Ability of a biomarker-based score to predict death from circulatory disease and cancer in NHANES III

作者：Van Hemelrijck Mieke^*; Eichholzer Monika; Faeh David; Rohrmann Sabine

来源：BMC Public Health, 2012, 12: 895.

DOI：10.1186/1471-2458-12-895

• Mortality
• Albumin
• HDL-cholesterol
• C-reactive protein
• Gamma-glutamyltransferase

Background: A score based on serum concentrations of C-reactive protein (CRP), albumin, gamma-glutamyl transferase (GGT), and HDL cholesterol was positively associated with death from cancer, circulatory disease, and all-cause mortality. We replicated this in the third National Health and Nutrition Examination Survey (NHANES III), a US nationally representative survey conducted between 1988-1994.
Methods: Baseline measurements of CRP, albumin, GGT, and HDL were available for participants with mortality follow-up (n=13,056). A biomarker score, ranging 0-4, was created by adding number of markers with abnormal values (cut-off: CRP>10mg/L, albumin<35mg/L, GGT>36U/L, HDL<1.04mmol/L). Its association with mortality was analyzed with multivariate Cox proportional hazards models.
Results: The score was positively associated with death from all causes, cancer and circulatory disease [e.g. HR all-cause mortality: 1.21 (95% CI: 1.09, 1.35), 1.92 (1.67, 2.20), 3.38 (2.62, 4.36), and 7.93 (5.77, 10.89), for score 1, 2, 3, 4 vs. 0]. These patterns were found across the Charlson Comorbidity Index (CCI). Where CCI = 3, risk of cancer death was 1.09 (0.93, 1.28), 1.81 (1.43, 2.29), 4.67 (3.05, 7.14), and 6.97 (5.32, 9.14) for score 1, 2, 3, 4 vs. 0. No effect-modification by sex or race/ethnicity was observed.
Conclusions: These findings correlate with results from a Swedish study. This biomarker-based score could help clinicians make decisions in prevention and disease management.

• 出版日期2012-10-23