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1Department of Preventive Medicine, Graduate School, Kyung Hee University, Seoul, Korea
2Department of Occupational and Environmental Medicine, Kyung Hee University Hospital, Seoul, Korea
3Ewha Medical Data Organization, Ewha Womans University Seoul Hospital, Seoul, Korea
4Department of Preventive Medicine, Kyung Hee University School of Medicine, Seoul, Korea
5Department of Family Medicine, Ewha Womans University College of Medicine, Seoul, Korea
6Department of Occupational and Environment Medicine, Ewha Womans University College of Medicine, Seoul, Korea
7Department of Internal Medicine, Veterans Healthcare Service Medical Center, Seoul, Korea
8Department of Neurosurgery, Ewha Womans University Seoul Hospital, Seoul, Korea
9Department of Anesthesiology and Pain Medicine, Kyung Hee University Medical Center, Seoul, Korea
10Department of Obstetrics and Gynecology, Kyung Hee University Hospital, Seoul, Korea
11Department of Occupational and Environmental Medicine, Kyung Hee University School of Medicine, Seoul, Korea
© 2024, Korean Society of Epidemiology
This is an open-access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
Conflict of interest
The authors have no conflicts of interest to declare for this study.
Funding
This work was supported by a grant from Kyung Hee University in 2023 (KHU-20230913).
Author contributions
Conceptualization: Ryoo JH. Data curation: Ryoo JH, Kim MH. Formal analysis: Ryoo JH, Kim MH. Funding acquisition: Ryoo JH. Methodology: Ryoo JH, Kim MH. Project administration: Ryoo JH, Oh CM, Chun H, Ha E. Visualization: Shin S, Lee HC, Moon SH. Writing – original draft: Shin S, Ryoo JH. Writing – review & editing: Shin S, Kim MH, Oh CM, Chun H, Ha E, Lee HC, Moon SH, Lee DY, Cho D, Lee S, Jung MH, Ryoo JH.
Characteristics | Overall |
eGFR (mL/min/1.73 m2) |
|||
---|---|---|---|---|---|
Group 1 (eGFR≥90, n=114,986) | Group 2 (60≤eGFR<90, n=208,708) | Group 3 (eGFR<60, n=34,599) | p-value1 | ||
Person-years (total) | 3,470,426.78 | 1,127,480.18 | 2,021,331.03 | 321,615.57 | |
Person-years (average) | 9.69±1.55 | 9.81±1.29 | 9.68±1.54 | 9.30±2.17 | <0.001 |
Age (yr) | 58.77±8.94 | 56.13±6.66 | 59.26±9.23 | 64.62±10.43 | <0.001 |
Sex | <0.001 | ||||
Male | 194,063 (54.2) | 58,894 (51.2) | 117,031 (56.1) | 18,138 (52.4) | |
Female | 164,230 (45.8) | 56,092 (48.8) | 91,677 (43.9) | 16,461 (47.6) | |
BMI (kg/m2) | 24.01±2.92 | 23.86±2.93 | 24.06±2.90 | 24.24±3.03 | <0.001 |
Systolic BP (mmHg) | 125.29±15.27 | 124.38±15.05 | 125.39±15.26 | 127.65±15.76 | <0.001 |
Diastolic BP (mmHg) | 77.58±9.96 | 77.32±10.02 | 77.67±9.91 | 77.91±10.04 | <0.001 |
Total cholesterol (mg/dL) | 200.07±37.68 | 198.52±37.08 | 200.92±37.56 | 200.14±40.10 | <0.001 |
Triglycerides (mg/dL) | 117 (83-169) | 113 (79-163) | 118 (84-170) | 127 (91-182) | <0.001 |
HDL cholesterol (mg/dL) | 55.27±30.93 | 55.83±29.95 | 54.39±23.81 | 58.80±59.06 | <0.001 |
LDL cholesterol (mg/dL) | 118.62±38.16 | 117.31±38.84 | 119.38±37.75 | 118.41±38.25 | <0.001 |
Fasting blood glucose (mg/dL) | 100.99±25.25 | 100.21±25.18 | 100.79±24.44 | 104.81±29.57 | <0.001 |
SCr (mg/dL) | 1.09±1.33 | 0.73±0.13 | 0.96±0.15 | 3.07±3.71 | <0.001 |
