title: CRP level and HDL cholesterol concentration jointly predict mortality in a Korean population.
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.
authors: Department of Internal Medicine, Seoul National University College of Medicine, Seoul, Republic of Korea.
authors: Kwang-Il
authors: KI
authors: Kim
authors: Se Won
authors: SW
authors: Oh
authors: Soyeon
authors: S
authors: Ahn
authors: Nam Ju
authors: NJ
authors: Heo
authors: Sejoong
authors: S
authors: Kim
authors: Ho Jun
authors: HJ
authors: Chin
authors: Ki Young
authors: KY
authors: Na
authors: Dong-Wan
authors: DW
authors: Chae
authors: Cheol-Ho
authors: CH
authors: Kim
authors: Suhnggwon
authors: S
authors: Kim
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002097:C-Reactive Protein / Q000032:analysis*; D002318:Cardiovascular Diseases / Q000401:mortality*; D002423:Cause of Death; D008076:Cholesterol, HDL / Q000097:blood*; D005260:Female; D005500:Follow-Up Studies; D006306:Health Surveys; D006785:Hospitals, University; D006801:Humans; D008297:Male; D008875:Middle Aged; D009369:Neoplasms / Q000401:mortality*; D011237:Predictive Value of Tests; D012016:Reference Values; D056910:Republic of Korea; D018570:Risk Assessment
chemical_list: D008076:Cholesterol, HDL; D002097:C-Reactive Protein