红细胞分布宽度与中国成年人新发糖尿病的关系：一项队列研究。
The Relationship between Red Blood Cell Distribution Width and Incident Diabetes in Chinese Adults: A Cohort Study.
机构信息
Department of Clinical Nutrition, Ren Ji Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China.
Department of Gastroenterology, Ren Ji Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China.
出版信息
J Diabetes Res. 2020 Feb 27;2020:1623247. doi: 10.1155/2020/1623247. eCollection 2020.
BACKGROUND
Previous studies reported the controvertible association between red blood cell distribution width (RDW) and diabetes. The aim of this study is to explore whether RDW is associated with incident diabetes.
METHODS
We performed this cohort study in 16,971 Chinese adults (9,956 men and 7,015 women, aged 43.3 ± 12.8 years). The level of RDW was measured at baseline (2014). All the participants were further classified into four quartile groups based on baseline RDW. Fasting blood glucose (FBG) and glycated hemoglobin A1c (HbA1c) were measured annually during follow-up (2014-2019). Diabetes was diagnosed if either FBG ≥ 7.0 mmol/L or HbA1c ≥ 6.5%. We used the Cox proportional hazards regression model to evaluate the association between baseline RDW and incident diabetes.
RESULTS
We identified 2,703 new cases of diabetes during five-year follow-up. The incidence was 15.9%. Comparing with participants in the lowest quartile group (reference group), the adjusted hazard ratios (HR) for the risk of diabetes were 1.31 (95% CI: 1.16, 1.48) for the highest quartile group ( trend < 0.001), after adjustment for potential confounders. Further adjusting baseline FBG and HbA1c did not materially change the association between RDW and incident diabetes. Each unit increase of RDW was associated with a 16% higher risk of incident diabetes (HR = 1.16, 95% CI: 1.06, 1.26) in a fully adjusted model. Sensitivity analysis generated similar results with prospective analyses after excluding aged participants, participants who are overweight and with obesity, participants with elevated blood pressure, participants with decreased eGFR, and those with anemia at baseline.
CONCLUSIONS
High RDW was associated with high risk of developing diabetes in Chinese adults. As RDW is an inexpensive, noninvasive, and convenient indicator, RDW might be considered for inclusion in the risk assessment of high-risk groups of diabetes.
背景
先前的研究报告称红细胞分布宽度（RDW）与糖尿病之间存在争议性关联。本研究旨在探讨 RDW 是否与糖尿病发病相关。
方法
我们在 16971 名中国成年人（9956 名男性和 7015 名女性，年龄 43.3±12.8 岁）中进行了这项队列研究。在基线（2014 年）测量 RDW 水平。所有参与者根据基线 RDW 进一步分为四个四分位组。在随访期间（2014-2019 年）每年测量空腹血糖（FBG）和糖化血红蛋白 A1c（HbA1c）。如果 FBG≥7.0mmol/L 或 HbA1c≥6.5%，则诊断为糖尿病。我们使用 Cox 比例风险回归模型评估基线 RDW 与新发糖尿病之间的关系。
结果
在五年的随访中，我们发现了 2703 例新发糖尿病病例，发病率为 15.9%。与最低四分位组（参考组）相比，最高四分位组（趋势<0.001）发生糖尿病的风险调整后 HR 为 1.31（95%CI：1.16，1.48）。进一步调整基线 FBG 和 HbA1c 并未实质性改变 RDW 与新发糖尿病之间的关联。在完全调整模型中，RDW 每增加一个单位，新发糖尿病的风险增加 16%（HR=1.16，95%CI：1.06，1.26）。敏感性分析在排除基线时年龄较大、超重和肥胖、血压升高、eGFR 降低以及贫血的参与者后，采用前瞻性分析得出了类似的结果。
结论
高 RDW 与中国成年人发生糖尿病的风险增加相关。由于 RDW 是一种廉价、无创、方便的指标，因此 RDW 可能被考虑纳入糖尿病高危人群的风险评估中。
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