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ORIGINAL RESEARCH article

Front. Public Health
Sec. Environmental Health and Exposome
Volume 12 - 2024 | doi: 10.3389/fpubh.2024.1447303
This article is part of the Research Topic Re-visiting Risk Factors for Cardiometabolic Diseases: Towards a New Epidemiological Frontier View all 11 articles

Associations between smoking and coronary heart disease: Mediating role of RDW

Provisionally accepted
Mingfeng Ma Mingfeng Ma 1,2*Yue Wu Yue Wu 3Xingmin He Xingmin He 3Miaomiao Zhang Miaomiao Zhang 3Yanlin Han Yanlin Han 3Renwei Guo Renwei Guo 1Shaojie Li Shaojie Li 3
  • 1 Shanxi Fenyang Hospital, Fenyang, China
  • 2 Other, Lvliang, China
  • 3 Fenyang College of Shanxi Medical University, Fenyang, China

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

    Introduction: Previous studies have demonstrated that both smoking and coronary heart disease (CHD) are linked to red cell distribution width (RDW). However, the role of the RDW in the association between smoking and CHD remains unclear. This study investigates the role of RDW in the association between smoking and coronary heart disease. Methods: Data from 13,080 adults aged 40–80 years were analyzed from the National Health and Nutrition Examination Survey (NHANES) conducted between 2006 and 2017. Statistical methods included regression analysis, restricted cubic spline curve (RCS), subgroup analysis, and mediation analysis. Results: Results showed higher RDW levels in participants with smoking and/or CHD than in those without. Smoking status was positively associated with RDW and CHD even after adjusting for potential confounders. A nonlinear relationship between RDW and CHD was observed (P for nonlinear <0.001). Subgroup analysis revealed that sex influenced the relationship between smoking and CHD (P =0.0284). Mediation analysis showed that increased RDW levels mediated the association between smoking status and CHD (PM = 2.1959%, ACME = 0.000694, 95% CI = 0.000262–0.001259, P <0.001). Discussion: Our research showed that smoking, RDW, and CHD are interrelated, with RDW playing as a mediator, offering a novel perspective for the prevention and management of CHD.

    Keywords: coronary heart disease, Smoking, Red blood cell distribution width, NHANES, Mediation analysis

    Received: 11 Jun 2024; Accepted: 30 Oct 2024.

    Copyright: © 2024 Ma, Wu, He, Zhang, Han, Guo and Li. 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: Mingfeng Ma, Shanxi Fenyang Hospital, Fenyang, China

    Disclaimer: All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article or claim that may be made by its manufacturer is not guaranteed or endorsed by the publisher.