Red Cell Distribution Width: a Potential Marker of Reduced Femoral Neck Bone Mineral Density in Men and Postmenopausal Women

Overview

Journal Endocrine

Specialty Endocrinology

Date 2024 Nov 14

PMID 39543060

Authors

Zhengrong Qi

Liang Zhang

Zhiyao Li

Haomiao Yu

Qiang Li

Lifeng Ma

Yan Yang

Affiliations

Soon will be listed here.

Abstract

Purpose: Osteoporosis imposes significant burdens. Early detection of high-risk individuals through simple indicators can greatly improve prognosis. Red cell distribution width (RDW), a standard component of a complete blood count, shows promise, yet remains underexplored. This cross-sectional study aimed to investigate the association between RDW and femoral neck and spinal bone mineral density (BMD).

Methods: Participants aged 20-79 years from the 2005-2010, 2013-2014, and 2017-2020 cycles of the National Health and Nutrition Examination Survey (NHANES) were included. BMD was measured using dual-energy X-ray absorptiometry (DXA).

Results: A total of 13,029 participants were included, comprising 6684 men, 3238 postmenopausal women, and 3107 premenopausal women, with the sample weighted to represent 98,712,128 people. After adjusting for covariates, RDW exhibited a negative association with femoral neck BMD in both men (β = -0.006; 95% CI: -0.010 to -0.002; p = 0.0053) and postmenopausal women (β = -0.005; 95% CI: -0.010 to -0.000; p = 0.0413). Subgroup and sensitivity analyses supported the robustness of these findings. A negative association between RDW and spinal BMD in men approached significance (β = -0.004; 95% CI: -0.008 to 0.000; p = 0.0557). Persistent trends were observed for RDW with spinal BMD in postmenopausal women and with both femoral neck and spinal BMD in premenopausal women.

Conclusions: Our study suggests a negative association between RDW and femoral neck BMD in both men and postmenopausal women. These findings highlight the potential of RDW as a marker for identifying individuals at higher risk of osteoporosis.

References

Zhu B, Hu S, Guo J, Dong Z, Dong Y, Li F . Differences in the global exposure, mortality and disability of low bone mineral density between men and women: the underestimated burden in men. BMC Public Health. 2023; 23(1):991. PMC: 10226255. DOI: 10.1186/s12889-023-15947-7. View

Trevisani L, Kulcsar I, Kulcsar M, Dedivitis R, Kowalski L, Matos L . Prognostic Value of Hematological Parameters in Oral Squamous Cell Carcinoma. Cancers (Basel). 2023; 15(21). PMC: 10649982. DOI: 10.3390/cancers15215245. View

Zhang L, Lan Y, Qi B, Shuai P, Hou Q, Liu W . RDW-SD and PCT Are Potential Prognostic Factors for In-hospital Death in Patients With Stevens-Johnson Syndrome/Toxic Epidermal Necrolysis. Allergy Asthma Immunol Res. 2023; 15(6):812-824. PMC: 10643861. DOI: 10.4168/aair.2023.15.6.812. View

Zhang Q, Zhou B, Li X, Cong H . In-hospital changes in the red blood cell distribution width and mortality in critically ill patients with heart failure. ESC Heart Fail. 2023; 10(6):3287-3298. PMC: 10682898. DOI: 10.1002/ehf2.14513. View

Kim M, Lee C, Kang H, Son N, Bae S, Seo J . Red cell distribution width as a prognosticator in patients with heart failure. ESC Heart Fail. 2022; 10(2):834-845. PMC: 10053156. DOI: 10.1002/ehf2.14231. View

Wu H, Liao B, Cao T, Ji T, Huang J, Ma K . Diagnostic value of RDW for the prediction of mortality in adult sepsis patients: A systematic review and meta-analysis. Front Immunol. 2022; 13:997853. PMC: 9618606. DOI: 10.3389/fimmu.2022.997853. View

Hong J, Hu X, Liu W, Qian X, Jiang F, Xu Z . Impact of red cell distribution width and red cell distribution width/albumin ratio on all-cause mortality in patients with type 2 diabetes and foot ulcers: a retrospective cohort study. Cardiovasc Diabetol. 2022; 21(1):91. PMC: 9166463. DOI: 10.1186/s12933-022-01534-4. View

