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Changes in proteinuria and the associated risks of ischemic heart disease, acute myocardial infarction, and angina pectoris in Korean population
Sung Keun Park, Ju Young Jung, Min-Ho Kim, Chang-Mo Oh, Eunhee Ha, Eun Hye Yang, Hyo Choon Lee, Soonsu Shin, Woo Yeon Hwang, Sangho Lee, So Youn Shin, Jae-Hong Ryoo
Epidemiol Health. 2023;45:e2023088.   Published online September 30, 2023
DOI: https://doi.org/10.4178/epih.e2023088
  • 1,649 View
  • 136 Download
AbstractAbstract AbstractSummary PDFSupplementary Material
Abstract
OBJECTIVES
Proteinuria is widely used to predict cardiovascular risk. However, there is insufficient evidence to predict how changes in proteinuria may affect the incidence of cardiovascular disease.
METHODS
The study included 265,236 Korean adults who underwent health checkups in 2003-2004 and 2007-2008. They were categorized into 4 groups based on changes in proteinuria (negative: negative → negative; resolved: proteinuria ≥1+ → negative; incident: negative → proteinuria ≥1+; persistent: proteinuria ≥1+ → proteinuria ≥1+). We conducted 6 years of follow-up to identify the risks of developing ischemic heart disease (IHD), acute myocardial infarction (AMI), and angina pectoris according to changes in proteinuria. A multivariate Cox proportional-hazards model was used to calculate adjusted hazard ratios (HRs) and 95% confidence intervals (CIs) for incident IHD, AMI, and angina pectoris.
RESULTS
The IHD risk (expressed as HR [95% CI]) was the highest for persistent proteinuria, followed in descending order by incident and resolved proteinuria, compared with negative proteinuria (negative: reference, resolved: 1.211 [95% CI, 1.104 to 1.329], incident: 1.288 [95% CI, 1.184 to 1.400], and persistent: 1.578 [95% CI, 1.324 to 1.881]). The same pattern was associated with AMI (negative: reference, resolved: 1.401 [95% CI, 1.048 to 1.872], incident: 1.606 [95% CI, 1.268 to 2.035], and persistent: 2.069 [95% CI, 1.281 to 3.342]) and angina pectoris (negative: reference, resolved: 1.184 [95% CI, 1.065 to 1.316], incident: 1.275 [95% CI, 1.160 to 1.401], and persistent: 1.554 [95% CI, 1.272 to 1.899]).
CONCLUSIONS
Experiencing proteinuria increased the risks of IHD, AMI, and angina pectoris even after proteinuria resolved.
Summary
Korean summary
- 본 연구의 목적은 요 시험지 검사를 통해 확인된 단백뇨의 3-5년간의 변화 수준에 따른 허혈성 심질환, 급성 심근 경색, 협심증의 발생 위험을 평가하는 것이다. - 지속적으로 단백뇨가 음성인 집단에 (negative proteinuria) 비해서, 단백뇨가 있었다 사라진 집단 (resolved proteinuria), 새로이 단백뇨가 생긴 집단 (incident proteinuria), 지속적으로 단백뇨가 존재하는 집단 (persistent proteinuria)은 유의하게 증가한 허혈성 심질환, 급성 심근 경색, 협심증의 발생 위험을 나타내었다. - 이러한 결과는 단백뇨가 일단 발생한 사람은, 나중에 사라지더라도, 관상 동맥 질환에 대한 위험이 높으며, 이에 대한 관리와 주의가 필요하다는 것을 시사한다.
Key Message
- The present study was to evaluate the risk of incident ischemic heart disease, acute myocardial infarction, and angina pectoris according to changes in urine dipstick proteinuria over 3-5 years. - Compared with persistently negative proteinuria (negative → negative), resolved proteinuria (positive → negative), incident proteinuria (negative → positive), and persistent proteinuria (positive → positive) had the increased risk of ischemic heart disease, acute myocardial infarction, and angina pectoris. - These results suggest that once manifested proteinuria lead to the increased risk of coronary artery disease, regardless of changes in proteinuria.
The influence of the dietary intake of vitamin C and vitamin E on the risk of gastric intestinal metaplasia in a cohort of Koreans
Sung Keun Park, Yeongu Chung, Chang-Mo Oh, Jae-Hong Ryoo, Ju Young Jung
Epidemiol Health. 2022;44:e2022062.   Published online July 29, 2022
DOI: https://doi.org/10.4178/epih.e2022062
  • 5,218 View
  • 191 Download
  • 1 Web of Science
  • 1 Crossref
AbstractAbstract AbstractSummary PDFSupplementary Material
Abstract
OBJECTIVES
Studies have suggested that the dietary intake of antioxidant vitamins, such as vitamin C and vitamin E, has a potential role in inhibiting gastric carcinogenesis. The present study investigated the effect of antioxidant vitamins on the incidence of gastric intestinal metaplasia (GIM).
METHODS
This study included 67,657 Koreans free of GIM who periodically underwent health check-ups. Dietary intake was assessed by a semiquantitative food frequency questionnaire based on the Korean National Health and Nutrition Examination Survey. Participants were categorized into 4 groups by quartiles of dietary vitamin C and vitamin E intake. The Cox proportional hazard assumption was used to determine the multivariable hazard ratio (HR) and 95% confidence interval (95% CI) for GIM.
RESULTS
The third and fourth quartiles of vitamin C intake had a lower risk of GIM than the first quartile (multivariable-adjusted HR, 0.95; 95% CI, 0.88 to 1.03 in the second quartile, HR, 0.88; 95% CI, 0.81 to 0.97 in the third quartile, and HR, 0.85; 95% CI, 0.76 to 0.95 in the fourth quartile). Vitamin E intake greater than the second quartile level was significantly associated with a lower risk of GIM than the first quartile (multivariable-adjusted HR, 0.90; 95% CI, 0.82 to 0.97 in the second quartile, HR, 0.90; 95% CI, 0.82 to 0.99 in the third quartile, and HR, 0.83; 95% CI, 0.74 to 0.94 in the fourth quartile). This association was observed only in the subgroup analysis for men.
CONCLUSIONS
Higher dietary intake of vitamin C and vitamin E was associated with a lower risk of GIM.
Summary
Korean summary
본 연구에서는 6만명 이상의 한국인을 대상으로 비타민 C와 비타민 E의 섭취량과 장기적인 위 장상피화생 (GIM) 발생 위험도의 상관 관계를 연구했다. 우리는 비타민 C와 E 섭취량이 많은 근로 연령대의 한국인에서 낮은 위 장상피화생 발생 위험을 확인했다. 이 연관성은 여성보다 남성에서 더 분명하게 나타났다.
Key Message
1. This study investigated the long-term effect of vitamin C and vitamin E intake on the longitudinal risk of GIM in more than 60,000 Koreans 2. We found increased intake of Vitamin C/E is associated with lower incidental risk of GIM in working aged Korean. 3. This association was more prominent in men than women.

Citations

Citations to this article as recorded by  
  • Longitudinal analysis for the risk of depression according to the consumption of sugar-sweetened carbonated beverage in non-diabetic and diabetic population
    Sung Keun Park, Yeongu Chung, Yoosoo Chang, Chang-Mo Oh, Jae-Hong Ryoo, Ju Young Jung
    Scientific Reports.2023;[Epub]     CrossRef

Epidemiol Health : Epidemiology and Health