The second problem relates to the mechanism that MM with increased RDW levels,which involve shortening of telomere length, oxidative stress,inflammation,deregulation of iron metabolism,poor nutritional status (i.e., deficiencies in nutrients such as iron, vitamin B12, and folate),dyslipidemia, hypertension, erythrocyte fragmentation,inadequate production and alteration of erythropoietin function,erythrocyte maturation impairment,changes in red blood cell maturation by altering the red cell membrane and the impaired iron release from reticuloendothelial macrophages [20–23]. Here, EPO is linked to metabolic syndrome.