Abstract
One pathophysiological sign of sarcopenia is chronic inflammation. Given that levels of red blood cell distribution width (RDW) are increased in chronic inflammation, we evaluated the association between increased RDW and sarcopenia among adults in the general U. S. population and analyzed data from 11,761 participants from the National Health and Nutrition Examination Survey (NHANES) 1999–2006. Sarcopenia was defined as an appendicular skeletal muscle mass (ASM) divided by weight (%) that was less than one standard deviation (SD) below the mean of young adults. The odds ratios (ORs) and confidence intervals (CIs) for sarcopenia were calculated across RDW quartiles after adjusting for confounding factors. Elevated RDW levels were significantly associated with sarcopenia after adjusting for age, sex, race, education, household income, smoking, physical activity, hypertension, diabetes, cardiovascular disease, C-reactive protein, and hemoglobin (OR of highest quartile: 1.72 (95% CI: 1.43, 2.06)). Further, in a model stratified by obesity, an elevated RDW was associated with sarcopenia in the overweight and obese group, but not in the normal weight group. Our study shows that elevated RDW is associated with sarcopenia, and this association is particularly strong in people who are overweight and obese.
Highlights
The underlying mechanisms in sarcopenia are not fully understood, inflammation, neuromuscular, and hormonal changes as well as nutrition and physical inactivity are currently discussed as leading to sarcopenia[1,7,8]
When we examined sarcopenia that was defined using lower muscle mass alone, red blood cell distribution width (RDW) levels were significantly associated with the risk of sarcopenia in all sequential models
Sarcopenia is a systemic condition with various risk factors and whose prevalence increases with age[17]
Summary
The underlying mechanisms in sarcopenia are not fully understood, inflammation, neuromuscular, and hormonal changes as well as nutrition and physical inactivity are currently discussed as leading to sarcopenia[1,7,8]. Increased RDW values have been reported in relationship to underlying chronic inflammation which induces red blood cell (RBC) membrane deformability and changes in erythropoiesis[10]. An epidemiologic study has suggested that RDW is associated with increased levels in high-sensitivity C-reactive protein (CRP), a biomarker of inflammation[10]. Recent epidemiologic studies have reported that RDW may be an effective predictor of chronic diseases and mortality in cardiovascular disease (CVD), cancer, and other diseases[11,12,13,14,15,16]. We hypothesized that chronic inflammation may be the common pathophysiological link between increased RDW levels and sarcopenia. We evaluated the association between increased RDW and the risk of sarcopenia in a nationally representative U.S population using the National Health and Nutrition Examination Survey (NHANES) 1999–2006
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