Incremental Predictive Value of Platelet Distribution Width for Left Ventricular Hypertrophy in Pediatric Primary Hypertension

Incremental Predictive Value of Platelet Distribution Width for Left Ventricular Hypertrophy in Pediatric Primary Hypertension | Research Square window.SnipcartSettings = { analytics: { enabled: false } }; (function() { var accessVector = localStorage.getItem('access_vector') || ''; window.dataLayer = window.dataLayer || []; if (accessVector) { window.dataLayer.push({ user: { profile: { profileInfo: { snid: accessVector } } } }); } })(); (function(w,d,s,l,i){w[l]=w[l]||[];w[l].push({'gtm.start':new Date().getTime(),event:'gtm.js'});var f=d.getElementsByTagName(s)[0],j=d.createElement(s),dl=l!='dataLayer'?'&l='+l:'';j.async=true;j.src='https://www.googletagmanager.com/gtm.js?id='+i+dl;f.parentNode.insertBefore(j,f);})(window,document,'script','dataLayer','GTM-K279D39R'); Browse Preprints In Review Journals COVID-19 Preprints AJE Video Bytes Research Tools Research Promotion AJE Professional Editing AJE Rubriq About Preprint Platform In Review Editorial Policies Our Team Advisory Board Help Center Sign In Submit a Preprint Cite Share Download PDF Research Article Incremental Predictive Value of Platelet Distribution Width for Left Ventricular Hypertrophy in Pediatric Primary Hypertension Kexin Zhu, Ruijuan Su, Jiao Yang, Guowen Liu, Liyuan Xu, Jingya Li, and 6 more This is a preprint; it has not been peer reviewed by a journal. https://doi.org/ 10.21203/rs.3.rs-9473856/v1 This work is licensed under a CC BY 4.0 License Status: Posted Version 1 posted You are reading this latest preprint version Abstract Purpose:Left ventricular hypertrophy (LVH) represents the most common form of target-organ damage in pediatric primary hypertension, yet accessible biomarkers associated with early cardiac remodeling remain poorly characterized. This study investigated whether platelet distribution width (PDW), a routinely available platelet index, is associated with LVH in children with primary hypertension using an adiposity-matched design and evaluated its incremental predictive value beyond conventional clinical factors. Methods: We conducted a 1:1 matched case–control study including 126 treatment-naïve children with primary hypertension (63 matched pairs). Patients with echocardiographic LVH were matched to controls by age, sex, and body mass index. Conditional logistic regression was used to evaluate the association between PDW and LVH after adjustment for visceral adiposity index, obstructive sleep apnea syndrome, and hypertension grade. Incremental predictive value was assessed using receiver-operating characteristic analysis and reclassification metrics. Results: Despite comparable body mass index, PDW was significantly higher in children with LVH than in matched controls (12.22 ±1.44 vs. 11.13 ±1.18 fL, P < 0.001). PDW showed modest discrimination for LVH (AUC = 0.696). After multivariable adjustment, PDW remained independently associated with LVH (odds ratio 1.53, 95% confidence interval 1.09–2.13; P = 0.013). Addition of PDW to the clinical base model improved discrimination (AUC 0.703 to 0.791; ΔAUC 0.087, 95% CI 0.022–0.152) and risk reclassification (continuous NRI = 0.603). Conclusion: PDW independently predicts LVH and enhances risk stratification in pediatric hypertension. platelet distribution width left ventricular hypertrophy pediatric hypertension target organ damage risk stratification Full Text Additional Declarations No competing interests reported. Supplementary Files SupplementaryMaterial.pdf Cite Share Download PDF Status: Posted Version 1 posted You are reading this latest preprint version Research Square lets you share your work early, gain feedback from the community, and start making changes to your manuscript prior to peer review in a journal. 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Also discoverable on Platform About Our Team In Review Editorial Policies Advisory Board Help Center Resources Author Services Accessibility API Access RSS feed Manage Cookie Preferences © Research Square 2026 | ISSN 2693-5015 (online) Privacy Policy Terms of Service Do Not Sell My Personal Information {"props":{"pageProps":{"initialData":{"identity":"rs-9473856","acceptedTermsAndConditions":true,"allowDirectSubmit":true,"archivedVersions":[],"articleType":"Research Article","associatedPublications":[],"authors":[{"id":634321852,"identity":"3a906846-5af1-490d-ad1b-fa05765dc3b9","order_by":0,"name":"Kexin Zhu","email":"","orcid":"","institution":"Capital Medical University","correspondingAuthor":false,"prefix":"","firstName":"Kexin","middleName":"","lastName":"Zhu","suffix":""},{"id":634321853,"identity":"b987b1f6-e9c3-4b33-861f-3a8963aef857","order_by":1,"name":"Ruijuan Su","email":"","orcid":"","institution":"Capital Medical 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14:53:10","currentVersionCode":1,"declarations":"","doi":"10.21203/rs.3.rs-9473856/v1","doiUrl":"https://doi.org/10.21203/rs.3.rs-9473856/v1","draftVersion":[],"editorialEvents":[],"editorialNote":"","failedWorkflow":false,"files":[{"id":109412663,"identity":"949ecb3a-0395-4d04-b931-3642eb174f75","added_by":"auto","created_at":"2026-05-17 