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Original Articles
- Sex-specific Associations Between Serum Hemoglobin Levels and the Risk of Cause-specific Death in Korea Using the National Health Insurance Service-National Health Screening Cohort (NHIS HEALS)
- Yoonsuk An, Jieun Jang, Sangjun Lee, Sungji Moon, Sue K. Park
- J Prev Med Public Health. 2019;52(6):393-404. Published online November 1, 2019
- DOI: https://doi.org/10.3961/jpmph.19.146
- 6,492 View
- 142 Download
- 4 Crossref
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Abstract
Summary
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Supplementary Material - Objectives
The purpose of this study was to determine the associations between blood hemoglobin (Hgb) levels and the risk of death by specific causes.
Methods
Using the National Health Insurance Services-National Health Screening Cohort (n=487 643), we classified serum Hgb levels into 6 sex-specific groups. Cox regression analysis was used to analyze the associations between Hgb levels and the risk of cause-specific death.
Results
Hgb levels in male population showed a U-shaped, J-shaped, or inverse J-shaped association with the risk of death from ischemic heart disease, acute myocardial infarction, liver cancer, cirrhosis and chronic obstructive pulmonary disease (COPD) (all non-linear p<0.05; hazard ratio [HR]; 95% confidence interval [CI]) for the lowest and the highest Hgb levels for the risk of each cause of death in male population: HR, 1.14; 95% CI, 0.98 to 1.34; HR, 2.87; 95% CI, 1.48 to 5.57; HR, 1.16; 95% CI, 0.96 to 1.40; HR, 3.05; 95% CI, 1.44 to 6.48; HR, 1.36; 95% CI, 1.18 to 1.56; HR, 2.11; 95% CI, 1.05 to 4.26; HR, 3.64; 95% CI, 2.49 to 5.33; HR, 5.97; 95% CI, 1.44 to 24.82; HR, 1.62; 95% CI, 1.14 to 2.30; HR, 3.84; 95% CI, 1.22 to 12.13, respectively), while in female population, high Hgb levels were associated with a lower risk of death from hypertension and a higher risk of death from COPD (overall p<0.05; HR, 1.86; 95% CI, 1.29 to 2.67 for the lowest Hgb levels for hypertension; overall p<0.01, HR, 6.60; 95% CI, 2.37 to 18.14 for the highest Hgb levels for COPD). For the risk of lung cancer death by Hgb levels, a linear negative association was found in male population (overall p<0.01; the lowest Hgb levels, HR, 1.17; 95% CI, 1.05 to 1.33) but an inverse J-shaped association was found in female population (non-linear p=0.01; HR, 1.25; 95% CI, 0.96 to 1.63; HR, 2.58; 95% CI, 1.21 to 5.50).
Conclusions
Both low and high Hgb levels were associated with an increased risk of death from various causes, and some diseases showed different patterns according to sex. -
SummaryKorean summary
본 연구는 2002년 및 2003년 한국 국민건강보험공단 건강검진 수검자 코호트(NHIS-HEALS)를 이용하여 총 487,643명을 대상으로 2013년 말일까지의 통계청 사망자료 추적관찰 기반 혈중 헤모글로빈과 전체, 심뇌혈관, 암, 기타 질환의 (만성 폐쇄성 폐질환, 간경화증) 사망위험 간 상관관계를 성별 층화하여 콕스회귀모형으로 분석하였음. 연구 결과 남성에서는 낮은 헤모글로빈 및 높은 헤모글로빈 농도와 허혈성 심질환, 심근경색, 간암, 간경화증, 그리고 만성 폐쇄성 폐질환 사망위험이 통계적으로 유의하게 증가함을 보인 반면, 여성에서는 낮은 헤모글로빈 농도에서는 고혈압, 높은 헤모글로빈 농도에서는 만성 폐쇄성 폐질환 사망위험도가 통계적으로 유의하게 증가하였음.결과적으로 낮은 그리고 높은 헤모글로빈 농도가 기존에 알려져 있던 심혈관질환의 사망위험에 영향을 주었을 뿐만 아니라 암 질환 및 기타 다른 질환들의 사망위험에도 영향을 주는 것으로 나타났기에 혈중 헤모글로빈 농도가 사망위험도의 잠재적인 예측인자로써의 가능성을 보였음. 주요 단어: 헤모글로빈, 빈혈, 사망, 성별, 한국인 -
Citations
Citations to this article as recorded by
- Cross-phenotype association analysis of gastric cancer: in-silico functional annotation based on the disease–gene network
Sangjun Lee, Han-Kwang Yang, Hyuk-Joon Lee, Do Joong Park, Seong-Ho Kong, Sue K. Park
Gastric Cancer.2023; 26(4): 517. CrossRef - 1H-NMR metabolomics-based surrogates to impute common clinical risk factors and endpoints
D. Bizzarri, M.J.T. Reinders, M. Beekman, P.E. Slagboom, BBMRI-NL, E.B. van den Akker
eBioMedicine.2022; 75: 103764. CrossRef - Coronary Atherosclerotic Disease and Cancer: Risk Factors and Interrelation
Jinjing Li, Jieqiong Zhao, Yonghong Lei, Yan Chen, Miaomiao Cheng, Xiaoqing Wei, Jing Liu, Pengyun Liu, Ruirui Chen, Xiaoqing Yin, Lei Shang, Xue Li
Frontiers in Cardiovascular Medicine.2022;[Epub] CrossRef - Binary cutpoint and the combined effect of systolic and diastolic blood pressure on cardiovascular disease mortality: A community-based cohort study
Ju-Yeun Lee, Ji Hoon Hong, Sangjun Lee, Seokyung An, Aesun Shin, Sue K. Park, Tariq Jamal Siddiqi
PLOS ONE.2022; 17(6): e0270510. CrossRef
- Cross-phenotype association analysis of gastric cancer: in-silico functional annotation based on the disease–gene network
- The Type of Anemia in Organic Solvent Workers by MCV and RDW.
- S J Kim, S H Ohm, D H Kim, C U Lee, J H Chun, S C Kim, K T Pae
- Korean J Prev Med. 1992;25(2):162-171.
- 2,149 View
- 32 Download
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Abstract
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- The hematologic effect by low-concentration and repeated exposure to mixed organic solvent remains obscure. This study was performed to evaluate the hematologic effect by mixed organic solvent exposure, especially on the type of anemia by mean corpuscular volume(MCV) and red blood cell distribution width(RDW). The subject were 64 organic solvent workers(male 4, female 60) and 78 general workers(male 18, female 60) who showed anemic tendency in worker's health examination which carried out by Pusan Paik Hospital from January to December, 1988. The author gained some hematologic findings (hemoglobin, hematocrit, RBC, WBC, MCV, MCHC, platelet count, ESR, RDW) from auto-analysis method by coulter counter S plus IV, and compared the type of anemia by MCV and RDW. In the pilot study for estimating the prevalence of anemia according to the type of job, the prevalence rate was higher in organic solvent workers than in public officials as 10.9% and 4.1% respectively. There were statistical significance in the value of hemoglobin, hematocrit, MCV, MCHC, platelet count, ESR, RDW between the two study groups with more severe anemic tendency in organic solvent workers. The type of anemia in organic solvent workers was microcytic and anisocytic with the mean value of 68.28+/-8.3fL of MCV and 19.1+/-4.0% of RDW.
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