Ratio of red blood cell distribution width to albumin level and risk of mortality in sarcopenic obesity

Abstract The aim of this study was to investigate the relationship between red blood cell distribution width and albumin ratio (RAR) levels and mortality in adult patients with sarcopenic obesity in the United States. The study included 1,361 adult patients with sarcopenic obesity from the National...

Full description

Saved in:
Bibliographic Details
Main Authors: Xiong-Bin Ma, Yan-Lin Lv, Lin Qian, Shi-Tao Huang, Xi-Xia Pu, Yong-Ming Liu
Format: Article
Language:English
Published: Nature Portfolio 2024-11-01
Series:Scientific Reports
Subjects:
Online Access:https://doi.org/10.1038/s41598-024-79055-1
Tags: Add Tag
No Tags, Be the first to tag this record!
_version_ 1846165264492658688
author Xiong-Bin Ma
Yan-Lin Lv
Lin Qian
Shi-Tao Huang
Xi-Xia Pu
Yong-Ming Liu
author_facet Xiong-Bin Ma
Yan-Lin Lv
Lin Qian
Shi-Tao Huang
Xi-Xia Pu
Yong-Ming Liu
author_sort Xiong-Bin Ma
collection DOAJ
description Abstract The aim of this study was to investigate the relationship between red blood cell distribution width and albumin ratio (RAR) levels and mortality in adult patients with sarcopenic obesity in the United States. The study included 1,361 adult patients with sarcopenic obesity from the National Health and Nutrition Examination Survey (1999–2006). The X-tile was used to determine the optimal subgroup thresholds for RAR values, and propensity score matching (PSM) was employed to reduce baseline bias. Cox regression analysis, Kaplan-Meier survival curves, and restricted cubic spline analysis were utilized to assess the relationship between RAR levels and all-cause and cardiovascular mortality. Subgroup analysis and the Subpopulation Treatment Effect Pattern Plot were employed to determine survival advantages across different subgroups. Time-dependent ROC analysis to evaluate the accuracy of RAR level in predicting survival outcomes at different time points. Post-PSM multifactorial Cox regression analyses revealed that RAR was a significant independent predictor of all-cause mortality (HR 1.487, 95% CI: 1.259–1.756) and an independent risk factor for cardiovascular mortality (HR 1.487, 95% CI: 1.260–1.758) in patients with sarcopenic obesity. The survival advantage was consistent across subgroups. Restricted cubic spline analysis indicated an approximate S-shaped association between RAR levels and mortality. Time-dependent ROC curves demonstrate that the areas under the all-cause mortality curves at the RAR level for 1-year, 3-year, 5-year, and 10-year are 0.79, 0.66, 0.64, and 0.63, respectively. The areas under the cardiovascular mortality curve are 0.80, 0.70, 0.66, and 0.61, respectively. Moreover, in comparison to the baseline model lacking covariates, the AUC values of the joint model exhibited heightened levels at various time points. Therefore, We demonstrated that the RAR level is an independent prognostic factor for mortality risk in the American population with sarcopenic obesity, and it is reasonable to consider the RAR level as a simple and effective risk prediction tool.
format Article
id doaj-art-798ec0a6b07446d3981415bc08685082
institution Kabale University
issn 2045-2322
language English
publishDate 2024-11-01
publisher Nature Portfolio
record_format Article
series Scientific Reports
spelling doaj-art-798ec0a6b07446d3981415bc086850822024-11-17T12:25:41ZengNature PortfolioScientific Reports2045-23222024-11-0114111410.1038/s41598-024-79055-1Ratio of red blood cell distribution width to albumin level and risk of mortality in sarcopenic obesityXiong-Bin Ma0Yan-Lin Lv1Lin Qian2Shi-Tao Huang3Xi-Xia Pu4Yong-Ming Liu5The First Clinical Medical College of Lanzhou UniversityThe First Clinical Medical College of Lanzhou UniversityThe First Clinical Medical College of Lanzhou UniversityThe First Clinical Medical College of Lanzhou UniversityThe First Clinical Medical College of Lanzhou UniversityGeriatric Cardiovascular Department and Gansu Clinical Research Center for Geriatric Diseases, First Hospital of Lanzhou UniversityAbstract