TitleRaised levels of immunoglobulin G, A and M are associated with an increased risk of total and cause-specific mortality: the Vietnam Experience Study.
Publication TypeJournal Article
Year of Publication2015
AuthorsPhillips, AC, Carroll, D, Drayson, MT, Batty, GD
JournalJ Epidemiol Community Health
Volume69
Issue2
Pagination129-35
Date Published02/2015
ISSN1470-2738
KeywordsAdult, Biomarkers, Cardiovascular Diseases, Cause of Death, Communicable Diseases, Humans, Immunoglobulin A, Immunoglobulin G, Immunoglobulin M, Immunoglobulins, Male, Middle Aged, Neoplasms, Proportional Hazards Models, Retrospective Studies, Risk Assessment, United States, Veterans, Vietnam Conflict
Abstract
 

BACKGROUND: Immunoglobulins (Ig) are essential for combating infectious disease. However, high levels are associated with a range of diseases and/or poor health behaviours, such as autoimmune diseases, chronic infection, HIV and excessive alcohol consumption. In the present analyses, we extend this body of work by examining whether higher levels of serum Ig G, A and M are associated with increased mortality risk.

METHODS: Participants were 4255 Vietnam-era, former US army personnel (the Vietnam Experience Study). From military service files, telephone interviews in 1983 and a medical examination in 1986, sociodemographic, and health data were collected. Contemporary morning fasted blood samples were taken from which IgG, IgA and IgM concentrations were determined. Mortality surveillance over 15 years gave rise to deaths ascribed to all-causes, cardiovascular disease mortality, all cancers combined mortality, external cause and 'other' causes (predominantly comprising deaths due to infectious disease). Cox proportional hazard models were utilised to compute HRs per SD increase in Ig which were first adjusted for age and then additionally adjusting for a range of candidate confounders.

RESULTS: In multiply adjusted analyses, in general, the higher the immunoglobulin concentration, the greater the risk of death. Thus, IgA (HR=2.0 95% CI 1.47 to 2.73), IgM (HR=1.5 95% CI 1.11 to 1.91) and IgG (HR=5.8 95% CI 3.38 to 9.95) were positively related to all-cause mortality. Corresponding results for 'other' causes of mortality were 4.7 (2.64 to 8.19), 3.5 (2.29 to 5.45) and 33.4 (15.13 to 73.64).

CONCLUSIONS: In the present study, high levels of Ig are associated with an elevated risk of death from total and 'other' causes, mainly infectious disease. High levels of Ig, particularly IgG, may signal subclinical disease.

DOI10.1136/jech-2014-204345
Alternate JournalJ Epidemiol Community Health
PubMed ID25267764
Grant ListMR/K00414X/1 / / Medical Research Council / United Kingdom