMA), insulin and high density lipoprotein (HDL), respectively. This was evident by the elevated HOMA and insulin levels and the decreased levels of HDL. Finally, ROS-related markers did not affect directly RDW and MCV.

Conclusion: The reported outcomes suggest that RDW might play a mediatory role in the relationship between WC and the dysmetabolic outcomes in overweight and obese individuals. CRP seems to modulate the linkage between BMI and MCV. This study provides the backbone structure for future scenarios and lays the foundation for further research on the role of RDW and MCV as suitable biomarkers for the assessment of cardiovascular disease (HDL-cholesterol), inflammatory bowels and insulin resistance.

Keywords: Inflammation; Mean corpuscular volume; Metabolism; Obesity; Path analysis; Pathway; Reactive oxygen species; Red cell distribution width; Structural equation modelling.

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Conflict of interest statement

The authors declare that they have no competing interests.

Figures

Fig. 1
Fig. 1
Flow diagram of the subjects studied
Fig. 2
Fig. 2
Graph of the conceptual path analysis model. Note. → = effect, BMI = Body Mass Index, WC = Waist Circumference, CRP = C-Reactive Protein, ROS = Reactive Oxygen Species, RDW = Red Cell Distribution Width, MCV = Mean Corpuscular Volume, SBP = Systolic Blood Pressure, DBP = Diastolic Blood Pressure, BGL = Blood Glucose Level, HOMA = Homeostasis Model Assessment, TGL = Triglycerides, CHL = cholesterol, HDL= high-density lipoprotein cholesterol, LDL = low-density lipoprotein cholesterol. The grey boxes represent the exogenous variables, the white boxes the endogenous ones. All the variables are continuous
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