Red blood cell distribution width, vascular ageing biomarkers and EPCs for predicting vascular ageing and diagnosing/prognosing age-related degenerative arterial diseases.

The emerging evidence emphasizes Red blood cell distribution width (RDW) as optimal prognostic biomarker for cardiovascular diseases. However, several clinical biases impede its clinical application. Recent recommendations suggest of combining RDW with other biomarkers. Accordingly, we propose of evaluating the well-recognized biomarkers of vascular ageing (i.e. the leukocyte telomere length and telomerase activity, and reduced levels of endothelial progenitor cells (EPCs)) with RDW, for predicting the risk for vascular ageing and onset and prognosis of age-related degenerative arterial diseases, such as sporadic ascending aorta aneurysm (AAA), characterized to have an increased incidence in old people. Consequently, in this study (and for the first time), we simultaneously investigated the relationship between RDW values, systemic inflammatory molecules, mean values of leukocyte telomere length, telomerase activity and EPCs, and the risk for vascular ageing and AAA onset and prognosis. To achieve this aim, we selected 80 old and 80 young healthy subjects and 80 AAA cases. Appropriate methodologies were used for assessing blood parameters, aorta alterations, genotyping, impairment of the leukocyte telomere length and telomerase activity. The main findings obtained demonstrated that increased RDW values along with the augmented blood levels of hs-CRP and the reduced mean values of both leukocyte telomere length, telomerase activity and EPCs are independently associated with the high risk for both vascular ageing and AAA onset and prognosis. They might be used as the best predictor biomarker profile for vascular ageing, and for both diagnosis and outcome of sporadic AAA. Keywords: RDW; Leukocyte Telomere Length; Telomere activity; EPCs; Risk for Vascular ageing and Sporadic AAA; Diagnostic and Prognostic AAA Biomarkers.