Department of Orthopedics, the First Affiliated Hospital of Jinan University, Guangzhou, 510630, China.
Department of Spine Surgery, Maoming People's Hospital, Maoming, 525000, China.
BMC Musculoskelet Disord. 2024 Oct 30;25(1):866. doi: 10.1186/s12891-024-07984-z.
Hemoglobin-to-Red Cell Distribution Width Ratio (HRR) represents novel prognostic markers for diseases. However, there remains a lack of systematic research into the relationship between HRR and Bone Mineral Density (BMD) or osteoporosis in older adults.
This study utilized information from the NHANES database, selecting individuals over 50 years of age with complete femoral DXA scans and full blood counts. The relationship between HRR and femoral BMD was investigated using weighted linear models and restricted cubic spline (RCS) models. Moreover, the association between HRR and osteoporosis was further explored using logistic regression models and RCS models, with subgroup analysis conducted to test the robustness of the results.
This study included a total of 7,149 participants, and the BMD of the group with higher HRR was significantly greater than that of the group with lower HRR. Weighted linear regression analysis found a linear positive correlation between HRR and femoral BMD. When HRR was converted from a continuous variable to a categorical variable, this relationship remained stable. In addition, multivariate logistic regression analysis showed that for each 1-unit increase in HRR, the prevalence of osteoporosis significantly decreased (OR = 0.25, 95% CI: 0.12-0.51), further confirming the findings of this study. Subgroup analysis showed that this association was not significantly affected by confounding factors across different populations.
HRR may serve as one of the potential indicators for evaluating BMD and assessing the prevalence of osteoporosis in the elderly. Elevating HRR levels may play a crucial role in the prevention and slowing of osteoporosis progression.
血红蛋白与红细胞分布宽度比值（HRR）是疾病新的预后标志物。然而，对于 HRR 与老年人的骨密度（BMD）或骨质疏松症之间的关系，仍缺乏系统的研究。
本研究利用 NHANES 数据库中的信息，选择年龄在 50 岁以上、股骨 DXA 扫描完整且全血细胞计数完整的个体。使用加权线性模型和限制立方样条（RCS）模型研究 HRR 与股骨 BMD 之间的关系。此外，使用逻辑回归模型和 RCS 模型进一步探讨 HRR 与骨质疏松症之间的关联，并进行亚组分析以检验结果的稳健性。
本研究共纳入 7149 名参与者，HRR 较高组的 BMD 显著高于 HRR 较低组。加权线性回归分析发现 HRR 与股骨 BMD 之间存在线性正相关。当 HRR 从连续变量转换为分类变量时，这种关系仍然稳定。此外，多变量逻辑回归分析表明，HRR 每增加 1 个单位，骨质疏松症的患病率显著降低（OR=0.25，95%CI：0.12-0.51），进一步证实了本研究的结果。亚组分析表明，这种关联在不同人群中不受混杂因素的显著影响。
HRR 可能是评估老年人 BMD 和骨质疏松症患病率的潜在指标之一。升高 HRR 水平可能在预防和减缓骨质疏松症进展方面发挥关键作用。