The aim of this study was to investigate the relationship between red blood cell distribution width and albumin ratio (RAR) levels and mortality in adult patients with sarcopenic obesity in the United States. The study included 1,361 adult patients with sarcopenic obesity from the National Health and Nutrition Examination Survey (1999–2006). The X-tile was used to determine the optimal subgroup thresholds for RAR values, and propensity score matching (PSM) was employed to reduce baseline bias. Cox regression analysis, Kaplan-Meier survival curves, and restricted cubic spline analysis were utilized to assess the relationship between RAR levels and all-cause and cardiovascular mortality. Subgroup analysis and the Subpopulation Treatment Effect Pattern Plot were employed to determine survival advantages across different subgroups. Time-dependent ROC analysis to evaluate the accuracy of RAR level in predicting survival outcomes at different time points. Post-PSM multifactorial Cox regression analyses revealed that RAR was a significant independent predictor of all-cause mortality (HR 1.487, 95% CI: 1.259–1.756) and an independent risk factor for cardiovascular mortality (HR 1.487, 95% CI: 1.260–1.758) in patients with sarcopenic obesity. The survival advantage was consistent across subgroups. Restricted cubic spline analysis indicated an approximate S-shaped association between RAR levels and mortality. Time-dependent ROC curves demonstrate that the areas under the all-cause mortality curves at the RAR level for 1-year, 3-year, 5-year, and 10-year are 0.79, 0.66, 0.64, and 0.63, respectively. The areas under the cardiovascular mortality curve are 0.80, 0.70, 0.66, and 0.61, respectively. Moreover, in comparison to the baseline model lacking covariates, the AUC values of the joint model exhibited heightened levels at various time points. Therefore, We demonstrated that the RAR level is an independent prognostic factor for mortality risk in the American population with sarcopenic obesity, and it is reasonable to consider the RAR level as a simple and effective risk prediction tool.https://doi.org/10.1038/s41598-024-79055-1Red blood cell distribution width/Albumin ratioSarcopenic obesityMortalityNational Health and Nutrition Examination Survey
spellingShingle Xiong-Bin Ma
Yan-Lin Lv
Lin Qian
Shi-Tao Huang
Xi-Xia Pu
Yong-Ming Liu
Ratio of red blood cell distribution width to albumin level and risk of mortality in sarcopenic obesity
Scientific Reports
Red blood cell distribution width/Albumin ratio
Sarcopenic obesity
Mortality
National Health and Nutrition Examination Survey
title Ratio of red blood cell distribution width to albumin level and risk of mortality in sarcopenic obesity
title_full Ratio of red blood cell distribution width to albumin level and risk of mortality in sarcopenic obesity
title_fullStr Ratio of red blood cell distribution width to albumin level and risk of mortality in sarcopenic obesity
title_full_unstemmed Ratio of red blood cell distribution width to albumin level and risk of mortality in sarcopenic obesity
title_short Ratio of red blood cell distribution width to albumin level and risk of mortality in sarcopenic obesity
title_sort ratio of red blood cell distribution width to albumin level and risk of mortality in sarcopenic obesity
topic Red blood cell distribution width/Albumin ratio
Sarcopenic obesity
Mortality
National Health and Nutrition Examination Survey
url https://doi.org/10.1038/s41598-024-79055-1
work_keys_str_mv AT xiongbinma ratioofredbloodcelldistributionwidthtoalbuminlevelandriskofmortalityinsarcopenicobesity
AT yanlinlv ratioofredbloodcelldistributionwidthtoalbuminlevelandriskofmortalityinsarcopenicobesity
AT linqian ratioofredbloodcelldistributionwidthtoalbuminlevelandriskofmortalityinsarcopenicobesity
AT shitaohuang ratioofredbloodcelldistributionwidthtoalbuminlevelandriskofmortalityinsarcopenicobesity
AT xixiapu ratioofredbloodcelldistributionwidthtoalbuminlevelandriskofmortalityinsarcopenicobesity
AT yongmingliu ratioofredbloodcelldistributionwidthtoalbuminlevelandriskofmortalityinsarcopenicobesity