吸烟与冠心病之间的关联：红细胞分布宽度的中介作用

Associations between smoking and coronary heart disease: mediating role of RDW.

作者信息

Ma Mingfeng, Wu Yue, He Xingmin, Zhang Miaomiao, Han Yanlin, Guo Renwei, Li Shaojie

机构信息

Department of Cultivation Key Laboratory of Metabolic Cardiovascular Diseases Research, Fenyang Hospital Affiliated to Shanxi Medical University, Fenyang, Shanxi, China.

Department of Cardiovascular Medicine, Fenyang Hospital Affiliated to Shanxi Medical University, Fenyang, Shanxi, China.

出版信息

Front Public Health. 2024 Nov 15;12:1447303. doi: 10.3389/fpubh.2024.1447303. eCollection 2024.

DOI:10.3389/fpubh.2024.1447303

PMID:39618953

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC11604624/

Abstract

INTRODUCTION

Previous studies have demonstrated that both smoking and coronary heart disease (CHD) are linked to red cell distribution width (RDW). However, the role of the RDW in the association between smoking and CHD remains unclear. This study investigates the role of RDW in the association between smoking and coronary heart disease.

METHODS

Data from 13,080 adults aged 40-80 years were analyzed from the National Health and Nutrition Examination Survey (NHANES) conducted between 2006 and 2017. Statistical methods included regression analysis, restricted cubic spline curve (RCS), subgroup analysis, and mediation analysis.

RESULTS

Results showed higher RDW levels in participants with smoking and/or CHD than in those without. Smoking status was positively associated with RDW and CHD even after adjusting for potential confounders. A nonlinear relationship between RDW and CHD was observed ( for nonlinear <0.001). Subgroup analysis revealed that sex influenced the relationship between smoking and CHD ( = 0.0284). Mediation analysis showed that increased RDW levels mediated the association between smoking status and CHD (PM = 2.1959%, ACME = 0.000694, 95% CI = 0.000262-0.001259, < 0.001).

DISCUSSION

Our research showed that smoking, RDW, and CHD are interrelated, with RDW playing as a mediator, offering a novel perspective for the prevention and management of CHD.

摘要

引言

先前的研究表明，吸烟和冠心病（CHD）均与红细胞分布宽度（RDW）有关。然而，RDW在吸烟与冠心病关联中的作用仍不明确。本研究旨在探讨RDW在吸烟与冠心病关联中的作用。

方法

分析了2006年至2017年期间进行的美国国家健康与营养检查调查（NHANES）中13080名40 - 80岁成年人的数据。统计方法包括回归分析、限制性立方样条曲线（RCS）、亚组分析和中介分析。

结果

结果显示，吸烟和/或患有冠心病的参与者的RDW水平高于未患冠心病的参与者。即使在调整潜在混杂因素后，吸烟状况仍与RDW和冠心病呈正相关。观察到RDW与冠心病之间存在非线性关系（非线性<0.001）。亚组分析显示，性别影响吸烟与冠心病之间的关系（=0.0284）。中介分析表明，RDW水平升高介导了吸烟状况与冠心病之间的关联（PM = 2.1959%，ACME = 0.000694，95% CI = 0.000262 - 0.001259，<0.001）。