ObjectivesThis 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 (NCDhistory) on the association.DesignProspective cohort study.SettingHealth Examinees cohort.ParticipantsA total of 41 070 men and 81 011 women aged ≥40 years were involved (follow-up: 6.8 years).Outcome measuresData 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 NCDhistory 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.ResultsThe association between serum hsCRP and risk of all-cause mortality was observed with strong linearity in both genders and was not influenced by NCDhistory. The association of serum hsCRP with risk of cancer mortality was not observed in women with NCDhistory, but the association with risk of cardiovascular disease (CVD) mortality was predominantly observed in men with NCDhistory.ConclusionsThis 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 NCDhistory.

Macronutrient intake is important in the prevention and management of metabolic syndrome (MetS). This study aimed to evaluate total energy and macronutrient intake of participants diagnosed with MetS at recruitment of the health examinees (HEXA) cohort, considering the plant and animal sources of each macronutrient. We included 130,423 participants aged 40–69 years for analysis. Odds ratios (OR) and 95% confidence intervals (CI) were estimated to evaluate the intake of macronutrients stratified by gender. Energy and macronutrient intake were estimated by linking food frequency questionnaire data to the Korean food composition database, and were calculated separately for plant and animal foods. Low energy (men: OR = 0.95, 95% CI: 0.92–0.98; women: OR = 0.97, 95% CI: 0.95–0.99), and fat intake (men: OR = 0.93, 95% CI: 0.90–0.96; women: OR = 0.80, 95% CI: 0.77–0.83) were observed. Only postmenopausal women had lower intake of total energy (OR = 0.95, 95% CI: 0.92–0.97), whereas low fat intake was observed in all women (OR = 0.80, 95% CI: 0.77–0.83). For carbohydrate intake, the OR were 1.14 (95% CI: 1.08–1.22) and 1.17 (95% CI: 1.08–1.27) among women in their 50s and 60s, respectively. Protein intake was low (OR = 0.90, 95% CI: 0.86–0.95; and OR = 0.88, 95% CI: 0.82–0.94) among women in their 50s and 60s, respectively. High intake of plant carbohydrates in women (OR = 1.16, 95% CI: 1.12–1.20), and plant protein in both genders (OR = 1.09, 95% CI: 1.05–1.13) were observed, but low intake of total energy, fat, and animal-source carbohydrates in both genders was also observed. Fat intake was low regardless of food source. In conclusion, high consumption of plant-source macronutrients, and low consumption of animal-source macronutrients was observed in Korean adults diagnosed with MetS. Attention should be directed to plant sources of carbohydrates and proteins when designing population interventions for metabolic syndrome reduction in Korea.