Linear and non-linear relationships between red blood cell indices and cardiovascular risk factors: findings from the China National Health Survey

Abstract Introduction Cardiovascular diseases (CVDs) are a leading cause of mortality worldwide. Red blood cell indices (RBIs) are associated with CVD risk factors (CRFs) and easy to test, making them useful as a screening tool for early identification of individuals at high risk for CVDs. Methods D...

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Main Authors: Huijing He, Li Pan, Feng Liu, Xiaolan Ren, Ze Cui, Lize Pa, Dingming Wang, Jingbo Zhao, Hailing Wang, Xianghua Wang, Jianwei Du, Xia Peng, Guangliang Shan
Format: Article
Language:English
Published: BMC 2024-12-01
Series:BMC Public Health
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Online Access:https://doi.org/10.1186/s12889-024-20988-7
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author Huijing He
Li Pan
Feng Liu
Xiaolan Ren
Ze Cui
Lize Pa
Dingming Wang
Jingbo Zhao
Hailing Wang
Xianghua Wang
Jianwei Du
Xia Peng
Guangliang Shan
author_facet Huijing He
Li Pan
Feng Liu
Xiaolan Ren
Ze Cui
Lize Pa
Dingming Wang
Jingbo Zhao
Hailing Wang
Xianghua Wang
Jianwei Du
Xia Peng
Guangliang Shan
author_sort Huijing He
collection DOAJ
description Abstract Introduction Cardiovascular diseases (CVDs) are a leading cause of mortality worldwide. Red blood cell indices (RBIs) are associated with CVD risk factors (CRFs) and easy to test, making them useful as a screening tool for early identification of individuals at high risk for CVDs. Methods Data from 31,781 participants in the China National Health Survey conducted from 2012 to 2017 were analyzed. Linear and non-linear relationships between RBIs and CRFs (hyperuricemia, diabetes, dyslipidemia) were assessed using restricted cubic splines. Propensity score weighting was used to balance confounders between RBI groups in the multivariable logistic regression models. Results Hemoglobin concentration, red blood cell count and hematocrit all showed a significant linear dose-response association with all CRFs (p values < 0.001). Higher RBIs levels were associated with increased risk of hyperuricemia, diabetes, high LDL, high triglycerides, and high total cholesterol, but decreased HDL. For example, compared to the lowest quantile of HGB, the highest quantile had a 26% (13-40%) higher risk for hyperuricemia, a 43% (25-63%) higher risk of diabetes, 87% (61%-1.18 fold) higher risk of high LDL, and 68% (52-85%) higher risk of high triglycerides. Non-linear relationships were revealed between RBIs and most CRFs except uric acid and glucose. Sex differences were observed, with stronger associations between RBIs and hyperuricemia in women but stronger links with high LDL in men. Conclusions Elevated RBIs indicated higher risk of multiple CRFs. These findings suggest incorporating RBIs into CVD screening strategies to facilitate early prevention efforts, with consideration of sex differences.
