The combined effect of lipid accumulation product, visceral adiposity index and red blood cell count on the risk of developing coronary heart disease

Objective To investigate the effect of the combination of red blood cell count (RBC) with lipid accumulation product (LAP) and visceral adiposity index (VAI) on the risk of coronary heart disease in adults. Methods A total of 310 newly diagnosed patients with coronary heart disease who were admitted to the department of cardiovascular medicine at the First Affiliated Hospital of Fujian Medical University from January 2019 to July 2021 were recruited (the case group), and 310 newly admitted patients without cardiovascular related diseases who were admitted to the orthopedics department of Fujian Medical University Union Medical College Hospital during the same period were matched 1∶1 by age and gender (the control group). Logistic regression analysis was used to analyze the joint effect of RBC with LAP and VAI on the risk of coronary heart disease. Results LAP 37.95 (24.87, 57.42) vs 28.80 (17.28, 42.92), Z=5.472, P<0.001 and VAI 2.22 (1.47, 3.53) vs 1.61 (1.10, 2.55), Z=5.165, P<0.001 in the case group were higher than those in the control group, while the RBC count 4.36 (4.02, 4.71) × 10¹²/L vs 4.44 (4.16, 4.79)×10¹²/L, Z=-1.980, P=0.048 was lower than that in the control group. Multifactorial logistic regression analysis revealed that RBC (OR: 0.717, 95%CI: 0.541-0.951), LAP (OR: 1.013, 95%CI: 1.005-1.021), and VAI (OR: 1.164, 95%CI: 1.042-1.301) were associated with the risk of coronary heart disease (P<0.05). The multiplicative interaction effects of RBC with LAP (OR: 0.985, 95%CI:0.973-0.998) and RBC with VAI (OR: 0.826, 95%CI:0.695-0.980) on the risk of coronary heart disease were statistically significant. The risk of coronary heart disease was 2.870 (95%CI 1.068-7.717), 3.047 (95%CI 1.053-8.812), 5.126 (95%CI 1.930-13.614) and 5.183 (95%CI 1.821-14.753) times higher in the RBC Q2/LAP Q4, RBC Q3/LAP Q4, RBC Q1/LAP Q4, RBC Q1/LAP Q4 and RBC Q1/LAP Q3 groups, respectively, with RBC Q4/LAP Q1 as the reference group and RBC Q2/LAP Q4, RBC Q3/LAP Q4, RBC Q1/LAP Q4 and RBC Q1/LAP Q3, respectively.The risk of coronary heart disease in the RBC Q1 group/VAI Q1 group was 7.753 (95%CI 2.65-22.654) times higher than that in the RBC Q1 group/VAI Q4 group, using the RBC Q4/VAI Q1 group as a reference. Conclusion RBC is a protective factor, while LAP and VAI are risk factors of coronary heart disease, and the combination of RBC and LAP or VAI has a combined effect on the risk of coronary heart disease.