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

Abstract

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.