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ORIGINAL RESEARCH article

Front. Nutr.

Sec. Clinical Nutrition

Volume 12 - 2025 | doi: 10.3389/fnut.2025.1572196

This article is part of the Research TopicThe Relationship between Nutrition and Frailty/Multimorbidity: Prevention and Clinical Nutritional ManagementView all 23 articles

Relationship between hemoglobin and red blood cell distribution width ratio and albuminuria in the United States adults aged 20 years and above: a cross-sectional analysis

Provisionally accepted
Guangxin  LiGuangxin Li1Guangxin  LiGuangxin Li2Wenyu  XuWenyu Xu1Yanping  YangYanping Yang1Jing  ZhangJing Zhang1Jin-An  ZhangJin-An Zhang1*
  • 1Department of Endocrinology, Shanghai Pudong New District Zhoupu Hospital, Pudong New Area, Shanghai, China
  • 2Heilongjiang University of Chinese Medicine, Harbin, Heilongjiang Province, China

The final, formatted version of the article will be published soon.

Objective:Hemoglobin to red blood cell distribution width ratio (HRR) is a novel prognostic indicator of disease, and is also associated with a variety of chronic systemic diseases. However, there are fewer studies on the relationship between HRR and albuminuria. This study aimed to investigate the association between the two subjects.Methods: A total of 13,971 participants aged 20 and older in the National Health and Nutrition Examination Survey (NHANES) between 2007 and 2018. The HRR is the ratio of hemoglobin to the width of the red blood cell distribution. Smoothed curve fitting and multivariate segmented linear 2 regression models were used to study the relationship between HRR and albuminuria. Finally, subgroup analysis and interaction tests were performed to test the stability of the results.The results of the univariate analysis showed that HRR was negatively associated with albuminuria (OR = 0.86, P <0.0001). After further adjustment of potential confounding factors, the smooth curve fitting showed that HRR was nonlinearly related to albuminuria. The inflection point of HRR in multiple segmented linear regression analysis was 1.213. Specifically, when HRR < 1.213, (OR =0.93, 95% CI 0.90, 0.97; P=0.0007 ); when HRR ≥ 1.213, (OR= 1.24, 95% CI 1.08, 1.43; P<0.0001 ). Subgroup analyses revealed that this association exists as stable in different populations.There was a nonlinear correlation between HRR and albuminuria in adults aged 20 or older in the United States.

Keywords: Hemoglobin to red cell distribution width ratio, Albuminuria, NHANES, Cross-sectional study, nonlinear correlation

Received: 06 Feb 2025; Accepted: 06 Oct 2025.

Copyright: © 2025 Li, Li, Xu, Yang, Zhang and Zhang. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.

* Correspondence: Jin-An Zhang, zhangjinan@hitnail.com

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