eGFR (mL/min/1.73 m2) | 80.89±19.40 | 100.10±7.99 | 76.79±8.23 | 41.79±20.45 | <0.001 |
Urine protein level | <0.001 | ||||
Normal | 338,290 (94.9) | 109,735 (95.7) | 197,817 (95.1) | 30,738 (89.6) | |
Trace | 8,352 (2.3) | 2,452 (2.1) | 4,659 (2.2) | 1,241 (3.6) | |
1+ | 6,582 (1.8) | 1,728 (1.5) | 3,622 (1.7) | 1,232 (3.6) | |
≥2+ | 3,669 (1.0) | 783 (0.7) | 1,804 (0.9) | 1,082 (3.2) | |
AST (U/L) | 24 (20-29) | 23 (20-29) | 24 (20-29) | 24 (20-29) | <0.001 |
ALT (U/L) | 21 (16-29) | 21 (16-29) | 21 (16-29) | 20 (15-27) | <0.001 |
GGT (U/L) | 24 (17-40) | 24 (16-41) | 25 (17-40) | 24 (17-38) | <0.001 |
Smoking amount (pack-years) | 7.52±13.83 | 7.37±13.62 | 7.65±13.87 | 7.16±14.26 | <0.001 |
Smoking status | <0.001 | ||||
Never smoker | 227,475 (64.7) | 73,908 (65.5) | 130,661 (63.8) | 22,906 (67.4) | |
Former smoker | 63,739 (18.1) | 18,208 (16.1) | 39,078 (19.1) | 6,453 (19.0) | |
Current smoker | 60,346 (17.2) | 20,656 (18.3) | 35,088 (17.1) | 4,602 (13.5) | |
Alcohol consumption | 49,034 (13.8) | 17,230 (15.1) | 28,250 (13.7) | 3,554 (10.4) | <0.001 |
Physical activity | 60,133 (17.0) | 18,953 (16.7) | 35,334 (17.2) | 5,846 (17.1) | 0.003 |
COPD | 105,801 (29.5) | 30,876 (26.8) | 62,229 (29.8) | 12,696 (36.7) | <0.001 |
Asthma | 71,392 (19.9) | 20,867 (18.1) | 41,885 (20.1) | 8,640 (25.0) | <0.001 |
Development of lung cancer | 5,757 (1.6) | 1,519 (1.3) | 3,481 (1.7) | 757 (2.2) | <0.001 |
Values are presented as the mean±standard deviation, number (%), or median (interquartile range).
eGFR, estimated glomerular filtration rate; BMI, body mass index; BP, blood pressure; HDL, high-density lipoprotein; LDL, low-density lipoprotein; AST, aspartate aminotransferase; SCr, serum creatinine; ALT, alanine aminotransferase; GGT, gamma-glutamyltransferase; COPD, chronic obstructive pulmonary disease.
1 Using analysis of variance for continuous variables and the chi-square test for categorical variables.
Variables | Person-years | Incident cases | Incidence density (per 10,000 person-years) | Unadjusted model | Multivariate-adjusted model1 |
---|---|---|---|---|---|
eGFR (mL/min/1.73 m2) | |||||
Group 1 (≥90) | 1,127,480.18 | 1,519 | 13.47 | 1.00 (reference) | 1.00 (reference) |
Group 2 (≥60 to <90) | 2,021,331.03 | 3,481 | 17.22 | 1.28 (1.20, 1.36) | 1.26 (1.19, 1.35) |
Group 3 (<60) | 321,615.57 | 757 | 23.54 | 1.75 (1.61, 1.91) | 1.72 (1.58, 1.89) |
p for trend | <0.001 | <0.001 | |||
Sex (female vs. male) | - | - | - | - | 0.56 (0.52, 0.61) |
BMI | - | - | - | - | 0.93 (0.92, 0.94) |
Fasting blood glucose | - | - | - | - | 1.00 (1.00, 1.00) |
GGT | - | - | - | - | 1.00 (1.00, 1.00) |
Smoking amount (pack-years) | - | - | - | - | 1.02 (1.02, 1.02) |
Smoking status | |||||
Never smoker | - | - | - | - | 1.00 (reference) |
Former smoker | - | - | - | - | 0.75 (0.68, 0.82) |
Current smoker | - | - | - | - | 1.18 (1.08, 1.29) |
Alcohol consumption | - | - | - | - | 1.07 (0.99, 1.14) |
Physical activity | - | - | - | - | 1.02 (0.95, 1.09) |
COPD | - | - | - | - | 1.68 (1.59, 1.78) |
Asthma | - | - | - | - | 1.40 (1.32, 1.49) |
eGFR, estimated glomerular filtration rate; BMI, body mass index; GGT, gamma-glutamyltransferase; COPD, chronic obstructive pulmonary disease.
