Nonlinear relationship of red blood cell indices (MCH, MCHC, and MCV) with all-cause and cardiovascular mortality: A cohort study in U.S. adults

• Published in: PloS one 2024-08, Vol.19 (8), p.e0307609
• Main Authors: Li, Dan, Wang, Aiting, Li, Yeting, Ruan, Zhishen, Zhao, Hengyi, Li, Jing, Zhang, Qing, Wu, Bo
• Format: Article
• Language: English
• Subjects: Adult; Adults; Aged; Analysis; Anemia; Blood; Body mass index; Cancer; Cardiovascular disease; Cardiovascular diseases; Cardiovascular Diseases - blood; Cardiovascular Diseases - mortality; Cause of Death; Chronic obstructive pulmonary disease; Cohort Studies; Curve fitting; Data collection; Diabetes; Education; Erythrocyte Indices; Erythrocytes; Fatalities; Female; Females; Gender; Glycosylated hemoglobin; Hemoglobin; Humans; Hyperlipidemia; Hypertension; Inflection points; Kidney diseases; Male; Males; Medical prognosis; Medical research; Medicine, Experimental; Middle Aged; Mortality; Nutrition Surveys; Population; Proportional Hazards Models; Regression analysis; Sensitivity analysis; Smoking; Surveys; United States - epidemiology
• ISSN: 1932-6203; 1932-6203
• DOI: 10.1371/journal.pone.0307609

In recent years, increasing attention has been focused on the impact of red blood cell indices (RCIs) on disease prognosis. We aimed to investigate the association of mean corpuscular hemoglobin (MCH), mean corpuscular hemoglobin concentration (MCHC), and mean corpuscular volume (MCV) with mortality. The study used cohort data from U.S. adults who participated in the 1999-2008 National Health and Nutrition Examination Survey. All-cause mortality was the primary outcome during follow-up, with secondary cardiovascular mortality outcomes. COX regression was applied to analyze the connection between RCIs and mortality. We adopted three models to minimize potential bias. Smooth-fit curves and threshold effect analyses were utilized to observe the dose-response relationship between RCIs and all-cause and cardiovascular mortality. In addition, we performed sensitivity analyses. 21,203 individuals were enrolled in our research. During an average 166.2 ± 54.4 months follow-up, 24.4% of the population died. Curve fitting indicated a U-shaped relationship between MCV and MCH with all-cause mortality, and the relationship of MCHC to all-cause mortality is L-shaped. We identified inflection points in the relationship between MCV, MCH, and MCHC and all-cause mortality as 88.56732 fl, 30.22054 pg, 34.34624 g/dl (MCV 88.56732 fl, adjusted HR 1.05, 95 CI% 1.04-1.06. MCH 30.22054 pg, adjusted HR 1.08, 95 CI% 1.04-1.12. MCHC