16:10:19","extension":"pdf","order_by":1,"title":"","display":"","copyAsset":false,"role":"manuscript-pdf","size":403395,"visible":true,"origin":"","legend":"","description":"","filename":"Manuscript.pdf","url":"https://assets-eu.researchsquare.com/files/rs-9473856/v1_covered_d79f32c5-64bd-4f10-9649-c571d2c8dd5f.pdf"},{"id":108502078,"identity":"4f710474-3281-4de4-9bea-e158ff2c1f04","added_by":"auto","created_at":"2026-05-05 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Hypertension\u003c/p\u003e","fulltext":[],"fulltextSource":"","fullText":"","funders":[],"hasAdminPriorityOnWorkflow":false,"hasManuscriptDocX":false,"hasOptedInToPreprint":true,"hasPassedJournalQc":"","hasAnyPriority":false,"hideJournal":true,"highlight":"","institution":"","isAcceptedByJournal":false,"isAuthorSuppliedPdf":true,"isDeskRejected":"","isHiddenFromSearch":false,"isInQc":false,"isInWorkflow":false,"isPdf":true,"isPdfUpToDate":true,"isWithdrawnOrRetracted":false,"journal":{"display":true,"email":"[email protected]","identity":"researchsquare","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":true,"externalIdentity":"","sideBox":"","snPcode":"","submissionUrl":"/submission","title":"Research Square","twitterHandle":"researchsquare","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"","reportingPortfolio":"","inReviewEnabled":false,"inReviewRevisionsEnabled":true},"keywords":"platelet distribution width, left ventricular hypertrophy, pediatric hypertension, target organ damage, risk stratification","lastPublishedDoi":"10.21203/rs.3.rs-9473856/v1","lastPublishedDoiUrl":"https://doi.org/10.21203/rs.3.rs-9473856/v1","license":{"name":"CC BY 4.0","url":"https://creativecommons.org/licenses/by/4.0/"},"manuscriptAbstract":"\u003cp\u003ePurpose:Left ventricular hypertrophy (LVH) represents the most common form of target-organ damage in pediatric primary hypertension, yet accessible biomarkers associated with early cardiac remodeling remain poorly characterized. This study investigated whether platelet distribution width (PDW), a routinely available platelet index, is associated with LVH in children with primary hypertension using an adiposity-matched design and evaluated its incremental predictive value beyond conventional clinical factors.\u003c/p\u003e\n\u003cp\u003eMethods: We conducted a 1:1 matched case–control study including 126 treatment-naïve children with primary hypertension (63 matched pairs). Patients with echocardiographic LVH were matched to controls by age, sex, and body mass index. Conditional logistic regression was used to evaluate the association between PDW and LVH after adjustment for visceral adiposity index, obstructive sleep apnea syndrome, and hypertension grade. Incremental predictive value was assessed using receiver-operating characteristic analysis and reclassification metrics.\u003c/p\u003e\n\u003cp\u003eResults: Despite comparable body mass index, PDW was significantly higher in children with LVH than in matched controls (12.22 ±1.44 vs. 11.13 ±1.18 fL, P \u0026lt; 0.001). PDW showed modest discrimination for LVH (AUC = 0.696). After multivariable adjustment, PDW remained independently associated with LVH (odds ratio 1.53, 95% confidence interval 1.09–2.13; P = 0.013). Addition of PDW to the clinical base model improved discrimination (AUC 0.703 to 0.791; ΔAUC 0.087, 95% CI 0.022–0.152) and risk reclassification (continuous NRI = 0.603).\u003c/p\u003e\n\u003cp\u003eConclusion: PDW independently predicts LVH and enhances risk stratification in pediatric hypertension.\u003c/p\u003e","manuscriptTitle":"Incremental Predictive Value of Platelet Distribution Width for Left Ventricular Hypertrophy in Pediatric Primary Hypertension","msid":"","msnumber":"","nonDraftVersions":[{"code":1,"date":"2026-05-05 10:55:30","doi":"10.21203/rs.3.rs-9473856/v1","editorialEvents":[{"type":"communityComments","content":0}],"status":"published","journal":{"display":true,"email":"[email protected]","identity":"researchsquare","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":true,"externalIdentity":"","sideBox":"","snPcode":"","submissionUrl":"/submission","title":"Research Square","twitterHandle":"researchsquare","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"","reportingPortfolio":"","inReviewEnabled":false,"inReviewRevisionsEnabled":true}}],"origin":"","ownerIdentity":"2c28e02b-9445-4fec-bf86-8ac79a62658d","owner":[],"postedDate":"May 5th, 2026","published":true,"recentEditorialEvents":[{"type":"decision","content":"Rejected","date":"2026-05-17T15:55:38+00:00","index":"","fulltext":""},{"type":"editorInvitedReview","content":"","date":"2026-05-17T13:22:07+00:00","index":49,"fulltext":""},{"type":"reviewerAgreed","content":"266978997199165658134635373716809725719","date":"2026-05-06T22:56:40+00:00","index":46,"fulltext":""}],"rejectedJournal":[],"revision":"","amendment":"","status":"posted","subjectAreas":[],"tags":[],"updatedAt":"2026-05-17T16:09:25+00:00","versionOfRecord":[],"versionCreatedAt":"2026-05-05 10:55:30","video":"","vorDoi":"","vorDoiUrl":"","workflowStages":[]},"version":"v1","identity":"rs-9473856","journalConfig":"researchsquare"},"__N_SSP":true},"page":"/article/[identity]/[[...version]]","query":{"redirect":"/article/rs-9473856","identity":"rs-9473856","version":["v1"]},"buildId":"XKTyCvWXoU3ODBz1xrDgd","isFallback":false,"isExperimentalCompile":false,"dynamicIds":[84888],"gssp":true,"scriptLoader":[]}