CRP level and HDL cholesterol concentration jointly predict mortality in a Korean population

Kwang Il Kim, Se Won Oh, Soyeon Ahn, Nam Ju Heo, Sejoong Kim, Ho Jun Chin, Ki Young Na, Dong Wan Chae, Cheol Ho Kim, Suhnggwon Kim

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14 Citations (Scopus)

Abstract

Background: C-reactive protein (CRP) and high-density lipoprotein (HDL) cholesterol are well-known cardiovascular predictors. However, the joint effect of these parameters on long-term mortality has not been established. Methods: We 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. Results: 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, 1.83∼2.87). 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, 1.59∼4.01). Interestingly, the joint effect of CRP and HDL cholesterol was observed for cardiovascular as well as cancer-related mortality prediction. Conclusions: Elevated CRP and low 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.

Original languageEnglish
Pages (from-to)787-795.e4
JournalAmerican Journal of Medicine
Volume125
Issue number8
DOIs
Publication statusPublished - 2012 Aug
Externally publishedYes

Keywords

  • C-reactive protein
  • HDL cholesterol
  • mortality

ASJC Scopus subject areas

  • Medicine(all)

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    Kim, K. I., Oh, S. W., Ahn, S., Heo, N. J., Kim, S., Chin, H. J., Na, K. Y., Chae, D. W., Kim, C. H., & Kim, S. (2012). CRP level and HDL cholesterol concentration jointly predict mortality in a Korean population. American Journal of Medicine, 125(8), 787-795.e4. https://doi.org/10.1016/j.amjmed.2012.02.013