METHODS: 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.
RESULTS: 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 0.99, 95 CI% 0.97-1.00; MCV >88.56732 fl, adjusted HR 1.05, 95 CI% 1.04-1.06. MCH <30.22054 pg, adjusted HR 0.95, 95 CI% 0.92-0.98; MCH >30.22054 pg, adjusted HR 1.08, 95 CI% 1.04-1.12. MCHC <34.34624 g/dl, adjusted HR 0.88, 95 CI% 0.83-0.93). Besides, the MCV curve was U-shaped in cardiovascular mortality (MCV <88.56732 fl, adjusted HR 0.97, 95 CI% 0.94-1.00; MCV >88.56732 fl, adjusted HR 1.04, 95 CI% 1.01-1.06).
CONCLUSIONS: This cohort study demonstrated that RCIs (MCH, MCHC, and MCV) were correlated with mortality in the general population. Three RCIs were nonlinearly correlated with all-cause mortality. In addition, there were nonlinear relationships between MCH and MCV and cardiovascular mortality.
方法:该研究使用了参加1999-2008年全国健康和营养调查的美国成年人的队列数据。全因死亡率是随访期间的主要结果,继发性心血管死亡结局。应用COX回归分析RCI与死亡率的关系。我们采用了三种模型来最小化潜在的偏差。使用平滑拟合曲线和阈值效应分析来观察RCI与全因死亡率和心血管死亡率之间的剂量反应关系。此外,我们进行了敏感性分析.
结果:21,203人被纳入我们的研究。在平均166.2±54.4个月的随访中,24.4%的人口死亡。曲线拟合显示MCV和MCH与全因死亡率呈U型关系,MCHC与全因死亡率呈L型关系。我们确定了MCV之间关系的拐点,MCH,MCHC和全因死亡率为88.56732fl,30.22054pg,34.34624g/dl(MCV<88.56732fl,调整后的HR0.99,95CI%0.97-1.00;MCV>88.56732fl,调整后HR1.05,95CI%1.04-1.06。MCH<30.22054pg,调整后的HR0.95,95CI%0.92-0.98;MCH>30.22054pg,调整后HR1.08,95CI%1.04-1.12。MCHC<34.34624g/dl,调整后的HR0.88,95CI%0.83-0.93)。此外,心血管死亡率的MCV曲线呈U形(MCV<88.56732fl,调整后的HR0.97,95CI%0.94-1.00;MCV>88.56732fl,调整后HR1.04,95CI%1.01-1.06)。
结论:这项队列研究表明,RCI(MCH,MCHC,和MCV)与普通人群的死亡率相关。三个RCI与全因死亡率呈非线性相关。此外,MCH和MCV与心血管死亡率之间存在非线性关系.