红细胞分布宽度与糖尿病患者的全因和心血管死亡率相关。
Red Cell Distribution Width Is Associated with All-Cause and Cardiovascular Mortality in Patients with Diabetes.
机构信息
Harrington Heart and Vascular Institute, University Hospitals Cleveland Medical Center, Cleveland, OH, USA.
Department of Internal Medicine, Cardiovascular Medicine/Cardiac Electrophysiology, American University of Beirut Faculty of Medicine and Medical Center, Beirut, Lebanon.
出版信息
Biomed Res Int. 2017;2017:5843702. doi: 10.1155/2017/5843702. Epub 2017 Nov 21.
BACKGROUND AND METHODS
Red cell distribution width (RDW) has emerged as a prognostic marker in patients with cardiovascular diseases. We investigated mortality in patients with diabetes included in the National Health and Nutrition Examination Survey, in relation to baseline RDW. RDW was divided into 4 quartiles (Q1: ≤12.4%, Q2: 12.5%-12.9%, Q3: 13.0%-13.7%, and Q4: >13.7%).
RESULTS
A total of 3,061 patients were included: mean age 61 ± 14 years, 50% male, 39% White. Mean RDW was 13.2% ± 1.4%. Compared with first quartile (Q1) of RDW, patients in Q4 were more likely to be older, female, and African-American, have had history of stroke, myocardial infarction, and heart failure, and have chronic kidney disease. After a median follow-up of 6 years, 628 patient died (29% of cardiovascular disease). Compared with Q1, patients in Q4 were at increased risk for all-cause mortality (HR 3.44 [2.74-4.32], < .001) and cardiovascular mortality (HR 3.34 [2.16-5.17], < .001). After adjusting for 17 covariates, RDW in Q4 remained significantly associated with all-cause mortality (HR 2.39 [1.30-4.38], = 0.005) and cardiovascular mortality (HR 1.99 [1.17-3.37], = 0.011).
CONCLUSION
RDW is a powerful and an independent marker for prediction of all-cause mortality and cardiovascular mortality in patients with diabetes.
背景与方法
红细胞分布宽度（RDW）已成为心血管疾病患者的预后标志物。我们研究了全国健康和营养检查调查中纳入的糖尿病患者的死亡率与基线 RDW 之间的关系。RDW 分为 4 个四分位（Q1：≤12.4%，Q2：12.5%-12.9%，Q3：13.0%-13.7%，Q4：>13.7%）。
结果
共纳入 3061 例患者：平均年龄 61±14 岁，50%为男性，39%为白人。平均 RDW 为 13.2%±1.4%。与 RDW 的第一四分位数（Q1）相比，Q4 组患者年龄更大、女性更多、非裔美国人更多，有中风、心肌梗死和心力衰竭病史，且患有慢性肾脏病。中位随访 6 年后，628 例患者死亡（29%死于心血管疾病）。与 Q1 相比，Q4 组患者全因死亡率（HR 3.44[2.74-4.32]，<0.001）和心血管死亡率（HR 3.34[2.16-5.17]，<0.001）均升高。调整 17 个协变量后，Q4 的 RDW 与全因死亡率（HR 2.39[1.30-4.38]，=0.005）和心血管死亡率（HR 1.99[1.17-3.37]，=0.011）仍显著相关。
结论
RDW 是预测糖尿病患者全因死亡率和心血管死亡率的有力且独立的标志物。
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