红细胞分布宽度升高增加心力衰竭的发病风险——基于英国生物样本库的队列研究

Elevated red blood cell distribution width increasing the risk of heart failure:a cohort study based on the UK Biobank

目的了解英国人群红细胞分布宽度(RDW)和心力衰竭(HF)的相关性,为预防和早期诊断HF提供新思路。方法分析466420名英国生物样本库参与者的数据,排除HF、心房颤动、心肌梗死和心绞痛患者。HF诊断标准为第10版国际疾病分类,诊断代码为I11.0、I130、I132和I50。按照RDW四分位数分为Q1组(RDW<12.90%)、Q2组(RDW为12.90%~13.32%)、Q3组(RDW为13.33%~13.84%)、Q4组(RDW≥13.85%)。采用Kaplan-Meier生存曲线和Cox比例风险回归分析探讨RDW对HF发病的影响。结果共收集5362例新发HF病例数据,总体年发病率为1.43‰,男性年发病率为2.05‰,女性年发病率为0.93‰。多变量逐步回归分析结果显示,性别、年龄、体重指数、血压、汤森剥夺指数、吸烟、健康饮食评分、有糖尿病史是HF发病的独立危险因素。校正相关变量后,RDW是HF发病的独立危险因素[以Q1组为对照,Q2组、Q3组、Q4组风险比(HR)分别为1.10、1.24、1.94,P值分别为0.19、<0.05、<0.01)。结论英国人群RDW升高与HF发病有关,或可作为HF的早期预测指标。

Objective To understand the correlation between red blood cell distribution width(RDW)and heart failure(HF)in British population,and to provide new clues for the prevention and early diagnosis of HF.Methods The data from 466420 UK Biobank participants,excluding those with the following prevalent diseases at baseline:HF,atrial fibrillation,myocardial infarction and angina pectoris,were collected.Patients with HF were defined using the International Classification of Diseases,10th edition,and diagnosis codes were I11.0,I130,I132 and I50.According to the quarters of RDW,they were classified into Q1(RDW<12.90%),Q2(RDW 12.90%-13.32%),Q3(RDW 13.33%-13.84%)and Q4(RDW≥13.85%)groups.Kaplan-Meier and Cox proportion hazard regression analysis were used to analyze the influence of RDW on the incidence of HF.Results During the follow-up period,a total of 5362 HF patients were enrolled,with an incidence rate of 1.43‰,a male incidence rate of 2.05‰and a female incidence rate of 0.93‰.Multivariate stepwise regression showed that sex,age,body mass index,blood pressure,Townsend deprivation index,smoking,healthy diet score and diabetes mellitus history were independent risk factors for HF.After adjusting the above variables,RDW was independently associated with the risk of HF[Q1 was used as control;Q2:hazard ratio(HR)=1.10,P=0.19;Q3:HR=1.24,P<0.05;Q4:HR=1.94,P<0.01].Conclusions Elevated RDW is associated with an increased risk of developing HF and may be a potential early predictor of HF.