1 The multivariate-adjusted model was adjusted for sex, BMI, fasting blood glucose, GGT, smoking amount (pack-years), smoking status, alcohol consumption, physical activity, COPD, and asthma; Age was not included in the multivariate-adjusted model.
Variables |
Urine protein level |
|||
---|---|---|---|---|
<2+ (n=353,224, 98.97%) |
≥2+ (n=3,669, 1.03%) |
|||
Unadjusted model | Multivariate-adjusted model1 | Unadjusted model | Multivariate-adjusted model1 | |
eGFR (mL/min/1.73 m2) | ||||
Group 1 (≥90) | 1.00 (reference) | 1.00 (reference) | 1.00 (reference) | 1.00 (reference) |
Group 2 (≥60 to <90) | 1.27 (1.20, 1.35) | 1.26 (1.18, 1.34) | 1.95 (0.95, 4.03) | 2.00 (0.97, 4.15) |
Group 3 (<60) | 1.73 (1.58, 1.89) | 1.70 (1.56, 1.87) | 2.94 (1.40, 6.17) | 2.93 (1.37, 6.24) |
p for trend | <0.001 | <0.001 | <0.001 | <0.001 |
Sex (female vs. male) | - | 0.56 (0.52, 0.61) | - | 0.28 (0.13, 0.62) |
BMI | - | 0.93 (0.92, 0.94) | - | 0.92 (0.85, 0.99) |
Fasting blood glucose | - | 1.00 (1.00, 1.00) | - | 1.00 (1.00, 1.01) |
GGT | - | 1.00 (1.00, 1.00) | - | 1.00 (0.99, 1.00) |
Smoking amount (pack-years) | - | 1.02 (1.02, 1.02) | - | 1.00 (0.99, 1.02) |
Smoking status | ||||
Never smoker | - | 1.00 (reference) | - | 1.00 (reference) |
Former smoker | - | 0.74 (0.68, 0.82) | - | 1.05 (0.51, 2.17) |
Current smoker | - | 1.18 (1.08, 1.28) | - | 1.80 (0.89, 3.65) |
Alcohol consumption | - | 1.06 (0.99, 1.14) | - | 1.47 (0.85, 2.52) |
Physical activity | - | 1.02 (0.95, 1.09) | - | 1.09 (0.63, 1.91) |
COPD | - | 1.69 (1.60, 1.79) | - | 1.19 (0.73, 1.96) |
Asthma | - | 1.40 (1.32, 1.50) | - | 1.35 (0.78, 2.33) |
eGFR, estimated glomerular filtration rate; BMI, body mass index; GGT, gamma-glutamyltransferase; COPD, chronic obstructive pulmonary disease.
1 The multivariate-adjusted model was adjusted for sex, BMI, fasting blood glucose, GGT, smoking amount (pack-years), smoking status, alcohol consumption, physical activity, COPD, and asthma; Age was not included in the multivariate-adjusted model.
