Jylhä Marja, Volpato Stefano, Guralnik Jack M
University of Tampere, School of Public Health, Medisiinarinkatu 3, Tampere, FIN-33014, Finland.
J Clin Epidemiol. 2006 May;59(5):465-71. doi: 10.1016/j.jclinepi.2005.12.004. Epub 2006 Mar 15.
Self-rated health is a widely used measure of health status, but its biologic foundations are poorly understood. We investigated the association of frequently used biomarkers with self-rated health, and the role of these biomarkers in the association of self-rated health with mortality.
The relation of self-rated health to blood levels of albumin, white blood cell count, hemoglobin, HDL cholesterol, and creatinine was examined in a population-based sample of 4,065 men and women aged 71 years or older. A Cox proportional hazards model was used to determine the association of self-rated health with mortality during 4.9 years. Sociodemographic factors, diagnosed chronic conditions, and activities of daily living disability were controlled for in these analyses.
All the biomarkers showed a graded relationship with self-rated health. After adjusting for other indicators, hemoglobin and white cell count were significantly associated with fair or poor self-rated health. When biomarkers and other indicators were adjusted for, self-rated health still was a significant predictor of mortality.
Self-rated health has a biologic basis, and it can be a sensitive barometer of physiologic states. Self-rated health is likely to predict mortality because it covers the spectrum of health conditions better than the variables measured in the study.
自评健康状况是一种广泛应用的健康状况衡量指标，但其生物学基础却鲜为人知。我们研究了常用生物标志物与自评健康之间的关联，以及这些生物标志物在自评健康与死亡率关联中的作用。
在一个基于人群的样本中，对4065名71岁及以上的男性和女性进行了研究，考察自评健康与血液中白蛋白、白细胞计数、血红蛋白、高密度脂蛋白胆固醇及肌酐水平之间的关系。采用Cox比例风险模型来确定自评健康与4.9年期间死亡率之间的关联。在这些分析中对社会人口学因素、已诊断的慢性病及日常生活活动能力障碍进行了控制。
所有生物标志物均与自评健康呈现出分级关系。在对其他指标进行调整后，血红蛋白和白细胞计数与自评健康状况为“一般”或“较差”显著相关。当对生物标志物和其他指标进行调整后，自评健康状况仍然是死亡率的一个显著预测指标。
自评健康具有生物学基础，并且它可能是生理状态的一个敏感晴雨表。自评健康状况有可能预测死亡率，因为它比研究中所测量的变量更能全面反映健康状况。
