{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,10]],"date-time":"2026-04-10T08:47:25Z","timestamp":1775810845957,"version":"3.50.1"},"reference-count":0,"publisher":"AVES YAYINCILIK A.\u015e.","license":[{"start":{"date-parts":[[2026,4,8]],"date-time":"2026-04-08T00:00:00Z","timestamp":1775606400000},"content-version":"unspecified","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Turkish Journal of Gastroenterology"],"abstract":"<jats:p>Background\/Aims: The treat-to-target (T2T) strategy requires objective biomarkers in inflammatory bowel disease (IBD). Red cell distribution width (RDW) is of interest and routinely available; however, its incremental diagnostic value beyond anemia and inflammatory markers for detecting endoscopic activity (and histologic activity in ulcerative colitis) remains unclear.\r\nMaterials and Methods: This retrospective cohort included 1000 IBD patients (ulcerative colitis (UC) = 580, Crohn\u2019s disease (CD) = 420). Objective activity was defined endoscopically (UC: Mayo endoscopic subscore \u22652; CD: SES-CD \u22653), with histologic activity (Nancy Index \u22651) as a prespecified secondary endpoint in UC. Red cell distribution width was measured within a peri-endoscopic window (median 1 day; IQR 0-3). Diagnostic performance was assessed using receiver operating characteristic (ROC) analysis, reporting observed and optimism-corrected area under the curve (AUC). Incremental value over C-reactive protein (CRP) was evaluated using the DeLong method. Multivariable logistic regression was adjusted for anemia, iron-related parameters, inflammatory markers, disease extent, and medications.\r\nResults: Active disease is present in 432 patients (43.2%). The RDW is higher in active vs. inactive disease (15.6 \u00c5} 1.8% vs 13.9 \u00c5} 1.4%; P &lt; .001) and shows good discrimination (observed AUC 0.820; optimism-corrected AUC 0.815). A cut-off of 14.5% yield 78.9% sensitivity and 76.3% specificity. Adding RDW to CRP improve AUC from 0.845 to 0.880 (P = .002). Each 1% RDW increase independently predict active disease (adjusted OR 1.65; 95% CI, 1.30-2.09), including non-anemic patients. In UC, RDW increase with histological severity (P &lt; .001).\r\nConclusion: Red cell distribution width independently reflects objective inflammatory activity in IBD and provides incremental value beyond standard markers, supporting its role as a low-cost adjunct for T2T monitoring.\r\n\u00a0\r\nCite this article as: .zden Y. Red cell distribution width as an independent marker of objective disease activity in ulcerative colitis and Crohn\u2019s disease: A large real-world cohort of 1000 patients. Turk J Gastroenterol. Published online April 8, 2026. doi: 10.5152\/ tjg.2026.25788.<\/jats:p>","DOI":"10.5152\/tjg.2026.25788","type":"journal-article","created":{"date-parts":[[2026,4,10]],"date-time":"2026-04-10T07:49:24Z","timestamp":1775807364000},"source":"Crossref","is-referenced-by-count":0,"title":["Red Cell Distribution Width as an Independent Marker of Objective Disease Activity in Ulcerative Colitis and Crohn\u2019s Disease: A Large Real-World Cohort of 1000 Patients"],"prefix":"10.5152","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-5760-3529","authenticated-orcid":false,"given":"Yavuz","family":"\u00d6zden","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"3111","published-online":{"date-parts":[[2026,4,8]]},"container-title":["Turkish Journal of Gastroenterology"],"original-title":[],"link":[{"URL":"https:\/\/www.turkjgastroenterol.org\/index.php\/tjg\/article\/download\/4671\/4367","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/www.turkjgastroenterol.org\/index.php\/tjg\/article\/download\/4671\/4367","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,4,10]],"date-time":"2026-04-10T07:49:24Z","timestamp":1775807364000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.turkjgastroenterol.org\/index.php\/tjg\/article\/view\/4671"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,4,8]]},"references-count":0,"URL":"https:\/\/doi.org\/10.5152\/tjg.2026.25788","relation":{},"ISSN":["2148-5607"],"issn-type":[{"value":"2148-5607","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,4,8]]}}}