ArticleThe Journal of international medical research2026
The association between the red cell distribution width to serum albumin ratio and erectile dysfunction in American adults: A cross-sectional National Health and Nutrition Examination Survey analysis from 2001 to 2004.
Article in The Journal of international medical research, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
BackgroundPrevious research has shown that red cell distribution width and serum albumin concentrations may serve as possible indicators of inflammation and nutritional status. Nevertheless, the relationship between erectile dysfunction and the red cell distribution width to serum albumin ratio (RAR) remains unclear. This study aimed to investigate the association between RAR and erectile dysfunction in a nationally representative cohort of US adults.MethodsData for this study were obtained from the National Health and Nutrition Examination Survey conducted between 2001 and 2004. The RAR was calculated by dividing red cell distribution width by serum albumin. Subgroup analyses, restricted cubic spline analysis, and multivariable logistic regression were performed to evaluate the association between RAR and erectile dysfunction. Additionally, receiver operating characteristic (ROC) curve analysis was used to assess the diagnostic performance of RAR for erectile dysfunction.ResultsThe study included 3633 participants, of whom 1026 individuals reported erectile dysfunction. After adjustment for various covariates, a significant positive association was observed between the RAR and erectile dysfunction (odds ratio: 1.68, 95% confidence interval: 1.16-2.44, p = 0.012). Higher quartiles of RAR were significantly associated with an increased risk of erectile dysfunction (T3 compared to T1: odds ratio: 1.68, 95% confidence interval: 1.16-2.44, p = 0.012). A smooth curve fitting analysis suggested a linear relationship between RAR and erectile dysfunction, and the positive association between RAR and erectile dysfunction prevalence was further confirmed by interaction tests and stratified analysis. Furthermore, the receiver operating characteristic analysis demonstrated that RAR outperformed conventional serological markers (area under the curve: 0.690). In contrast, albumin yielded an area under the curve of 0.650, red cell distribution width resulted in an area under the curve of 0.656, the platelet-to-albumin ratio had an area under the curve of 0.538, and neutrophil-to-albumin ratio demonstrated an area under the curve of 0.572.ConclusionThe investigation identifies RAR as a biomarker positively correlated with erectile dysfunction, with particular utility in disease stratification. These findings highlight the potential significance of maintaining an appropriate level of RAR in improving erectile dysfunction.
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