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Editor's Correspondence
September 12, 2009

Is Red Blood Cell Distribution Width a Marker of Overall Membrane Integrity?—Reply

Arch Intern Med. 2009;169(16):1540. doi:10.1001/archinternmed.2009.276

In reply

In response to our observation that higher RDW is associated with increased mortality risk in a community-based sample,1 Goldstein and colleagues suggest that RDW might be a marker of “overall cellular membrane integrity.”

As the basis for this suggestion, the authors speculate that RDW is associated with membrane cholesterol content. This is based on the declining prevalence of hypercholesterolemia with increasing RDW quintile. In an additional multivariate-adjusted analysis, the association of hypercholesterolemia with RDW did not persist. Also, circulating cholesterol levels are not associated with total cholesterol content in erythrocyte membranes.2 We do not believe that our data address the association of RDW with membrane cholesterol content. More importantly, we do not believe that our data should in any way be construed as suggesting that statin therapy be withheld from appropriate patients at risk for cardiovascular events, in whom the demonstrated benefits of statin therapy are consistent and compelling.3