Association between red blood cell distribution width and prediabetes: evidence from a single center cohort study

Background Prediabetes is a condition characterized with chronic inflammation. Alterations in hemogram parameters, especially, red cell distribution width (RDW), and mean platelet volume (MPV) are associated with inflammatory diseases. In present study, we aimed to compare hemogram parameters of subjects with prediabetes to healthy volunteers.Methods Patients with prediabetes were enrolled to the study who visited outpatient internal medicine clinics of our institution Hospital, between January 2023 and September 2025. Control subjects were healthy individuals who visited our clinics for a routine check-up. Hemogram parameters of prediabetes and control groups were compared.Results Study cohort was consisted of 324 subjects; 172 in prediabetes and 152 in control group. Median RDW of the prediabetes group (15,3 (2,1)%) was significantly higher than the RDW of control subjects (14,75 (3,1)%), (p < 0.001). Median MPV of the patients with prediabetes (7,9 (2,4)fL), was significantly lower than that of the controls (8,59 (2,4)fL), (p = 0.01). RDW, but not MPV, was significantly correlated with FPG (r = 0.18, p = 0.001), HbA1c (r = 0.4, p < 0.001), triglyceride (r = 0.23, p < 0.001), and serum albumin (r = 0.5, p < 0.001). The sensitivity and specificity of RDW (when higher than 14.7%) in detecting prediabetes were 69% and 49%, respectively (AUC: 0.67, p < 0.001, 95%CI: 0.61–0.73). Regression analysis, considering RDW, age, triglyceride, FPG and BMI, revealed that RDW was an independent predictor of prediabetes (OR: 1.6, p < 0.001, 95%CI: 1.3–1.9).Conclusions We suggest that RDW reflects certain changes in cardiometabolic health that occur in association with the development of prediabetes.