Huang Jiali, Liu Hong
Department of Gastroenterology, Beijing Shijitan Hospital, Capital Medical University, Beijing, 100038, China.
J Health Popul Nutr. 2025 Aug 12;44(1):288. doi: 10.1186/s41043-025-00905-3.
The red blood cell distribution width-to-albumin ratio (RAR) is an indicator of the body’s inflammatory condition and is associated with several diseases. RAR may be clinically relevant given that inflammation is involved in gallstone formation. However, its association with the development of gallstones remains unclear. This study aimed to explore the relationship between RAR and gallstones.
This population-based cross-sectional study analyzed data from 5800 American adults aged ≥ 20 years, in the National Health and Nutrition Examination Survey (NHANES) 2017–2020. Three multivariate logistic regression models (adjusted for demographics, behaviors, and comorbidities) and a restricted cubic spline (RCS) model were constructed to evaluate the association between RAR and gallstones. Sensitivity analyses, which included stratification and interaction analyses, were performed to identify the population of interest and evaluate the possible interactions between RAR and gallstones.
The study included 5,800 participants with complete data, of whom 620 (10.7%) had gallstones. RCS analysis indicated a positive correlation between RAR levels and the presence of gallstones. Fully adjusted multivariate logistic regression revealed that each 1-unit increase in RAR was significantly associated with elevated gallstone risk (OR = 1.25, 95% CI: 1.06–1.47; = 0.008). Compared to the low RAR group, the high RAR group showed a significantly increased gallstone risk (OR = 1.40, 95% CI: 1.09–1.81; = 0.010). Subgroup analyses indicated that the populations of special concern included individuals aged ≥ 50 years, females, widowed/divorced/separated, smokers, non-diabetic, non-hypertensive, and non-coronary heart disease individuals.
This is the first study to explore the direct positive relationship between RAR and the likelihood of developing gallstones. Its low cost and routine accessibility makes RAR a practical tool for early risk stratification, particularly in high-prevalence populations. Further longitudinal studies are required to confirm causality and clinical applicability.
The online version contains supplementary material available at 10.1186/s41043-025-00905-3.
红细胞分布宽度与白蛋白比值（RAR）是身体炎症状态的一个指标，与多种疾病相关。鉴于炎症参与胆结石形成，RAR可能具有临床相关性。然而，其与胆结石发生的关联仍不明确。本研究旨在探讨RAR与胆结石之间的关系。
这项基于人群的横断面研究分析了2017 - 2020年美国国家健康与营养检查调查（NHANES）中5800名年龄≥20岁的美国成年人的数据。构建了三个多变量逻辑回归模型（针对人口统计学、行为和合并症进行了调整）和一个受限立方样条（RCS）模型，以评估RAR与胆结石之间的关联。进行了敏感性分析，包括分层分析和交互作用分析，以确定感兴趣的人群，并评估RAR与胆结石之间可能的相互作用。
该研究纳入了5800名有完整数据的参与者，其中620人（10.7%）患有胆结石。RCS分析表明RAR水平与胆结石的存在呈正相关。完全调整后的多变量逻辑回归显示，RAR每增加1个单位，胆结石风险显著升高（OR = 1.25，95% CI：1.06 - 1.47；P = 0.008）。与低RAR组相比，高RAR组的胆结石风险显著增加（OR = 1.40，95% CI：1.09 - 1.81；P = 0.010）。亚组分析表明，特别关注的人群包括年龄≥50岁的个体、女性、丧偶/离婚/分居者、吸烟者、非糖尿病患者、非高血压患者和非冠心病患者。
这是第一项探讨RAR与胆结石发生可能性之间直接正相关关系的研究。其低成本和常规可及性使RAR成为早期风险分层的实用工具，特别是在高患病率人群中。需要进一步的纵向研究来证实因果关系和临床适用性。
在线版本包含可在10.1186/s41043 - 025 - 00905 - 3获取的补充材料。
