Abstract P236: Relationship Between Red Cell Distribution Width and Alcohol Intake: An Analysis of the NHANES, 1999 to 2006
Authors: Panaich Sidakpal S , Kommuri Naga V , Zalawadiya Sandip K , Veeranna Vikas , Shenoy Maithili , Niraj Ashutosh , Jacob Sony , Afonso Luis 
Published: March 2022

Introduction:
Moderate alcohol intake has been associated with reduced cardiovascular mortality. Red cell distribution width (RDW) is an emerging cardiovascular risk marker, that is increasingly gaining recognition. No prior study has evaluated the association between alcohol intake and RDW.

Methods:
We evaluated 6,424 nationally representative individuals participating in the National Health and Nutrition Examination Survey (NHANES) 1999 to 2006, free of cardiovascular co-morbidities (including coronary heart disease, diabetes, congestive heart failure, stroke and myocardial infarction) at baseline. RDW was divided into quartiles [Quartile 1 (Q1) ≤12 (reference category), Q2: 12.1-12.5; Q3: 12.6-13; Q4: >13] and alcohol intake was categorized by number of drinks per day [<1 drink/day, reference category), 1 drink/day, 2 drinks/day and ≥3 drinks/day]. Multivariate adjusted logistic regression analysis was performed to evaluate the risk relationship between RDW levels and daily alcohol intake.

Results:
Mean RDW levels varied inversely with number of drinks per day (12.9 in reference alcohol category versus 12.5 in ≥3 drinks/day, p<0.001). Results of multivariate adjusted logistic regression analysis are shown in Table 1.

Conclusion:
Moderate alcohol intake [1 to 2 drinks /day] is associated with more favorable levels of RDW. The association appears to be independent of nutritional deficiencies, inflammatory markers and other conventional cardiovascular risk factors.

Table 1:

Risk of Higher RDW with Increasing Alcohol Intake

RDW Categories

Alcohol Categories

*
≤12 n=1,612

12.1-12.5 n=2,037
12.6-13 n=1,215
>13 n=1,560

1
OR[95% CI] p-value
OR [95% CI] p-value
OR [95% CI] p-value

*
<1 drink/day n=2,037

1
1
1
1
1

1 drink/day
n=1,510

Model 1

1

0.93 [0.79-1.09] 0.351
0.97 [0.81-1.16] 0.750
0.72 [0.61-0.88] 0.001

Model 2

1

0.96 [0.82-1.13] 0.657
1.01 [0.84-1.21] 0.931
0.76 [0.62-0.93] 0.008

2 drinks/day
n=1,212

Model 1

1

1.00 [0.85-1.17] 0.963
0.81 [0.67-0.99] 0.046
0.67 [0.55-0.82] <0.001

Model 2

1

1.04 [0.88-1.22] 0.669
0.90 [0.74-1.11] 0.336
0.71 [0.56-0.88] 0.002

≥3 drinks/day

Model 1

1

1.00 [0.86-1.17] 0.995
0.85 [0.70-1.02] 0.082
0.86 [0.71-1.03] 0.105

Model 2

1

0.98 [0.84-1.15] 0.826
0.88 [0.72 -1.07]0.193
0.91 [0.74-1.11] 0.346

Model 1:

Alcohol Drinks + Sex, Age, systolic blood pressure, anti-hypertensive medications, High Density Lipoprotein cholesterol, total cholesterol, ever smoking and deficiency of nutritional factors (Iron, folic acid and vitamin B
12
)

Model 2:

Age, sex, race + body mass index, estimated Glomerular Filtration Rate, high sensitivity C - Reactive Protein, hypertension, hyperlipidemia, ever smoking, mean corpuscular volume, hemoglobin and deficiency of nutritional factors

Abbreviations: OR -

odds ratio,
CI
- Confidence Interval,
RDW
- Red cell Distribution Width.

*

RDW ≤12 and ‘Zero’ Alcohol drinks/day serve as reference categories for the comparison