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CRP level and HDL cholesterol concentration jointly predict mortality in a korean population
American Journal of Medicine, 08/16/2012
Kim K et al. – Elevated C–reactive protein (CRP) and low high–density lipoprotein (HDL) cholesterol jointly contribute to the prediction of all–cause, cancer, and cardiovascular mortality in Koreans. The interactive relationship between them in mediating inflammatory processes might explain these results.
Methods- Authors studied a total of 92,500 subjects older than 20 years who underwent routine health examination at the three health care centers affiliated with Seoul National University.
- High–sensitivity CRP and the lipid profile were obtained at baseline.
- Subjects were followed for a median of 45.5 months.
- Mortality data were obtained from the National Statistics Office of Korea.
- There were 649 deaths (0.7%) during the follow–up.
- The leading cause of death was cancer.
- The subjects who died were significantly older, had a male predominance, and had increased levels of inflammatory markers.
- A significant mortality difference was identified according to the CRP and HDL cholesterol levels.
- Considering both parameters jointly, subjects with a CRP ≥1.4 mg/L (highest quartile) and HDL cholesterol <45 mg/dL (lowest quartile) were at the highest risk for all–cause mortality, even after adjusting for covariates (hazard ratio 2.29, 95% confidence interval, 1.832.87).
- After matching on the propensity score, 6304 subjects with a high CRP and low HDL cholesterol were at high risk of death (hazard ratio 2.52, 95% confidence interval, 1.594.01).
- Interestingly, the joint effect of CRP and HDL cholesterol was observed for cardiovascular as well as cancer–related mortality prediction.