Characteristics | Overall | eGFR (mL/min/1.73 m2) |
|||
---|---|---|---|---|---|
Group 1 (eGFR≥90, n=114,986) | Group 2 (60≤eGFR<90, n=208,708) | Group 3 (eGFR<60, n=34,599) | p-value |
||
Person-years (total) | 3,470,426.78 | 1,127,480.18 | 2,021,331.03 | 321,615.57 | |
Person-years (average) | 9.69±1.55 | 9.81±1.29 | 9.68±1.54 | 9.30±2.17 | <0.001 |
Age (yr) | 58.77±8.94 | 56.13±6.66 | 59.26±9.23 | 64.62±10.43 | <0.001 |
Sex | <0.001 | ||||
Male | 194,063 (54.2) | 58,894 (51.2) | 117,031 (56.1) | 18,138 (52.4) | |
Female | 164,230 (45.8) | 56,092 (48.8) | 91,677 (43.9) | 16,461 (47.6) | |
BMI (kg/m2) | 24.01±2.92 | 23.86±2.93 | 24.06±2.90 | 24.24±3.03 | <0.001 |
Systolic BP (mmHg) | 125.29±15.27 | 124.38±15.05 | 125.39±15.26 | 127.65±15.76 | <0.001 |
Diastolic BP (mmHg) | 77.58±9.96 | 77.32±10.02 | 77.67±9.91 | 77.91±10.04 | <0.001 |
Total cholesterol (mg/dL) | 200.07±37.68 | 198.52±37.08 | 200.92±37.56 | 200.14±40.10 | <0.001 |
Triglycerides (mg/dL) | 117 (83-169) | 113 (79-163) | 118 (84-170) | 127 (91-182) | <0.001 |
HDL cholesterol (mg/dL) | 55.27±30.93 | 55.83±29.95 | 54.39±23.81 | 58.80±59.06 | <0.001 |
LDL cholesterol (mg/dL) | 118.62±38.16 | 117.31±38.84 | 119.38±37.75 | 118.41±38.25 | <0.001 |
Fasting blood glucose (mg/dL) | 100.99±25.25 | 100.21±25.18 | 100.79±24.44 | 104.81±29.57 | <0.001 |
SCr (mg/dL) | 1.09±1.33 | 0.73±0.13 | 0.96±0.15 | 3.07±3.71 | <0.001 |
eGFR (mL/min/1.73 m2) | 80.89±19.40 | 100.10±7.99 | 76.79±8.23 | 41.79±20.45 | <0.001 |
Urine protein level | <0.001 | ||||
Normal | 338,290 (94.9) | 109,735 (95.7) | 197,817 (95.1) | 30,738 (89.6) | |
Trace | 8,352 (2.3) | 2,452 (2.1) | 4,659 (2.2) | 1,241 (3.6) | |
1+ | 6,582 (1.8) | 1,728 (1.5) | 3,622 (1.7) | 1,232 (3.6) | |
≥2+ | 3,669 (1.0) | 783 (0.7) | 1,804 (0.9) | 1,082 (3.2) | |
AST (U/L) | 24 (20-29) | 23 (20-29) | 24 (20-29) | 24 (20-29) | <0.001 |
ALT (U/L) | 21 (16-29) | 21 (16-29) | 21 (16-29) | 20 (15-27) | <0.001 |
GGT (U/L) | 24 (17-40) | 24 (16-41) | 25 (17-40) | 24 (17-38) | <0.001 |
Smoking amount (pack-years) | 7.52±13.83 | 7.37±13.62 | 7.65±13.87 | 7.16±14.26 | <0.001 |
Smoking status | <0.001 | ||||
Never smoker | 227,475 (64.7) | 73,908 (65.5) | 130,661 (63.8) | 22,906 (67.4) | |
Former smoker | 63,739 (18.1) | 18,208 (16.1) | 39,078 (19.1) | 6,453 (19.0) | |
Current smoker | 60,346 (17.2) | 20,656 (18.3) | 35,088 (17.1) | 4,602 (13.5) | |
Alcohol consumption | 49,034 (13.8) | 17,230 (15.1) | 28,250 (13.7) | 3,554 (10.4) | <0.001 |
Physical activity | 60,133 (17.0) | 18,953 (16.7) | 35,334 (17.2) | 5,846 (17.1) | 0.003 |
COPD | 105,801 (29.5) | 30,876 (26.8) | 62,229 (29.8) | 12,696 (36.7) | <0.001 |
Asthma | 71,392 (19.9) | 20,867 (18.1) | 41,885 (20.1) | 8,640 (25.0) | <0.001 |
Development of lung cancer | 5,757 (1.6) | 1,519 (1.3) | 3,481 (1.7) | 757 (2.2) | <0.001 |
Variables | Person-years | Incident cases | Incidence density (per 10,000 person-years) | Unadjusted model | Multivariate-adjusted model |
---|---|---|---|---|---|
eGFR (mL/min/1.73 m2) | |||||
Group 1 (≥90) | 1,127,480.18 | 1,519 | 13.47 | 1.00 (reference) | 1.00 (reference) |
Group 2 (≥60 to <90) | 2,021,331.03 | 3,481 | 17.22 | 1.28 (1.20, 1.36) | 1.26 (1.19, 1.35) |
Group 3 (<60) | 321,615.57 | 757 | 23.54 | 1.75 (1.61, 1.91) | 1.72 (1.58, 1.89) |
p for trend | <0.001 | <0.001 | |||
