Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2021 Mar 17;11(1):6139.
doi: 10.1038/s41598-021-85668-7.

Self-rated health in individuals with and without disease is associated with multiple biomarkers representing multiple biological domains

L Kananen  1   2   3 , L Enroth  1   2 , J Raitanen  1   2 , J Jylhävä  2   4 , A Bürkle  5 , M Moreno-Villanueva  5 , J Bernhardt  6 , O Toussaint  7 , B Grubeck-Loebenstein  8 , M Malavolta  9 , A Basso  9 , F Piacenza  9 , S Collino  10 , E S Gonos  11 , E Sikora  12 , D Gradinaru  13 , E H J M Jansen  14 , M E T Dollé  14 , M Salmon  15 , W Stuetz  16 , D Weber  17 , T Grune  17   18   19 , N Breusing  19 , A Simm  20 , M Capri  21 , C Franceschi  21   22 , P E Slagboom  23 , D C S Talbot  24 , C Libert  25   26 , S Koskinen  27 , H Bruunsgaard  28 , Å M Hansen  29   30 , R Lund  29   31 , M Hurme  2   3 , M Jylhä  32   33
Affiliations

Self-rated health in individuals with and without disease is associated with multiple biomarkers representing multiple biological domains

L Kananen et al. Sci Rep. .

Abstract

Self-rated health (SRH) is one of the most frequently used indicators in health and social research. Its robust association with mortality in very different populations implies that it is a comprehensive measure of health status and may even reflect the condition of the human organism beyond clinical diagnoses. Yet the biological basis of SRH is poorly understood. We used data from three independent European population samples (N approx. 15,000) to investigate the associations of SRH with 150 biomolecules in blood or urine (biomarkers). Altogether 57 biomarkers representing different organ systems were associated with SRH. In almost half of the cases the association was independent of disease and physical functioning. Biomarkers weakened but did not remove the association between SRH and mortality. We propose three potential pathways through which biomarkers may be incorporated into an individual's subjective health assessment, including (1) their role in clinical diseases; (2) their association with health-related lifestyles; and (3) their potential to stimulate physical sensations through interoceptive mechanisms. Our findings indicate that SRH has a solid biological basis and it is a valid but non-specific indicator of the biological condition of the human organism.

PubMed Disclaimer

Conflict of interest statement

The authors declare no competing interests.

Figures

Figure 1
Figure 1
A summary of (A) the number of biomarkers in the analysis in the three data sets and (B) biomarkers associated with SRH, adjusted for age and gender (Model i, in the full samples). Sample types are indicated with colors: red = blood, yellow = urine, and * symbol indicates that association was significant also after the adjustment for diseases and physical functioning (Model ii, in the full samples).
Figure 2
Figure 2
Associations of the eight selected biomarkers, categorized as quartiles, with poor self-rated health. Odds ratios (ORs) and 95% confidence intervals (CIs) are from the logistic regression models, adjusted for age and gender. The “best” biomarker quartile was used as reference category. (A–H): C-reactive protein (CRP), high-density lipoprotein (HDL) cholesterol, haemoglobin A1C (HBA1C), 25-hydroxyl-vitamin-D (25-OH-vitaminD), zeaxanthin, apolipoprotein-B (Apo-B), cell-free DNA (cf-DNA) and protein carbonyls, respectively. The biomarkers were selected as examples of replicated and new associations representing different biological domains.
Figure 3
Figure 3
Association of self-rated health with mortality in the Health 2000 data (n = 5,957; deceased n = 1,207; 15-year follow-up). In Cox proportional hazards models (iii) hazard ratios (HRs) and 95% CIs were adjusted for (1) age and gender; (2) then additionally for number of diseases; and then (3) additionally for 10 biomarkers.
See this image and copyright information in PMC

Similar articles

See all similar articles

Cited by

See all "Cited by" articles

References

    1. Jylhä M. What is self-rated health and why does it predict mortality? Towards a unified conceptual model. Soc. Sci. Med. 2009;69:307–316. doi: 10.1016/j.socscimed.2009.05.013. - DOI - PubMed
    1. Idler E, Benyamini Y. Self-rated health and mortality: a review of twenty-seven community studies. J. Health Soc. Behav. 1997;38:21–37. doi: 10.2307/2955359. - DOI - PubMed
    1. Jylhä M, Volpato S, Guralnik JM. Self-rated health showed a graded association with frequently used biomarkers in a large population sample. J. Clin. Epidemiol. 2006;59:465–471. doi: 10.1016/j.jclinepi.2005.12.004. - DOI - PubMed
    1. Fried LP, Kronmal RA, Newman AB, et al. Risk factors for 5-year mortality in older adults: the cardiovascular health study. JAMA. 1998;279:585–592. doi: 10.1001/jama.279.8.585. - DOI - PubMed
    1. Mackenbach JP, Simon JG, Looman CW, Joung IM. Self-assessed health and mortality: could psychosocial factors explain the association? Int. J. Epidemiol. 2002;31:1162–1168. doi: 10.1093/ije/31.6.1162. - DOI - PubMed

Publication types

LinkOut - more resources