Department of Preventive Medicine, Nagoya University Graduate School of Medicine, 65 Tsurumai-cho, Showa-ku, Nagoya, 466-8550, Japan.
Department of Oral Epidemiology, Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima, Japan.
BMC Public Health. 2018 Dec 17;18(1):1380. doi: 10.1186/s12889-018-6251-6.
Although self-rated health (SRH) independently predicts mortality, the biological background of this association remains unexplained. This study aimed to examine the association between SRH and serum high-sensitivity C-reactive protein (hsCRP) level.
Subjects were 899 participants aged 35-69 years (237 men and 662 women) in the Daiko Study, part of the Japan Multi-Institutional Collaborative Cohort Study. They were enrolled from 2008 to 2010. Of the subjects, 666 participated in a second survey 5 years later. Lifestyle factors and SRH were assessed using a self-administered questionnaire. Serum hsCRP level was measured using a latex-enhanced immunonephelometric assay. The association between SRH and serum hsCRP level was evaluated using a general linear model with covariates. We further longitudinally investigated whether higher serum hsCRP level at baseline predicts poor SRH after 5 years using an unconditional logistic regression model.
A higher serum hsCRP level was significantly associated with poor SRH at baseline after adjusting for covariates (p for trend = 0.023). The age- and sex-adjusted odds ratio and 95% confidence interval (CI) for poor SRH after 5 years was 1.45 (95% CI: 0.76-2.78) for the highest tertile compared with the lowest tertile of serum hsCRP level at baseline with a significant linear trend (p for trend = 0.033), although the risk increase disappeared after adjustment for other covariates.
The present study demonstrated that poor SRH is cross-sectionally associated with higher serum hsCRP level. However, the longitudinal data did not support the relationship between serum hsCRP level at baseline and future SRH. Further longitudinal studies that include data on mortality and multiple inflammatory markers are warranted to elucidate the possible role of low-grade inflammation in the association between SRH and mortality risk.
尽管自评健康（SRH）独立预测死亡率，但这种关联的生物学背景仍未得到解释。本研究旨在探讨 SRH 与血清高敏 C 反应蛋白（hsCRP）水平之间的关系。
研究对象为日本多机构合作队列研究的一部分 Daiko 研究中的 899 名 35-69 岁的参与者（男性 237 名，女性 662 名）。他们于 2008 年至 2010 年期间被招募。其中，666 名参与者在 5 年后参加了第二次调查。使用自我管理的问卷评估生活方式因素和 SRH。使用乳胶增强免疫比浊法测量血清 hsCRP 水平。使用协变量的一般线性模型评估 SRH 与血清 hsCRP 水平之间的关系。我们进一步使用无条件逻辑回归模型纵向研究基线时较高的血清 hsCRP 水平是否预测 5 年后 SRH 较差。
调整协变量后，较高的血清 hsCRP 水平与基线时较差的 SRH 显著相关（趋势 p 值=0.023）。与基线时血清 hsCRP 水平最低三分位相比，最高三分位者在 5 年后发生较差 SRH 的年龄和性别调整优势比和 95%置信区间（95%CI）为 1.45（95%CI：0.76-2.78），具有显著的线性趋势（趋势 p 值=0.033），尽管在调整其他协变量后风险增加消失。
本研究表明，较差的 SRH 与较高的血清 hsCRP 水平呈横断面相关。然而，纵向数据不支持基线时血清 hsCRP 水平与未来 SRH 之间的关系。需要进一步的纵向研究，包括死亡率和多种炎症标志物的数据，以阐明低水平炎症在 SRH 与死亡率风险之间的关联中的可能作用。
