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

Lee, Sang-Ah; Kwon, Seungwon; Park, Hyerim; Shu, Xiao‐Ou; Lee, Jong Koo; Kang, Daehee

doi:10.1136/bmjopen-2021-052630

Cited by 5 publications

(8 citation statements)

References 42 publications

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“…Participants who did not experience the event were censored on December 31, 2020. We selected confounders based on predictors of mortality that have been published in previous studies [ 30 , 33 ], and by evaluating multivariable Cox regression models. To examine the association of total UPF intake or UPF items/subgroups with all-cause or cause-specific mortality, sex-stratified hazard ratios (HRs) and 95% confidence intervals (CIs) were estimated using Cox proportional hazard models with follow-up time as a time-scale variable.…”

Section: Methodsmentioning

confidence: 99%

The intake of ultra-processed foods, all-cause, cancer and cardiovascular mortality in the Korean Genome and Epidemiology Study-Health Examinees (KoGES-HEXA) cohort

Kityo

Lee

2023

PLoS ONE

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The relationship between ultra-processed food (UPF) intake and mortality is unknown in Asian countries, yet the intake of UPF is on the rise in these countries. This study examined the association of UPF intake with all-cause, cancer and cardiovascular disease (CVD) mortality. Participants were 113,576 adults who responded to a 106-item food frequency questionnaire during recruitment of the 2004–2013 Health Examinees (HEXA) study, a prospective cohort study in Korea. UPF were defined using the NOVA classification and evaluated as quartiles of the proportion of UPF in the diet (% total food weight). Multivariable Cox regression and restricted cubic spline models were used to examine the association of UPF intake with all-cause and cause specific mortality. A total of 3456 deaths were recorded during a median follow-up of 10.6 (interquartile range, 9.5–11.9) years. There was no evidence of an association of UPF intake with all-cause, cancer or CVD mortality comparing the highest with the lowest quartiles of UPF intake (all-cause mortality, men: hazard ratio [HR] 1.08, 95% confidence interval [CI] 0.95–1.22; women: HR 0.95, 95% CI 0.81–1.11; cancer mortality, men: HR 1.02, 95% confidence interval [CI] 0.84–1.22; women: HR 1.02, 95% CI 0.83–1.26; CVD mortality, men: HR 0.88, 95% CI 0.64–1.22; women: HR 0.80, 95% CI 0.53–1.19). However, the risk of all-cause mortality increased in both men and women with high consumption of ultra-processed red meat and fish (men, HR 1.26, 95% CI 1.11–1.43); women, HR 1.22 95% CI 1.05–1.43); and in men with high consumption of ultra-processed milk (HR 1.13, 95% CI 1.01–1.26); and soymilk drink (HR 1.12, 95% CI 1.00–1.25). We found no evidence of an association between total UPF intake and all-cause, cancer or CVD mortality, but ultra-processed red meat and fish in both sexes, and milk and soymilk drinks in men were positively associated with all-cause mortality.

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Section: Methodsmentioning

confidence: 99%

The intake of ultra-processed foods, all-cause, cancer and cardiovascular mortality in the Korean Genome and Epidemiology Study-Health Examinees (KoGES-HEXA) cohort

Kityo

Lee

2023

PLoS ONE

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“…This increase was evident with a HR of 1.45 (95% CI, 1.05–2.01) in quartile 2 (0.70–1.39 mg/day), rising to 1.95 (95% CI, 1.42–2.69) in quartile 4 (3.02–10.0 mg/day) when compared to quartile 1 (0.09–0.70 mg/L) 18 . In a study conducted in Korea with a total of 41,070 men and 81,011 women aged 40 years or older (follow‐up duration: 6.8 years), it was found that there was a dose–response relationship between elevated hsCRP levels and the risk of all‐cause mortality in both genders 20 . This study included 2206 participants who were 80 years of age or older (with a median age of 93.0 years) from the Healthy Aging and Biomarkers Cohort Study (follow‐up: 3.1 years).…”

Section: Discussionmentioning

confidence: 99%

“…18 In a study conducted in Korea with a total of 41,070 men and 81,011 women aged 40 years or older (follow-up duration: 6.8 years), it was found that there was a dose-response relationship between elevated hsCRP levels and the risk of all-cause mortality in both genders. 20 Abbreviations: CI, confidence interval; HR, hazard ratio; hsCRP, high-sensitivity c-reactive protein.…”

Section: Discussionmentioning

confidence: 99%

“…Moreover, many research studies have explored the links between hsCRP levels and mortality rates. For example, a recent study demonstrated that heightened hsCRP levels are connected to an increased risk of overall mortality 8,9,13–20 . Nevertheless, many of these studies are clinical trials or hospital‐based studies and are unlikely to reflect the basic health status of the general population.…”

