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Changes in proteinuria and the associated risks of ischemic heart disease, acute myocardial infarction,
and angina pectoris in Korean population
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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
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Epidemiol Health. 2023;45:e2023088. Published online September 30, 2023
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DOI: https://doi.org/10.4178/epih.e2023088
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 Abstract
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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.
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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.
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The association of pancreatic cancer incidence with smoking status and smoking amount in Korean men
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Do Jin Nam
 , Chang-Mo Oh, Eunhee Ha, Min-Ho Kim, Eun Hye Yang, Hyo Choon Lee, Soon Su Shin, Woo Yeon Hwang, Ann Hee You, Jae-Hong Ryoo
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Epidemiol Health. 2022;44:e2022040. Published online April 21, 2022
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DOI: https://doi.org/10.4178/epih.e2022040
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Abstract
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Abstract
OBJECTIVES
Our study examined the dose-response relationship between smoking amounts (pack-years) and the risk of developing pancreatic cancer in Korean men.
METHODS Of 125,743 participants who underwent medical health checkups in 2009, 121,408 were included in the final analysis and observed for the development of pancreatic cancer. We evaluated the associations between smoking amounts and incident pancreatic cancer in 4 groups classified by pack-year amounts. Cox proportional hazards models were used to estimate the adjusted hazard ratios (HRs) and 95% confidence intervals (CIs) of incident pancreatic cancer by comparing groups 2 (<20 pack-year smokers), 3 (20-≤40 pack-year smokers), and 4 (>40 pack-year smokers) with group 1 (never smokers).
RESULTS During 527,974.5 person-years of follow-up, 245 incident cases of pancreatic cancer developed between 2009 and 2013. The multivariate-adjusted HRs (95% CIs) for incident pancreatic cancer in groups 2, 3, and 4 were 1.05 (0.76 to 1.45), 1.28 (0.91 to 1.80), and 1.57 (1.00 to 2.46), respectively (p for trend=0.025). The HR (95% CI) of former smokers showed a dose-response relationship in the unadjusted model, but did not show a statistically significant association in the multivariate-adjusted model. The HR (95% CI) of current smokers showed a dose-response relationship in both the unadjusted (p for trend=0.020) and multivariate-adjusted models (p for trend=0.050).
CONCLUSIONS The risk of developing pancreatic cancer was higher in current smokers status than in former smokers among Korean men, indicating that smoking cessation may have a protective effect.
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Summary
Korean summary
본 연구에서는 대한민국 남성을 대상으로 흡연양 및 흡연상태에 따른 췌장암 발병을 분석하였다. 흡연양이 많을수록, 현재 흡연상태일수록 췌장암 발병이 높았고, 금연한 경우 췌장암의 발병이 낮은 것을 확인할 수 있었다.
Key Message
As a result of analyzing the incidence of pancreatic cancer according to the amount of smoking and smoking status among Korean men, it was confirmed that the more smoked and the current smoking status, the higher the incidence of pancreatic cancer, and the lower the incidence of pancreatic cancer when quitting smoking.
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Citations
Citations to this article as recorded by  - Associations between smoking status and infertility: a cross-sectional analysis among USA women aged 18-45 years
Sijie He, Li Wan
Frontiers in Endocrinology.2023;[Epub] CrossRef - Modifiable Pancreatic Ductal Adenocarcinoma (PDAC) Risk Factors
Natalia Michalak, Ewa Małecka-Wojciesko
Journal of Clinical Medicine.2023; 12(13): 4318. CrossRef
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