{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,2]],"date-time":"2026-05-02T13:04:04Z","timestamp":1777727044169,"version":"3.51.4"},"reference-count":63,"publisher":"SAGE Publications","issue":"1","license":[{"start":{"date-parts":[[2026,1,1]],"date-time":"2026-01-01T00:00:00Z","timestamp":1767225600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"},{"start":{"date-parts":[[2026,1,1]],"date-time":"2026-01-01T00:00:00Z","timestamp":1767225600000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["J Int Med Res"],"published-print":{"date-parts":[[2026,1]]},"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Previous 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.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Data 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.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>The 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\u20132.44, p\u2009=\u20090.012). 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\u20132.44, p\u2009=\u20090.012). 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.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>The 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.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/03000605251412569","type":"journal-article","created":{"date-parts":[[2026,1,31]],"date-time":"2026-01-31T10:33:32Z","timestamp":1769855612000},"update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":0,"title":["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"],"prefix":"10.1177","volume":"54","author":[{"ORCID":"https:\/\/orcid.org\/0009-0003-0695-4761","authenticated-orcid":false,"given":"Cunyao","family":"Li","sequence":"first","affiliation":[{"name":"Department of Urology, The Second People\u2019s Hospital of Hefei, Hefei Hospital Affiliated to Anhui Medical University, China"},{"name":"The Fifth Clinical School of Medicine, Anhui Medical University, China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Xiaoliang","family":"Yang","sequence":"additional","affiliation":[{"name":"Department of Urology, The Second People\u2019s Hospital of Hefei, Hefei Hospital Affiliated to Anhui Medical University, China"},{"name":"The Fifth Clinical School of Medicine, Anhui Medical University, China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yanbin","family":"Zhang","sequence":"additional","affiliation":[{"name":"Department of Urology, The Second People\u2019s Hospital of Hefei, Hefei Hospital Affiliated to Anhui Medical University, China"},{"name":"The Fifth Clinical School of Medicine, Anhui Medical University, China"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"179","published-online":{"date-parts":[[2026,1,31]]},"reference":[{"key":"e_1_3_12_2_2","doi-asserted-by":"publisher","DOI":"10.1080\/1485010490475147"},{"key":"e_1_3_12_3_2","doi-asserted-by":"publisher","DOI":"10.1038\/nrdp.2016.3"},{"key":"e_1_3_12_4_2","first-page":"89","article-title":"Erectile dysfunction in aging male","volume":"81","author":"Romanelli F","year":"2010","unstructured":"Romanelli F, Sansone A, Lenzi A. 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