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spelling doaj-art-008c05a30c6743e88e0bff1d5fcdb99c2024-12-22T12:52:25ZengBMCBMC Public Health1471-24582024-12-0124111210.1186/s12889-024-20988-7Linear and non-linear relationships between red blood cell indices and cardiovascular risk factors: findings from the China National Health SurveyHuijing He0Li Pan1Feng Liu2Xiaolan Ren3Ze Cui4Lize Pa5Dingming Wang6Jingbo Zhao7Hailing Wang8Xianghua Wang9Jianwei Du10Xia Peng11Guangliang Shan12Department of Epidemiology and Statistics, Institute of Basic Medical Sciences, School of Basic Medicine, Chinese Academy of Medical Sciences, Peking Union Medical CollegeDepartment of Epidemiology and Statistics, Institute of Basic Medical Sciences, School of Basic Medicine, Chinese Academy of Medical Sciences, Peking Union Medical CollegeDepartment of Chronic and Noncommunicable Disease Prevention and Control, Shaanxi Provincial Center for Disease Control and PreventionDepartment of Chronic and Noncommunicable Disease Prevention and Control, Gansu Provincial Center for Disease Control and PreventionDepartment of Chronic and Noncommunicable Disease Prevention and Control, Hebei Provincial Center for Disease Control and PreventionDepartment of Chronic and Noncommunicable Disease Prevention and Control, Xinjiang Uyghur Autonomous Region Center for Disease Control and PreventionDepartment of Chronic and Noncommunicable Disease Prevention and Control, Guizhou Provincial Center for Disease Control and PreventionDepartment of Epidemiology and Statistics, School of Public Health, Harbin Medical UniversityDepartment of Chronic and Noncommunicable Disease Prevention and Control, Inner Mongolia Autonomous Region Center for Disease Control and PreventionIntegrated Office, Institute of Biomedical Engineering, Chinese Academy of Medical Sciences, Peking Union Medical CollegeDepartment of Chronic and Noncommunicable Disease Prevention and Control, Hainan Provincial Center for Disease Control and PreventionDepartment of Chronic and Noncommunicable Disease Prevention and Control, Yunnan Provincial Center for Disease Control and PreventionDepartment of Epidemiology and Statistics, Institute of Basic Medical Sciences, School of Basic Medicine, Chinese Academy of Medical Sciences, Peking Union Medical CollegeAbstract Introduction Cardiovascular diseases (CVDs) are a leading cause of mortality worldwide. Red blood cell indices (RBIs) are associated with CVD risk factors (CRFs) and easy to test, making them useful as a screening tool for early identification of individuals at high risk for CVDs. Methods Data from 31,781 participants in the China National Health Survey conducted from 2012 to 2017 were analyzed. Linear and non-linear relationships between RBIs and CRFs (hyperuricemia, diabetes, dyslipidemia) were assessed using restricted cubic splines. Propensity score weighting was used to balance confounders between RBI groups in the multivariable logistic regression models. Results Hemoglobin concentration, red blood cell count and hematocrit all showed a significant linear dose-response association with all CRFs (p values < 0.001). Higher RBIs levels were associated with increased risk of hyperuricemia, diabetes, high LDL, high triglycerides, and high total cholesterol, but decreased HDL. For example, compared to the lowest quantile of HGB, the highest quantile had a 26% (13-40%) higher risk for hyperuricemia, a 43% (25-63%) higher risk of diabetes, 87% (61%-1.18 fold) higher risk of high LDL, and 68% (52-85%) higher risk of high triglycerides. Non-linear relationships were revealed between RBIs and most CRFs except uric acid and glucose. Sex differences were observed, with stronger associations between RBIs and hyperuricemia in women but stronger links with high LDL in men. Conclusions Elevated RBIs indicated higher risk of multiple CRFs. These findings suggest incorporating RBIs into CVD screening strategies to facilitate early prevention efforts, with consideration of sex differences.https://doi.org/10.1186/s12889-024-20988-7Cardiovascular risk factorsDyslipidemiaDiabetesHyperuricemiaRed blood cell
spellingShingle Huijing He
Li Pan
Feng Liu
Xiaolan Ren
Ze Cui
Lize Pa
Dingming Wang
Jingbo Zhao
Hailing Wang
Xianghua Wang
Jianwei Du
Xia Peng
Guangliang Shan
Linear and non-linear relationships between red blood cell indices and cardiovascular risk factors: findings from the China National Health Survey
BMC Public Health
Cardiovascular risk factors
Dyslipidemia
Diabetes
Hyperuricemia
Red blood cell
title Linear and non-linear relationships between red blood cell indices and cardiovascular risk factors: findings from the China National Health Survey
title_full Linear and non-linear relationships between red blood cell indices and cardiovascular risk factors: findings from the China National Health Survey
title_fullStr Linear and non-linear relationships between red blood cell indices and cardiovascular risk factors: findings from the China National Health Survey
title_full_unstemmed Linear and non-linear relationships between red blood cell indices and cardiovascular risk factors: findings from the China National Health Survey
title_short Linear and non-linear relationships between red blood cell indices and cardiovascular risk factors: findings from the China National Health Survey
title_sort linear and non linear relationships between red blood cell indices and cardiovascular risk factors findings from the china national health survey
topic Cardiovascular risk factors
Dyslipidemia
Diabetes
Hyperuricemia
Red blood cell
url https://doi.org/10.1186/s12889-024-20988-7
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