Department of Internal Medicine, Severance Hospital, Endocrine Research Institute, Yonsei University College of Medicine, 50-1 Yonsei-ro, Seodaemun-gu, Seoul, 03722, South Korea.
Graduate School, Yonsei University College of Medicine, Seoul, South Korea.
Calcif Tissue Int. 2019 Jan;104(1):26-33. doi: 10.1007/s00223-018-0470-9. Epub 2018 Aug 29.
Elevated red blood cell distribution width (RDW), a simple measure of red blood cell size heterogeneity, has been associated with increased mortality and morbidity in the elderly population, which might reflect systemic inflammation and malnutrition. However, whether elevated RDW is associated with prevalent morphometric vertebral fracture (VF) in older adults has not been investigated. We examined 2127 individuals (mean age 71.7 years; women 66%) from a community-based cohort. VF was defined as ≥ 25% reduction in vertebral column height using the Genant semiquantitative method. Multiple VF was defined as the presence of VF at two or more sites. The prevalence of any VF and multiple VF was 14% and 4%, respectively, increasing from the lowest to the highest RDW tertiles (12-18% and 3-6%, p for trend < 0.05 for all). RDW was positively associated with age, body mass index (BMI), malnutrition, and high-sensitivity C-reactive protein (hsCRP), whereas it was negatively associated with albumin, hemoglobin, and ferritin levels. Elevated RDW was associated with any VF [adjusted odds ratio (aOR) 1.26; p = 0.008] and multiple VF (aOR 1.36; p = 0.010) after adjustment for covariates, including age, sex, BMI, hsCRP, malnutrition, self-reported previous fracture, falls, osteoporosis, and hemoglobin and ferritin levels. The association between elevated RDW and VF remained robust in subgroups with (aOR 1.39; p = 0.048) or without anemia (aOR 1.26; p = 0.030). Elevated RDW was associated with prevalent morphometric VF in community-dwelling elderly individuals, independent of anemia, inflammation, and nutritional status.
红细胞体积分布宽度（RDW）升高，一种红细胞大小异质性的简单测量方法，与老年人群的死亡率和发病率增加相关，这可能反映了全身炎症和营养不良。然而，升高的 RDW 是否与老年人常见的形态计量性椎体骨折（VF）相关尚未被研究。我们检查了来自基于社区的队列的 2127 个人（平均年龄 71.7 岁；女性 66%）。VF 定义为使用 Genant 半定量方法椎体柱高度降低≥25%。多处 VF 定义为两个或更多部位存在 VF。任何 VF 和多处 VF 的患病率分别为 14%和 4%，从 RDW 三分位最低到最高依次递增（12-18%和 3-6%，所有趋势的 p 值均＜0.05）。RDW 与年龄、体重指数（BMI）、营养不良和高敏 C 反应蛋白（hsCRP）呈正相关，而与白蛋白、血红蛋白和铁蛋白水平呈负相关。校正协变量（包括年龄、性别、BMI、hsCRP、营养不良、自我报告的既往骨折、跌倒、骨质疏松症以及血红蛋白和铁蛋白水平）后，RDW 升高与任何 VF（调整后的比值比[aOR]1.26；p=0.008）和多处 VF（aOR 1.36；p=0.010）相关。在存在（aOR 1.39；p=0.048）或不存在贫血（aOR 1.26；p=0.030）的亚组中，RDW 与 VF 之间的关联仍然稳健。RDW 升高与社区居住的老年人群中常见的形态计量性 VF 相关，与贫血、炎症和营养状况无关。
