Red cell distribution width, inflammatory markers and cardiorespiratory fitness: Results from the National Health and Nutrition Examination Survey

Abstract

Aims

Cardiorespiratory fitness is an important predictor of cardiovascular morbidity and mortality. Both red cell distribution width (RDW) and inflammatory markers like C-reactive protein (CRP) have been shown to predict adverse outcomes in patients with heart disease.

Methods

We utilized pooled data from NHANES 1999–2004 to assess cardiorespiratory fitness in healthy adults 12–49 years old using submaximal exercise. The primary outcome was the estimated maximal oxygen uptake (VO2max). Low fitness was defined as VO2max < 20th percentile of age- and gender-based reference category.

Results

In our study, we estimated 21.2% of individuals had low fitness. Elevated RDW (>13%) was encountered in 20.4% subjects with low fitness as compared to 14.0% subjects in the control group (p < 0.001). Similarly, elevated CRP (>0.5 mg/dL) was found among 17.4% subjects with low fitness as compared to 12.4% subjects in the control group (p < 0.001). Adjusted analysis demonstrated a dose–response relationship between low cardiorespiratory fitness and increasing RDW or CRP.

Conclusion

In a large representative database of general US population, we observed a significant association between elevated RDW and elevated CRP with low cardiorespiratory fitness.