Ruan Zhishen, Wang Yanyan, Fan Yiling, Xu Bo, Yuan Shasha, Cong Xiaodong, Li Dan, Miao Qing
Xiyuan Hospital of Chinese Academy of Chinese Medical Sciences, Beijing, China.
Dongying People's Hospital (Dongying Hospital of Shandong Provincial Hospital Group), Dongying, Shandong, China.
Sci Rep. 2025 Feb 22;15(1):6487. doi: 10.1038/s41598-025-87469-8.
Statistically, 30% of asthma deaths occur among asthmatics with insignificant symptoms, which creates a social burden. We aimed to analyze the role of erythrocyte distribution width (RDW) in the prognosis of asthma, especially in patients with insignificant symptoms. We included 3039 adult (≥ 20 years) asthma patients from the National Health and Nutrition Examination Survey (NHANES). Cox regression was used to assess the association between RDW and long-term mortality. We adjusted three models to reduce potential bias. Subgroup analysis is used to evaluate specific populations. In addition, receiver operating characteristic (ROC) curves were used to analyze the predictive effect of RDW on asthma mortality. After a mean follow-up of 130 months, we found a positive correlation between RDW and long-term mortality. After aliquoting RDW into thirds, the high RDW (RDW ≥ 13.0%) group had higher all-cause mortality (HR 1.66, 95% CI 1.18-2.34) and respiratory mortality (HR 8.69, 95% CI 2.03-37.3). There was a significant interaction of RDW in the male and wheezing subgroups for respiratory mortality. Combining RDW and wheezing, we found that patients with high RDW and wheezing had the most increased respiratory mortality, and patients with high RDW but no wheezing also had higher mortality. Furthermore, the area under the curve of the RDW in predicting respiratory death in asthmatics was greater than 80%. Our study showed an association between high RDW and poor prognosis in asthma patients. In combination with wheezing symptoms, RDW is expected to be a biomarker for asthma management.
从统计学角度来看，30%的哮喘死亡发生在症状不明显的哮喘患者中，这造成了社会负担。我们旨在分析红细胞分布宽度（RDW）在哮喘预后中的作用，尤其是在症状不明显的患者中。我们纳入了来自美国国家健康与营养检查调查（NHANES）的3039名成年（≥20岁）哮喘患者。采用Cox回归分析RDW与长期死亡率之间的关联。我们调整了三个模型以减少潜在偏差。亚组分析用于评估特定人群。此外，采用受试者工作特征（ROC）曲线分析RDW对哮喘死亡率的预测作用。在平均随访130个月后，我们发现RDW与长期死亡率呈正相关。将RDW三等分后，高RDW（RDW≥13.0%）组的全因死亡率（HR 1.66，95%CI 1.18 - 2.34）和呼吸死亡率（HR 8.69，95%CI 2.03 - 37.3）更高。在男性和喘息亚组中RDW对呼吸死亡率有显著交互作用。结合RDW和喘息情况，我们发现高RDW且有喘息的患者呼吸死亡率增加最多，高RDW但无喘息的患者死亡率也较高。此外，RDW预测哮喘患者呼吸死亡的曲线下面积大于80%。我们的研究表明高RDW与哮喘患者预后不良有关。结合喘息症状，RDW有望成为哮喘管理的生物标志物。