Aslam H, Oza F, Ahmed K, Kopel J, Aloysius M, Ali A . The Role of Red Cell Distribution Width as a Prognostic Marker in Chronic Liver Disease: A Literature Review. Int J Mol Sci. 2023; 24(4). PMC: 9967940. DOI: 10.3390/ijms24043487. View

Feng G, Li H, Li Q, Fu Y, Huang R . Red blood cell distribution width and ischaemic stroke. Stroke Vasc Neurol. 2017; 2(3):172-175. PMC: 5628378. DOI: 10.1136/svn-2017-000071. View

10.

Salvagno G, Sanchis-Gomar F, Picanza A, Lippi G . Red blood cell distribution width: A simple parameter with multiple clinical applications. Crit Rev Clin Lab Sci. 2014; 52(2):86-105. DOI: 10.3109/10408363.2014.992064. View

11.

Steensma D . Clinical Implications of Clonal Hematopoiesis. Mayo Clin Proc. 2018; 93(8):1122-1130. DOI: 10.1016/j.mayocp.2018.04.002. View

12.

Yadav S, Deepika , Maurya P . A Systematic Review of Red Blood Cells Biomarkers in Human Aging. J Gerontol A Biol Sci Med Sci. 2024; 79(4). DOI: 10.1093/gerona/glae004. View

13.

Hong N, Kim C, Youm Y, Choi J, Kim H, Rhee Y . Elevated Red Blood Cell Distribution Width Is Associated with Morphometric Vertebral Fracture in Community-Dwelling Older Adults, Independent of Anemia, Inflammation, and Nutritional Status: The Korean Urban Rural Elderly (KURE) Study. Calcif Tissue Int. 2018; 104(1):26-33. DOI: 10.1007/s00223-018-0470-9. View

14.

Jia Q, Qin L, Niu Y, Liu L, Liu P, Miao S . Red blood cell distribution width is associated with sarcopenia risk in early-stage non-small cell lung cancer. BMC Cancer. 2024; 24(1):95. PMC: 10795386. DOI: 10.1186/s12885-024-11864-z. View

15.

Ciardullo S, Muraca E, Zerbini F, Manzoni G, Perseghin G . NAFLD and Liver Fibrosis Are Not Associated With Reduced Femoral Bone Mineral Density in the General US Population. J Clin Endocrinol Metab. 2021; 106(8):e2856-e2865. DOI: 10.1210/clinem/dgab262. View

16.

Pan R, Wang R, Zhang Y, Ji H, Liang X, Zhao Y . The association of waist circumference with bone mineral density and risk of osteoporosis in US adult: National health and nutrition examination survey. Bone. 2024; 185:117134. DOI: 10.1016/j.bone.2024.117134. View

17.

Zhao S, Gao W, Li J, Sun M, Fang J, Tong L . Dietary inflammatory index and osteoporosis: the National Health and Nutrition Examination Survey, 2017-2018. Endocrine. 2022; 78(3):587-596. DOI: 10.1007/s12020-022-03178-6. View

18.

Buckley J, Kim H, Wong E, Rebholz C . Ultra-processed food consumption and exposure to phthalates and bisphenols in the US National Health and Nutrition Examination Survey, 2013-2014. Environ Int. 2019; 131:105057. PMC: 6728187. DOI: 10.1016/j.envint.2019.105057. View

19.

Hu Z, Li Y, Yang Y, Yu W, Xie W, Song G . Serum lipids mediate the relationship of multiple polyaromatic hydrocarbons on non-alcoholic fatty liver disease: A population-based study. Sci Total Environ. 2021; 780:146563. DOI: 10.1016/j.scitotenv.2021.146563. View

20.

Chalasani N, Younossi Z, Lavine J, Charlton M, Cusi K, Rinella M . The diagnosis and management of nonalcoholic fatty liver disease: Practice guidance from the American Association for the Study of Liver Diseases. Hepatology. 2017; 67(1):328-357. DOI: 10.1002/hep.29367. View