C-reactive Protein Concentration Is Associated With a Higher Risk of Mortality in a Rural Korean Population

Association of serum high-sensitivity C reactive protein with risk of mortality in an Asian population: the Health Examinees cohort

OBJECTIVES

This study aimed to examine the association of high-sensitivity C reactive protein (hsCRP) with mortality risk and the attenuated effect of non-communicable disease history (NCD _history ) on the association.

DESIGN

Prospective cohort study.

SETTING

Health Examinees cohort.

PARTICIPANTS

A total of 41 070 men and 81 011 women aged ≥40 years were involved (follow-up: 6.8 years).

OUTCOME MEASURES

Data and cause of death occurring until 31 December 2015 were confirmed by death statistics from the National Statistical Office. We conducted advanced analysis after stratification by NCD _history and sensitivity analysis after excluding death before 1 or 2 years from recruitment. Cox proportional hazard and restricted cubic spline models were used to assess the association.

RESULTS

The association between serum hsCRP and risk of all-cause mortality was observed with strong linearity in both genders and was not influenced by NCD _history . The association of serum hsCRP with risk of cancer mortality was not observed in women with NCD _history , but the association with risk of cardiovascular disease (CVD) mortality was predominantly observed in men with NCD _history .

CONCLUSIONS

This study suggests a dose-response association of hsCRP with mortality risk, including cancer and CVD mortality, in Koreans with low serum hsCRP, although the association with cancer and CVD mortality risk could be influenced by gender and NCD _history .

Binary cutpoint and the combined effect of systolic and diastolic blood pressure on cardiovascular disease mortality: A community-based cohort study

Objectives

This study aimed to examine the risk of cardiovascular disease (CVD) death according to blood pressure levels and systolic and/or diastolic hypertension.

Methods

From 20,636 cohort participants, 14,375 patients were enrolled after patients with prior hypertension on antihypertensive drugs were excluded. For the combination analysis, participants were divided into four groups (systolic/diastolic hypertension, systolic hypertension only, diastolic hypertension only, and non-hypertension). The risk of CV death was calculated using the hazard ratio (HR) and 95% confidence intervals (95% CI) in a Cox regression model.

Results

The risk of CVD death increased in systolic hypertension (HR = 1.59, 95% CI 1.26–2.00) and systolic/diastolic hypertension (HR = 1.84, 95% CI 1.51–2.25). The highest risks of hemorrhagic and ischemic stroke were observed in the diastolic hypertension (HR = 4.11, 95% CI 1.40–12.06) and systolic/diastolic hypertension groups (HR = 2.59, 95% CI 1.92–3.50), respectively. The risk of CVD death was drastically increased in those with SBP≥120 mmHg/DBP≥80 mmHg. The highest risk was observed in those with SBP of 130–131 mmHg and 134–137 mmHg.

Conclusion

The combined analysis of systolic and/or diastolic hypertension appears to be a good predictor of CVD death. The risk of CVD death in the prehypertensive group could be carefully monitored as well as in the hypertensive group, presumably due to less attention and the lack of antihypertensive treatment.

Sex differences in the association between self-rated health and high-sensitivity C-reactive protein levels in Koreans: a cross-sectional study using data from the Korea National Health and Nutrition Examination Survey

BACKGROUND

No studies have investigated the association between self-rated health (SRH) and high-sensitivity C-reactive protein (hs-CRP) levels in South Koreans. We explored this association and analyzed differences between sexes.

METHODS

Using cross-sectional data from the 2015-2017 Korea National Health and Nutrition Examination Survey, we analyzed the association between SRH and high hs-CRP levels (> 1.0 mg/L) in 14,544 Koreans aged ≥ 19 years who responded to the SRH survey and had available hs-CRP test results. Differences in sociodemographic factors were analyzed using the Pearson's chi-square test for categorical variables or the Mann-Whitney U test for continuous variables. Multiple logistic regression analysis was used to measure the association between hs-CRP levels and SRH according to sex while adjusting for other possible confounders.

RESULTS

The percentage of very poor to poor SRH was higher in the high hs-CRP group (22.4%) than in the low hs-CRP group (17.66%). Among men, the risk of a high hs-CRP level increased with worse SRH (adjusted for confounders; P for trend < 0.001). After adjusting for all confounders, including chronic diseases, men with very poor SRH showed a higher odds ratio (OR) for high hs-CRP levels than those with very good SRH (fully adjusted OR, 1.74; 95% CI, 1.04-2.90). Significant correlations were absent among women.

CONCLUSIONS

Poor SRH was correlated with low-grade inflammation (high hs-CRP levels) among Korean male adults. These findings could be useful for developing health improvement programs and in goal setting at a national scale.

Associations of C-reactive protein and fibrinogen with mortality from all-causes, cardiovascular disease and cancer among U.S. adults

C-reactive protein (CRP) and fibrinogen are associated with an increased risk of death with suggested differences by gender, diet quality and race/ethnicity. However, the current evidence is limited. We used data including 8646 men and 9880 women from the National Health and Nutrition Examination Survey (NHANES) Linked Morality cohort (1999-2011) to investigate the associations of CRP and fibrinogen with mortality overall and by gender, race/ethnicity and diet quality. Cox-proportional hazard model was used to quantify the associations. With a median follow-up of 6 years, a strong dose-response relationship was observed between CRP levels and mortality risk in men after multivariable adjustment. For subjects who survived the first two years, the adjusted hazard ratios (HRs) for total mortality across quartiles (from lower to higher) of CRP were 1.97 (95% CI: 0.62-6.33), 1.89 (0.59, 6.06) and 6.34 (2.28-17.7) (P for trend <0.001). For cardiovascular disease (CVD) mortality, its association with CRP varied by diet quality. For cancer mortality, its association differed by history of cancer, and positive associations were observed only among subjects with history of cancer. In contrast, no such association of CRP with mortality was found in women. For fibrinogen, we observed its positive association with total mortality and the HRs across quartiles of fibrinogen (from lower to higher) were 1.21 (0.88, 1.67), 1.49 (1.22, 1.82) and 1.99 (1.56, 2.55). The association with CVD mortality differed by diet quality whereas no association was found with cancer mortality. Our findings suggest that higher levels of CRP and fibrinogen were associated with lower survival from total and CVD; the associations of CRP with mortality were more pronounced in men than women. Diet quality is an effect modifier for the association of CRP and fibrinogen with CVD mortality.