Plasma procalcitonin is associated with all-cause and cancer mortality in apparently healthy men: a prospective population-based studyReportar como inadecuado

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BMC Medicine

, 11:180

First Online: 13 August 2013Received: 06 February 2013Accepted: 13 June 2013DOI: 10.1186-1741-7015-11-180

Cite this article as: Cotoi, O.S., Manjer, J., Hedblad, B. et al. BMC Med 2013 11: 180. doi:10.1186-1741-7015-11-180


BackgroundThe inflammatory mediator procalcitonin PCT has previously been associated with prognosis in myocardial infarction, cancer and sepsis patients. The importance of PCT in the general population is currently unknown. Our aim was to assess the relationship between plasma PCT and the risk of all-cause and cause-specific mortality in apparently healthy individuals with no previous history of cardiovascular disease or cancer.

MethodsWe performed a prospective, population-based study on 3,322 individuals recruited from the Malmö Diet and Cancer cohort, with a median follow-up time of 16.2 years. Plasma PCT, high-sensitivity C-reactive protein hsCRP, low-density lipoprotein LDL, high-density lipoprotein HDL, triglycerides and cystatin C were measured at baseline and a thorough risk factor assessment was performed for all subjects. The primary end-points of the study were all-cause mortality, cancer mortality and cardiovascular mortality.

ResultsMen had higher PCT levels compared to women. In Cox proportional hazard models adjusted for age, sex, hypertension, diabetes, plasma lipids, renal function, body mass index and smoking, baseline PCT was associated with all-cause mortality and cancer mortality in men. The hazard ratio HR for men with PCT levels within the highest compared with the lowest quartile was 1.52 95% confidence interval CI 1.07 to 2.16; P = 0.024 for all-cause mortality and 2.37 95% CI 1.36 to 4.14; P = 0.006 for cancer mortality. Additionally, men with increased plasma PCT were found to be at a higher risk to develop colon cancer HR per 1 SD increase = 1.49 95% CI 1.13 to 1.95; P = 0.005. In multivariate Cox regression analyses with mutual adjustments for PCT and hsCRP, PCT was independently associated with cancer death HR per 1 SD increase = 1.28 95% CI 1.10 to 1.49; P = 0.001 and hsCRP with cardiovascular death HR per 1 SD increase = 1.42 95% CI 1.11 to 1.83; P = 0.006 in men. We found no significant correlations between baseline PCT or hsCRP and incident cancer or cardiovascular death in women.

ConclusionsWe disclose for the first time important independent associations between PCT and the risk for all-cause and cancer mortality in apparently healthy men. Our findings warrant further investigation into the mechanisms underlying the relationship between PCT and cancer.

KeywordsProcalcitonin Inflammation Cancer Cardiovascular disease CRP Mortality AbbreviationsAUCArea under the curve

BMIBody mass index

CIConfidence interval

hsCRPHigh sensitivity C-reactive protein


HDL-CHigh-density lipoprotein cholesterol

HRHazard ratio


ICDInternational Classification of Diseases

LDL-Clow-density lipoprotein cholesterol

MDCMalmö Diet and Cancer Study


ROCReceiver operating characteristic


TNFαTumor necrosis factor α.

Electronic supplementary materialThe online version of this article doi:10.1186-1741-7015-11-180 contains supplementary material, which is available to authorized users.

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Autor: Ovidiu S Cotoi - Jonas Manjer - Bo Hedblad - Gunnar Engström - Olle Melander - Alexandru Schiopu


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