红细胞分布宽度与非贫血的中年城市成年人认知表现不良直接相关。
Red Cell Distribution Width Is Directly Associated with Poor Cognitive Performance among Nonanemic, Middle-Aged, Urban Adults.
机构信息
Laboratory of Epidemiology and Population Sciences, National Institute on Aging, NIH, Intramural Research Program, Baltimore, MD, USA.
Department of Research Programs, Fort Belvoir Community Hospital, Fort Belvoir, VA, USA.
出版信息
J Nutr. 2020 Jan 1;150(1):128-139. doi: 10.1093/jn/nxz182.
BACKGROUND
Epidemiological evidence suggests that both anemia and elevated red cell distribution width (RDW) are associated with cognitive impairment. However, the interplay between these 2 predictors has been understudied.
OBJECTIVES
We examined sex- and anemia-specific associations between RDW and cognitive performance among urban adults in the United States.
METHODS
Data from the Healthy Aging in Neighborhoods of Diversity Across the Life Span Study (Baltimore, MD; participants aged 30-65 y at baseline, ∼59% African-American, 45% men) were used. Participants were selected based on the completion of 11 cognitive tasks at baseline (2004-2009) and follow-up (2009-2013) visits (mean time between visits: 4.64 ± 0.93 y) and availability of exposure and covariate data, yielding a sample of between 1526 and 1646 adults out of the initial 3720 adults recruited at baseline. Multiple linear mixed-effects regression models were conducted with RDW as the main exposure of interest and anemia/sex as the key effect modifiers.
RESULTS
Overall, high RDWs were linked to poorer baseline performance on the California Verbal Learning Test (CVLT) List A (per 1 unit increase in RDW %, main effect: γ01 = -0.369 ± 0.114; P = 0.001) and to slower rates of decline on the CVLT Delayed Free Recall (per 1 unit increase in RDW %, RDW × time: γ11 = +0.036 ± 0.013; P = 0.007). Among nonanemic participants, RDWs were consistently associated with poorer baseline performance on the Trailmaking Test, Part A (γ01 = +3.11 ± 0.89; P < 0.001) and on the CVLT List A (γ01 = -0.560 ± 0.158; P < 0.001). Moreover, RDWs were associated with poorer baseline performance on the Brief Test of Attention in the total population (γ01 = -0.123 ± 0.039; P = 0.001) and among men (γ01 = -0.221 ± 0.068; P = 0.001). We did not detect an association between hemoglobin (Hb) and baseline cognitive performance or changes over time.
CONCLUSIONS
Elevated RDW had a consistent cross-sectional association with poor cognitive performance in the domains of verbal memory and attention among the nonanemic group in a sample of middle-aged, urban adults. Anemia and Hb concentrations were not associated with cognition. More longitudinal studies are needed to replicate our findings.
背景
流行病学证据表明，贫血和红细胞分布宽度（RDW）升高均与认知障碍有关。然而，这两个预测因素之间的相互作用尚未得到充分研究。
目的
我们研究了美国城市成年人中，RDW 与认知表现之间的性别和贫血特异性关联。
方法
使用了来自多样性在生命跨度研究中的社区健康老龄化研究（巴尔的摩，MD；基线时年龄在 30-65 岁的参与者，约 59%为非裔美国人，45%为男性）的数据。根据在基线（2004-2009 年）和随访（2009-2013 年）访问时完成的 11 项认知任务（两次访问之间的平均时间：4.64±0.93 年）以及暴露和协变量数据的可用性选择参与者，从而从最初招募的 3720 名成年人中产生了 1526 至 1646 名成年人的样本。使用多元线性混合效应回归模型，以 RDW 作为主要关注的暴露因素，以贫血/性别作为关键的效应修饰剂。
结果
总体而言，RDW 升高与加州词语学习测试（CVLT）列表 A 的基线表现较差相关（RDW 每增加 1%，主要效应：γ01=-0.369±0.114；P=0.001），与 CVLT 延迟自由回忆的下降速度较慢相关（RDW 每增加 1%，RDW×时间：γ11=+0.036±0.013；P=0.007）。在非贫血参与者中，RDW 始终与 Trailmaking 测试 A 部分（γ01=+3.11±0.89；P<0.001）和 CVLT 列表 A（γ01=-0.560±0.158；P<0.001）的基线表现较差相关。此外，RDW 与总人群中注意力简短测试的基线表现较差相关（γ01=-0.123±0.039；P=0.001），与男性相关（γ01=-0.221±0.068；P=0.001）。我们没有发现血红蛋白（Hb）与认知表现或随时间变化之间存在关联。
结论
在中年城市成年人的非贫血组中，RDW 与言语记忆和注意力等领域的认知表现较差存在一致的横断面关联。贫血和 Hb 浓度与认知无关。需要更多的纵向研究来复制我们的发现。
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