Goldman Noreen, Glei Dana A, Chang Ming-Cheng
Office of Population Research, Princeton University, Princeton, NJ 08544, USA.
Ann Epidemiol. 2004 Jan;14(1):49-57. doi: 10.1016/s1047-2797(03)00077-2.
This study examines the importance of clinical risk factors for predicting self-ratings of general health status, with and without controls for a broad range of self-reported indicators of physical and psychological well-being.
Ordered probit models, estimated on 928 respondents aged 54 years and older who participated in an ongoing national survey in Taiwan, are used to examine the correlates of self-rated health. The model is estimated in two stages, first testing the association between clinical risk factors and self-rated health and second, examining whether those clinical measures remain significant after controlling for a large number of other factors hypothesized to affect self-ratings.
Most of the clinical variables are significantly associated with self-rated health, even in the presence of control variables. The largest effects pertain to the BMI, ratio of total to HDL cholesterol (among men) and presence of the epsilon4 allele of the APOE gene (among women).
The results suggest a variety of pathways linking clinical measures to the self-ratings. The findings also suggest that the clinical measures are less powerful predictors than self-reports about diverse aspects of well-being.
本研究探讨临床风险因素在预测总体健康状况自评方面的重要性,同时考虑和不考虑一系列广泛的自我报告的身心健康指标。
采用有序概率模型,对928名年龄在54岁及以上、参与台湾一项正在进行的全国性调查的受访者进行分析,以研究自评健康的相关因素。该模型分两个阶段进行估计,首先检验临床风险因素与自评健康之间的关联,其次,在控制大量其他假定会影响自评的因素后,检验这些临床指标是否仍然显著。
即使存在控制变量,大多数临床变量仍与自评健康显著相关。影响最大的因素包括体重指数、总胆固醇与高密度脂蛋白胆固醇之比(男性)以及APOE基因ε4等位基因的存在(女性)。
结果表明存在多种将临床指标与自评联系起来的途径。研究结果还表明,与关于幸福感各个方面的自我报告相比,临床指标作为预测指标的效力较弱。