title: C-reactive Protein Concentration Is Associated With a Higher Risk of Mortality in a Rural Korean Population.
abstract: OBJECTIVE
  C-reactive protein (CRP), an inflammatory biomarker, has been widely used as a preclinical marker predictive of morbidity and mortality. Although many studies have reported a positive association between CRP and mortality, uncertainty still remains about this association in various populations, especially in rural Korea.
  
  
  METHODS
  A total of 23 233 middle-aged participants (8862 men and 14 371 women) who were free from cardiovascular disease, cancer, and acute inflammation (defined by a CRP level ≥10 mg/L) were drawn from 11 rural communities in Korea between 2005 and 2011. Blood CRP concentration was analyzed as a categorical variable (low: 0.0-0.9 mg/L; intermediate: 1.0-3.0 mg/L; high: 3.1-9.9 mg/L) as well as a continuous variable. Each participant's vital status through December 2013 was confirmed by death statistics from the National Statistical Office. Cox proportional hazard models were used to assess the independent association between CRP and mortality after adjusting for other risk factors.
  
  
  RESULTS
  The total quantity of observed person-years was 57 975 for men and 95 146 for women, and the number of deaths was 649 among men and 367 among women. Compared to the low-CRP group, the adjusted hazard ratio for all-cause mortality of the intermediate group was 1.17 (95% confidence interval [CI], 0.98 to 1.40) for men and 1.27 (95% CI, 1.01 to 1.61) for women, and the corresponding values for the high-CRP group were 1.98 (95% CI, 1.61 to 2.42) for men and 1.41 (95% CI, 1.03 to 1.95) for women. Similar trends were found for CRP evaluated as a continuous variable and for cardiovascular mortality.
  
  
  CONCLUSIONS
  Higher CRP concentrations were associated with higher mortality in a rural Korean population, and this association was more prominent in men than in women.
authors.affiliation: Graduate School of Public Health, Yonsei University, Seoul, Korea.
authors.forename: Jung Hyun
authors.identifier: 0000-0001-7141-4532
authors.initials: JH
authors.lastname: Lee
authors.affiliation: Department of Preventive Medicine, Yonsei University College of Medicine, Seoul, Korea.
authors.forename: Hyungseon
authors.identifier: 0000-0002-8004-8244
authors.initials: H
authors.lastname: Yeom
authors.affiliation: Department of Preventive Medicine, Yonsei University College of Medicine, Seoul, Korea.
authors.forename: Hyeon Chang
authors.identifier: 0000-0001-7867-1240
authors.initials: HC
authors.lastname: Kim
authors.affiliation: Department of Preventive Medicine, Yonsei University College of Medicine, Seoul, Korea.
authors.forename: Il
authors.identifier: 0000-0002-9689-7849
authors.initials: I
authors.lastname: Suh
authors.affiliation: Department of Preventive Medicine, Hanyang University College of Medicine, Seoul, Korea.
authors.forename: Mi Kyung
authors.initials: MK
authors.lastname: Kim
authors.affiliation: Department of Preventive Medicine, Chonnam National University Medical School, Gwangju, Korea.
authors.forename: Min-Ho
authors.initials: MH
authors.lastname: Shin
authors.affiliation: Department of Preventive Medicine, Keimyung University School of Medicine, Daegu, Korea.
authors.forename: Dong Hoon
authors.initials: DH
authors.lastname: Shin
authors.affiliation: Department of Preventive Medicine, Yonsei University Wonju College of Medicine, Wonju, Korea.|Institute of Genomic Cohort, Yonsei University Wonju College of Medicine, Wonju, Korea.
authors.forename: Sang-Baek
authors.initials: SB
authors.lastname: Koh
authors.affiliation: Department of Preventive Medicine, Yonsei University Wonju College of Medicine, Wonju, Korea.|Institute of Genomic Cohort, Yonsei University Wonju College of Medicine, Wonju, Korea.
authors.forename: Song Vogue
authors.initials: SV
authors.lastname: Ahn
authors.affiliation: Department of Preventive Medicine, Chungnam National University School of Medicine, Daejeon, Korea.
authors.forename: Tae-Yong
authors.initials: TY
authors.lastname: Lee
authors.affiliation: Department of Preventive Medicine, Chosun University Medical School, Gwangju, Korea.
authors.forename: So Yeon
authors.initials: SY
authors.lastname: Ryu
authors.affiliation: Department of Preventive Medicine and Institute of Catholic Kwandong University College of Medicine, Gangneung, Korea.
authors.forename: Jae-Sok
authors.initials: JS
authors.lastname: Song
authors.affiliation: Department of Preventive Medicine and Institute of Catholic Kwandong University College of Medicine, Gangneung, Korea.
authors.forename: Hong-Soon
authors.initials: HS
authors.lastname: Choe
authors.affiliation: Department of Preventive Medicine and Institute of Wonkwang Medical Science, Wonkwang University School of Medicine, Iksan, Korea.
authors.forename: Young-Hoon
authors.initials: YH
authors.lastname: Lee
authors.affiliation: Department of Preventive Medicine, Hanyang University College of Medicine, Seoul, Korea.
authors.forename: Bo Youl
authors.identifier: 0000-0003-0115-5736
authors.initials: BY
authors.lastname: Choi
mesh_terms: D000368:Aged; D044466:Asian People; D015415:Biomarkers / Q000097:blood; D002097:C-Reactive Protein / Q000032:analysis*; D002318:Cardiovascular Diseases / Q000097:blood / Q000401:mortality*; D002423:Cause of Death; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D016016:Proportional Hazards Models; D056910:Republic of Korea; D012307:Risk Factors; D012424:Rural Population; D012737:Sex Factors; D015996:Survival Rate
chemical_list: D015415:Biomarkers; D002097:C-Reactive Protein
keywords: C-reactive protein; Cardiovascular diseases; Mortality; Republic of Korea; Rural population