The First Clinical College, Shandong University of Traditional Chinese Medicine, Ji Nan, People's Republic of China.
Dongying People's Hospital, Dongying, People's Republic of China.
PLoS One. 2024 Aug 2;19(8):e0307609. doi: 10.1371/journal.pone.0307609. eCollection 2024.
In recent years, increasing attention has been focused on the impact of red blood cell indices (RCIs) on disease prognosis. We aimed to investigate the association of mean corpuscular hemoglobin (MCH), mean corpuscular hemoglobin concentration (MCHC), and mean corpuscular volume (MCV) with mortality.
The study used cohort data from U.S. adults who participated in the 1999-2008 National Health and Nutrition Examination Survey. All-cause mortality was the primary outcome during follow-up, with secondary cardiovascular mortality outcomes. COX regression was applied to analyze the connection between RCIs and mortality. We adopted three models to minimize potential bias. Smooth-fit curves and threshold effect analyses were utilized to observe the dose-response relationship between RCIs and all-cause and cardiovascular mortality. In addition, we performed sensitivity analyses.
21,203 individuals were enrolled in our research. During an average 166.2 ± 54.4 months follow-up, 24.4% of the population died. Curve fitting indicated a U-shaped relationship between MCV and MCH with all-cause mortality, and the relationship of MCHC to all-cause mortality is L-shaped. We identified inflection points in the relationship between MCV, MCH, and MCHC and all-cause mortality as 88.56732 fl, 30.22054 pg, 34.34624 g/dl (MCV <88.56732 fl, adjusted HR 0.99, 95 CI% 0.97-1.00; MCV >88.56732 fl, adjusted HR 1.05, 95 CI% 1.04-1.06. MCH <30.22054 pg, adjusted HR 0.95, 95 CI% 0.92-0.98; MCH >30.22054 pg, adjusted HR 1.08, 95 CI% 1.04-1.12. MCHC <34.34624 g/dl, adjusted HR 0.88, 95 CI% 0.83-0.93). Besides, the MCV curve was U-shaped in cardiovascular mortality (MCV <88.56732 fl, adjusted HR 0.97, 95 CI% 0.94-1.00; MCV >88.56732 fl, adjusted HR 1.04, 95 CI% 1.01-1.06).
This cohort study demonstrated that RCIs (MCH, MCHC, and MCV) were correlated with mortality in the general population. Three RCIs were nonlinearly correlated with all-cause mortality. In addition, there were nonlinear relationships between MCH and MCV and cardiovascular mortality.
近年来，人们越来越关注红细胞指数（RCIs）对疾病预后的影响。我们旨在探讨平均红细胞血红蛋白（MCH）、平均红细胞血红蛋白浓度（MCHC）和平均红细胞体积（MCV）与死亡率之间的关系。
本研究使用了参加 1999-2008 年美国国家健康和营养检查调查的美国成年人的队列数据。全因死亡率是随访期间的主要结局，次要心血管死亡率结局。应用 COX 回归分析 RCIs 与死亡率之间的关系。我们采用了三种模型来最小化潜在的偏倚。采用平滑拟合曲线和阈值效应分析观察 RCIs 与全因和心血管死亡率之间的剂量反应关系。此外，我们还进行了敏感性分析。
共有 21203 人纳入我们的研究。在平均 166.2±54.4 个月的随访期间，有 24.4%的人群死亡。曲线拟合表明 MCV 和 MCH 与全因死亡率呈 U 形关系，而 MCHC 与全因死亡率呈 L 形关系。我们确定了 MCV、MCH 和 MCHC 与全因死亡率之间关系的拐点为 88.56732 fl、30.22054 pg、34.34624 g/dl（MCV<88.56732 fl，调整后的 HR 0.99，95%CI%0.97-1.00；MCV>88.56732 fl，调整后的 HR 1.05，95%CI%1.04-1.06。MCH<30.22054 pg，调整后的 HR 0.95，95%CI%0.92-0.98；MCH>30.22054 pg，调整后的 HR 1.08，95%CI%1.04-1.12。MCHC<34.34624 g/dl，调整后的 HR 0.88，95%CI%0.83-0.93）。此外，MCV 曲线在心血管死亡率方面呈 U 形（MCV<88.56732 fl，调整后的 HR 0.97，95%CI%0.94-1.00；MCV>88.56732 fl，调整后的 HR 1.04，95%CI%1.01-1.06）。
本队列研究表明，RCIs（MCH、MCHC 和 MCV）与普通人群的死亡率相关。三种 RCIs 与全因死亡率呈非线性相关。此外，MCH 和 MCV 与心血管死亡率之间存在非线性关系。