Sex (female vs. male) | - | - | - | - | 0.56 (0.52, 0.61) |
BMI | - | - | - | - | 0.93 (0.92, 0.94) |
Fasting blood glucose | - | - | - | - | 1.00 (1.00, 1.00) |
GGT | - | - | - | - | 1.00 (1.00, 1.00) |
Smoking amount (pack-years) | - | - | - | - | 1.02 (1.02, 1.02) |
Smoking status | |||||
Never smoker | - | - | - | - | 1.00 (reference) |
Former smoker | - | - | - | - | 0.75 (0.68, 0.82) |
Current smoker | - | - | - | - | 1.18 (1.08, 1.29) |
Alcohol consumption | - | - | - | - | 1.07 (0.99, 1.14) |
Physical activity | - | - | - | - | 1.02 (0.95, 1.09) |
COPD | - | - | - | - | 1.68 (1.59, 1.78) |
Asthma | - | - | - | - | 1.40 (1.32, 1.49) |
Variables | Urine protein level |
|||
---|---|---|---|---|
<2+ (n=353,224, 98.97%) |
≥2+ (n=3,669, 1.03%) |
|||
Unadjusted model | Multivariate-adjusted model |
Unadjusted model | Multivariate-adjusted model |
|
eGFR (mL/min/1.73 m2) | ||||
Group 1 (≥90) | 1.00 (reference) | 1.00 (reference) | 1.00 (reference) | 1.00 (reference) |
Group 2 (≥60 to <90) | 1.27 (1.20, 1.35) | 1.26 (1.18, 1.34) | 1.95 (0.95, 4.03) | 2.00 (0.97, 4.15) |
Group 3 (<60) | 1.73 (1.58, 1.89) | 1.70 (1.56, 1.87) | 2.94 (1.40, 6.17) | 2.93 (1.37, 6.24) |
p for trend | <0.001 | <0.001 | <0.001 | <0.001 |
Sex (female vs. male) | - | 0.56 (0.52, 0.61) | - | 0.28 (0.13, 0.62) |
BMI | - | 0.93 (0.92, 0.94) | - | 0.92 (0.85, 0.99) |
Fasting blood glucose | - | 1.00 (1.00, 1.00) | - | 1.00 (1.00, 1.01) |
GGT | - | 1.00 (1.00, 1.00) | - | 1.00 (0.99, 1.00) |
Smoking amount (pack-years) | - | 1.02 (1.02, 1.02) | - | 1.00 (0.99, 1.02) |
Smoking status | ||||
Never smoker | - | 1.00 (reference) | - | 1.00 (reference) |
Former smoker | - | 0.74 (0.68, 0.82) | - | 1.05 (0.51, 2.17) |
Current smoker | - | 1.18 (1.08, 1.28) | - | 1.80 (0.89, 3.65) |
Alcohol consumption | - | 1.06 (0.99, 1.14) | - | 1.47 (0.85, 2.52) |
Physical activity | - | 1.02 (0.95, 1.09) | - | 1.09 (0.63, 1.91) |
COPD | - | 1.69 (1.60, 1.79) | - | 1.19 (0.73, 1.96) |
Asthma | - | 1.40 (1.32, 1.50) | - | 1.35 (0.78, 2.33) |
Values are presented as the mean±standard deviation, number (%), or median (interquartile range). eGFR, estimated glomerular filtration rate; BMI, body mass index; BP, blood pressure; HDL, high-density lipoprotein; LDL, low-density lipoprotein; AST, aspartate aminotransferase; SCr, serum creatinine; ALT, alanine aminotransferase; GGT, gamma-glutamyltransferase; COPD, chronic obstructive pulmonary disease. Using analysis of variance for continuous variables and the chi-square test for categorical variables.
eGFR, estimated glomerular filtration rate; BMI, body mass index; GGT, gamma-glutamyltransferase; COPD, chronic obstructive pulmonary disease. The multivariate-adjusted model was adjusted for sex, BMI, fasting blood glucose, GGT, smoking amount (pack-years), smoking status, alcohol consumption, physical activity, COPD, and asthma; Age was not included in the multivariate-adjusted model.
eGFR, estimated glomerular filtration rate; BMI, body mass index; GGT, gamma-glutamyltransferase; COPD, chronic obstructive pulmonary disease. The multivariate-adjusted model was adjusted for sex, BMI, fasting blood glucose, GGT, smoking amount (pack-years), smoking status, alcohol consumption, physical activity, COPD, and asthma; Age was not included in the multivariate-adjusted model.