Hemoglobin-to-red blood cell distribution width ratio as a protective factor against coronary artery disease: a cross-sectional analysis of NHANES (2011-2018)

BackgroundCoronary artery disease (CAD) is the leading cause of death worldwide, and inflammation is a significant factor in its development. While the hemoglobin-to-red blood cell distribution width ratio (HRR), an indicator of inflammation, has been linked to various diseases, its association with...

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Main Authors: Xin-Da Wang, Chaoya Li, Jia Hu, Fen Cao, Li Zhu, Yongzhi Zhu, Zhongzheng Wen, Jun Liu
Format: Article
Language:English
Published: Frontiers Media S.A. 2025-01-01
Series:Frontiers in Pharmacology
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Online Access:https://www.frontiersin.org/articles/10.3389/fphar.2025.1534479/full
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author Xin-Da Wang
Chaoya Li
Jia Hu
Fen Cao
Li Zhu
Yongzhi Zhu
Zhongzheng Wen
Jun Liu
author_facet Xin-Da Wang
Chaoya Li
Jia Hu
Fen Cao
Li Zhu
Yongzhi Zhu
Zhongzheng Wen
Jun Liu
author_sort Xin-Da Wang
collection DOAJ
description BackgroundCoronary artery disease (CAD) is the leading cause of death worldwide, and inflammation is a significant factor in its development. While the hemoglobin-to-red blood cell distribution width ratio (HRR), an indicator of inflammation, has been linked to various diseases, its association with CAD is not well established.MethodsWe conducted an analysis using data from the National Health and Nutrition Examination Survey (NHANES) spanning from 2011 to 2018. After excluding participants due to age, missing data, and potential confounding factors, 6,881 individuals were included in our study. CAD was identified through self-reported questionnaires, and HRR was determined from laboratory measurements. We controlled for factors such as hypertension, waist circumference, systolic blood pressure, fasting plasma glucose, and others in our logistic regression analysis to explore the relationship between HRR and CAD.ResultsWe found that higher HRR levels were associated with a lower risk of CAD. In our fully adjusted model, the odds ratios for CAD for the second, third, and fourth quartiles of HRR were 0.38, 0.42, and 0.51, respectively, compared to the first quartile (P < 0.001). An increase in HRR by one unit was associated with a 49% decrease in the likelihood of CAD. Furthermore, linear regression models indicated a 74% reduction in CAD risk for each one-unit increase in HRR (P = 0.0002). There was a notable threshold at HRR 1.02; beyond this point, each unit increase in HRR was associated with a 91% decrease in CAD odds. This suggests that for individuals with an HRR above 1.02, strategies to increase body water content and reduce blood viscosity could potentially lower their risk of developing CAD.ConclusionOur study revealed an inverse linear relationship between HRR and CAD risk, indicating that HRR may serve as a protective factor against CAD.
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publisher Frontiers Media S.A.
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spelling doaj-art-78a5175b5f944fc7a6754b6fa867f71a2025-01-29T05:21:24ZengFrontiers Media S.A.Frontiers in Pharmacology1663-98122025-01-011610.3389/fphar.2025.15344791534479Hemoglobin-to-red blood cell distribution width ratio as a protective factor against coronary artery disease: a cross-sectional analysis of NHANES (2011-2018)Xin-Da Wang0Chaoya Li1Jia Hu2Fen Cao3Li Zhu4Yongzhi Zhu5Zhongzheng Wen6Jun Liu7Department of Cardiology, Chengdu First People’s Hospital, Chengdu, Sichuan, ChinaDepartment of Cardiology, Chengdu First People’s Hospital, Chengdu, Sichuan, ChinaDepartment of Cardiology, Chengdu First People’s Hospital, Chengdu, Sichuan, ChinaHunan University of Medicine General Hospital, Huaihua, ChinaDepartment of Cardiology, Chengdu First People’s Hospital, Chengdu, Sichuan, ChinaHunan University of Medicine General Hospital, Huaihua, ChinaDepartment of Cardiology, Chengdu First People’s Hospital, Chengdu, Sichuan, ChinaHunan University of Medicine General Hospital, Huaihua, ChinaBackgroundCoronary artery disease (CAD) is the leading cause of death worldwide, and inflammation is a significant factor in its development. While the hemoglobin-to-red blood cell distribution width ratio (HRR), an indicator of inflammation, has been linked to various diseases, its association with CAD is not well established.MethodsWe conducted an analysis using data from the National Health and Nutrition Examination Survey (NHANES) spanning from 2011 to 2018. After excluding participants due to age, missing data, and potential confounding factors, 6,881 individuals were included in our study. CAD was identified through self-reported questionnaires, and HRR was determined from laboratory measurements. We controlled for factors such as hypertension, waist circumference, systolic blood pressure, fasting plasma glucose, and others in our logistic regression analysis to explore the relationship between HRR and CAD.ResultsWe found that higher HRR levels were associated with a lower risk of CAD. In our fully adjusted model, the odds ratios for CAD for the second, third, and fourth quartiles of HRR were 0.38, 0.42, and 0.51, respectively, compared to the first quartile (P < 0.001). An increase in HRR by one unit was associated with a 49% decrease in the likelihood of CAD. Furthermore, linear regression models indicated a 74% reduction in CAD risk for each one-unit increase in HRR (P = 0.0002). There was a notable threshold at HRR 1.02; beyond this point, each unit increase in HRR was associated with a 91% decrease in CAD odds. This suggests that for individuals with an HRR above 1.02, strategies to increase body water content and reduce blood viscosity could potentially lower their risk of developing CAD.ConclusionOur study revealed an inverse linear relationship between HRR and CAD risk, indicating that HRR may serve as a protective factor against CAD.https://www.frontiersin.org/articles/10.3389/fphar.2025.1534479/fullcoronary artery diseasehemoglobin-to-red blood cell distribution width ratioinflammationNHANEScross-sectional study
spellingShingle Xin-Da Wang
Chaoya Li
Jia Hu
Fen Cao
Li Zhu
Yongzhi Zhu
Zhongzheng Wen
Jun Liu
Hemoglobin-to-red blood cell distribution width ratio as a protective factor against coronary artery disease: a cross-sectional analysis of NHANES (2011-2018)
Frontiers in Pharmacology
coronary artery disease
hemoglobin-to-red blood cell distribution width ratio
inflammation
NHANES
cross-sectional study
title Hemoglobin-to-red blood cell distribution width ratio as a protective factor against coronary artery disease: a cross-sectional analysis of NHANES (2011-2018)
title_full Hemoglobin-to-red blood cell distribution width ratio as a protective factor against coronary artery disease: a cross-sectional analysis of NHANES (2011-2018)
title_fullStr Hemoglobin-to-red blood cell distribution width ratio as a protective factor against coronary artery disease: a cross-sectional analysis of NHANES (2011-2018)
title_full_unstemmed Hemoglobin-to-red blood cell distribution width ratio as a protective factor against coronary artery disease: a cross-sectional analysis of NHANES (2011-2018)
title_short Hemoglobin-to-red blood cell distribution width ratio as a protective factor against coronary artery disease: a cross-sectional analysis of NHANES (2011-2018)
title_sort hemoglobin to red blood cell distribution width ratio as a protective factor against coronary artery disease a cross sectional analysis of nhanes 2011 2018
topic coronary artery disease
hemoglobin-to-red blood cell distribution width ratio
inflammation
NHANES
cross-sectional study
url https://www.frontiersin.org/articles/10.3389/fphar.2025.1534479/full
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