Section: Introductionmentioning

confidence: 99%

“…For example, a recent study demonstrated that heightened hsCRP levels are connected to an increased risk of overall mortality. 8 , 9 , 13 , 14 , 15 , 16 , 17 , 18 , 19 , 20 Nevertheless, many of these studies are clinical trials or hospital‐based studies and are unlikely to reflect the basic health status of the general population. In addition, in these studies, low‐grade systemic inflammation can be defined by hsCRP levels <1.00, 1.00–3.00, and >3.00 mg/L indicating lower, average, or higher relative cardiovascular risk, respectively.…”

Section: Introductionmentioning

confidence: 99%

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High‐sensitivity C‐reactive protein is a predictor of all‐cause mortality in a rural Japanese population

Kawamoto,

Kikuchi,

Niomiya

et al. 2024

Clinical Laboratory Analysis

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BackgroundHigh‐sensitivity C‐reactive protein (hsCRP) is a sensitive marker of inflammation. This study aimed to determine whether increased hsCRP levels are associated with all‐cause mortality rate.MethodsWe examined data for participants from the 2002 Nomura Cohort Study who attended follow‐ups for 20 years (follow‐up rate: 93.3%). Of these, 793 were male (aged 61 ± 14 years) and 1040 were female (aged 63 ± 11 years). The Japanese Basic Resident Registry provided data on adjusted relative hazards for all‐cause mortality. The data were subjected to a Cox regression analysis using a time variable of age and confounding risk factors.ResultsThe median (interquartile range) follow‐up period was 6548 days (6094–7452 days). The follow‐up confirmed that there were 632 (34.8%) deaths, of which 319 were male (40.2% of all males) and 313 were female (30.6% of all females). Multivariable‐adjusted hazard ratio (1.27; 95% confidence interval, 1.01–1.59) in the highest hsCRP category was also significantly higher compared with reference. A higher hsCRP was associated with a greater risk of all‐cause mortality in male participants aged ≥65 years, a BMI < 25 kg/m2, and no history of CVD or diabetes, and this association was particularly significant among participants with both of the latter two risk factors (p = 0.004 and 0.022 for interaction, respectively).ConclusionsOur results indicate a significant association between hsCRP levels and all‐cause mortality in a rural Japanese population. Specifically, hsCRP appears to be a crucial biomarker for predicting long‐term survival, particularly among older persons.

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Early elevation of high-sensitivity C-reactive protein as a predictor for cardiovascular disease incidence and all-cause mortality: a landmark analysis

Lee,

Lee

2023

Sci Rep

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We investigated the association between early elevation of high-sensitivity C-reactive protein (hsCRP) and cardiovascular disease (CVD) incidence, all-cause mortality, and CVD mortality. We analyzed 6567 participants from the Korean Genome and Epidemiology Study_Ansan_Ansung cohort between 2005 and 2018. The Kaplan–Meier curves and modified Cox regression by Fine and Gray were used to estimate hazard ratios (HRs) with 95% confidence intervals (CIs) for CVD incidence, all-cause mortality, CVD mortality, cancer mortality, and mortality from other causes. Landmark analyses were performed at the first (2007–2008) and second (2009–2010) follow-up periods, with early elevation defined as hsCRP > 2 mg/L. At the first and second landmark points, the early hsCRP elevation group had a higher incidence of CVD and all-cause mortality. At first landmark point, the adjusted HRs (95% CIs) were 1.37 (1.08–1.74) for incident CVD and 1.26 (1.04–1.53) for all-cause mortality, respectively. At second landmark point, the adjusted HRs in the early hsCRP elevation group were 1.45 (1.12–1.89) for incident CVD and 1.34 (1.10–1.63) for all-cause mortality, respectively. However, there were no significant differences in CVD mortality and cancer mortality between the groups. In conclusion, early elevation of serum hsCRP is a predictor of incident CVD and all-cause mortality. The timing of hsCRP increase is also a significant predictor of incident CVD, even considering the competing risk. Regular hsCRP testing may help monitor hsCRP trends and develop individualized treatment plans for CVD prevention.

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

Cited by 5 publications

References 42 publications

The intake of ultra-processed foods, all-cause, cancer and cardiovascular mortality in the Korean Genome and Epidemiology Study-Health Examinees (KoGES-HEXA) cohort

The intake of ultra-processed foods, all-cause, cancer and cardiovascular mortality in the Korean Genome and Epidemiology Study-Health Examinees (KoGES-HEXA) cohort

High‐sensitivity C‐reactive protein is a predictor of all‐cause mortality in a rural Japanese population

Early elevation of high-sensitivity C-reactive protein as a predictor for cardiovascular disease incidence and all-cause mortality: a landmark analysis

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