Red cell distribution width (RDW), routinely assessed as a component of a complete blood count (CBC), quantifies the variation in the size of red blood cells. It increases with age, and increased RDW predicts many aging-related diseases and mortality. However, whether it also predicts hip fracture is unknown. We prospectively evaluated the association between RDW and hip fracture using data from the Osteoporotic Fracture in Men (MrOS) study. RDW was measured in 3635 men (aged 71 to 99 years) along with bone mineral density (BMD) in MrOS. RDW ranged from 11.3% to 32.9% (median 14.0%; interquartile range 13.5% to 14.8%) and was categorized into four groups (≤13.0%, 13.1% to 14.0%, 14.1% to 15.0%, ≥15.1%). Study participants with a hemoglobin level <13.0 g/dL were classified as having anemia. During an average 8.1 years, 164 men suffered hip fractures. The risks of hip fractures increased with increase of RDW category. Furthermore, there was a significant interaction between anemia and RDW: An association between RDW and hip fractures was only observed in participants without anemia. In those without anemia, the relative hazard of hip fractures increased with increases in RDW category: Men in the highest RDW category had a 2.8 times higher risk of hip fractures than men in the lowest group (95% confidence interval 1.1 to 7.1). The risks of all-clinical fractures were also increased along with higher RDW values. Additionally, RDW was significantly associated with the risk of having a fall but not with femoral neck or total hip BMD. In conclusion, RDW and anemia defined by hemoglobin are widely available routine laboratory measurements that together could indicate increased risk of hip fracture, reflecting the neuromuscular effects of aging rather than lower hip BMD. © 2020 American Society for Bone and Mineral Research.

中文翻译：

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红细胞分布宽度是无贫血老年男性髋部骨折的危险因素。

红细胞分布宽度 (RDW) 作为全血细胞计数 (CBC) 的组成部分进行常规评估，可量化红细胞大小的变化。它随着年龄的增长而增加，RDW 的增加预示着许多与衰老相关的疾病和死亡率。然而，它是否也能预测髋部骨折尚不清楚。我们使用来自男性骨质疏松性骨折 (MrOS) 研究的数据前瞻性地评估了 RDW 与髋部骨折之间的关联。在 MrOS 中测量了 3635 名男性（71 至 99 岁）的 RDW 以及骨矿物质密度 (BMD)。RDW 的范围从 11.3% 到 32.9%（中位数 14.0%；四分位数范围 13.5% 到 14.8%），分为四组（≤13.0%、13.1% 到 14.0%、14.1% 到 15.0%、≥15.1%）。血红蛋白水平 <13.0 g/dL 的研究参与者被归类为患有贫血。在平均 8.1 年的时间里，164 名男性髋部骨折。髋部骨折的风险随着 RDW 类别的增加而增加。此外，贫血与 RDW 之间存在显着的相互作用：RDW 与髋部骨折之间的关联仅在没有贫血的参与者中观察到。在没有贫血的人群中，髋部骨折的相对风险随着 RDW 类别的增加而增加：RDW 类别最高的男性发生髋部骨折的风险是最低 RDW 类别男性的 2.8 倍（95% 置信区间为 1.1 至 7.1）。全临床骨折的风险也随着 RDW 值的增加而增加。此外，RDW 与跌倒风险显着相关，但与股骨颈或全髋骨密度无关。综上所述，RDW 和由血红蛋白定义的贫血是广泛可用的常规实验室测量值，它们一起可以表明髋部骨折的风险增加，反映了衰老对神经肌肉的影响，而不是较低的髋部 BMD。© 2020 美国骨骼和矿物研究协会。