Kim Kyoung Min, Lui Li-Yung, Cauley Jane A, Ensrud Kristine E, Orwoll Eric S, Schousboe John T, Cummings Steven R
San Francisco Coordinating Center, California Pacific Medical Center Research Institute, San Francisco, CA, USA.
Department of Endocrinology and Metabolism, Seoul National University Bundang Hospital and Seoul National University College of Medicine, Seongnam, South Korea.
J Bone Miner Res. 2020 May;35(5):869-874. doi: 10.1002/jbmr.3963. Epub 2020 Mar 19.
Red cell distribution width (RDW), routinely assessed as a component of a complete blood count (CBC), quantifies the variation in the size of red blood cells. It increases with age, and increased RDW predicts many aging-related diseases and mortality. However, whether it also predicts hip fracture is unknown. We prospectively evaluated the association between RDW and hip fracture using data from the Osteoporotic Fracture in Men (MrOS) study. RDW was measured in 3635 men (aged 71 to 99 years) along with bone mineral density (BMD) in MrOS. RDW ranged from 11.3% to 32.9% (median 14.0%; interquartile range 13.5% to 14.8%) and was categorized into four groups (≤13.0%, 13.1% to 14.0%, 14.1% to 15.0%, ≥15.1%). Study participants with a hemoglobin level <13.0 g/dL were classified as having anemia. During an average 8.1 years, 164 men suffered hip fractures. The risks of hip fractures increased with increase of RDW category. Furthermore, there was a significant interaction between anemia and RDW: An association between RDW and hip fractures was only observed in participants without anemia. In those without anemia, the relative hazard of hip fractures increased with increases in RDW category: Men in the highest RDW category had a 2.8 times higher risk of hip fractures than men in the lowest group (95% confidence interval 1.1 to 7.1). The risks of all-clinical fractures were also increased along with higher RDW values. Additionally, RDW was significantly associated with the risk of having a fall but not with femoral neck or total hip BMD. In conclusion, RDW and anemia defined by hemoglobin are widely available routine laboratory measurements that together could indicate increased risk of hip fracture, reflecting the neuromuscular effects of aging rather than lower hip BMD. © 2020 American Society for Bone and Mineral Research.
红细胞分布宽度（RDW）通常作为全血细胞计数（CBC）的一部分进行评估，用于量化红细胞大小的变异。它随年龄增长而增加，且RDW升高预示着许多与衰老相关的疾病和死亡风险。然而，它是否也能预测髋部骨折尚不清楚。我们利用男性骨质疏松性骨折（MrOS）研究的数据，前瞻性地评估了RDW与髋部骨折之间的关联。在MrOS研究中，对3635名男性（年龄71至99岁）测量了RDW，并同时测量了骨密度（BMD）。RDW范围为11.3%至32.9%（中位数14.0%；四分位间距13.5%至14.8%），并被分为四组（≤13.0%、13.1%至14.0%、14.1%至15.0%、≥15.1%）。血红蛋白水平<13.0 g/dL的研究参与者被归类为贫血。在平均8.1年的时间里，164名男性发生了髋部骨折。髋部骨折的风险随着RDW分类的增加而增加。此外，贫血与RDW之间存在显著的交互作用：仅在无贫血的参与者中观察到RDW与髋部骨折之间的关联。在无贫血的参与者中，髋部骨折的相对风险随着RDW分类的增加而增加：RDW最高组的男性发生髋部骨折的风险比最低组的男性高2.8倍（95%置信区间1.1至7.1）。所有临床骨折的风险也随着RDW值的升高而增加。此外，RDW与跌倒风险显著相关，但与股骨颈或全髋部BMD无关。总之，RDW和由血红蛋白定义的贫血是广泛可用的常规实验室测量指标，两者共同表明髋部骨折风险增加，反映了衰老的神经肌肉效应而非较低的髋部BMD。©2020美国骨与矿物质研究学会。
