Association of hemoglobin variability with the risk of cardiovascular disease: a nationally representative retrospective cohort study from South Korea

• Published in: Scientific reports Vol. 13; no. 1; p. 2148
• Main Authors: Lee, Won Jung, Choi, Seulggie, Park, Sang Min, Lee, Gyeongsil, Chang, Jooyoung, Oh, Yun Hwan, Son, Joung Sik, Kim, Kyae Hyung, Choi, Soo Jung
• Format: Journal Article
• Language: English
• Published: London Nature Publishing Group UK 07.02.2023; Nature Publishing Group; Nature Portfolio
• Subjects: 692/4019; 692/499; Adult; Cardiovascular disease; Cardiovascular diseases; Cardiovascular Diseases - blood; Cardiovascular Diseases - epidemiology; Cohort analysis; Coronary artery disease; Health risks; Heart diseases; Hemoglobin; Hemoglobins - analysis; Humanities and Social Sciences; Humans; Kidney diseases; Medical screening; multidisciplinary; Republic of Korea - epidemiology; Retrospective Studies; Risk Assessment; Risk Factors; Science; Science (multidisciplinary); Stroke - blood; Stroke - epidemiology; Variability; Republic of Korea; South Korea
• ISSN: 2045-2322; 2045-2322
• DOI: 10.1038/s41598-023-28029-w

Hemoglobin variability is known to increase cardiovascular mortality in chronic kidney disease, but the association of hemoglobin variability with the risk of cardiovascular disease (CVD) in the general population is yet unclear. This retrospective cohort study based on ‘the South Korean National Health Insurance Service database’ consisted of 198,347 adults who went through all three health examinations. Hemoglobin variability is defined as the average successive variability of three separate hemoglobin values from each health screening period. Participants were followed up for 6 years to determine the risk of coronary heart disease and stroke. We used multivariate Cox proportional hazards regression to examine the adjusted hazard ratios for CVD according to hemoglobin variability. Per 1 unit increase of hemoglobin variability, the risk for CVD (aHR 1.06, 95% CI 1.02–1.09) and stroke (aHR 1.08, 95% CI 1.03–1.13) increased significantly. The risk-increasing trend was preserved in the low-to-moderate risk group of CVDs (aHR 1.07, 95% CI 1.02–1.11). This result suggests that subjects with high hemoglobin variability who would otherwise be categorized as having low-to-moderate CVD risk may have higher risk of CVD than those with low hemoglobin variability.