Self-rated health is related to levels of circulating cytokines.
OBJECTIVE
Self-rated health is a powerful and independent predictor of long-term health, but its biological basis is unknown. Because factors associated with poor self-rated health (eg, pain, daily discomforts, and low energy and fitness) resemble symptoms of a generalized cytokine-induced sickness response, we examined the relationship between circulating cytokines and self-rated health.


METHODS
In 265 consecutive primary health care patients (174 women and 91 men), we examined self-rated and physician-rated health, circulating levels of interleukin (IL)-1beta, IL-1 receptor antagonist (IL-1ra), IL-6, and tumor necrosis factor (TNF)-alpha as determined from plasma samples using high-sensitivity enzyme-linked immunoassay.


RESULTS
Self-rated health correlated with levels of IL-1beta (r = 0.27; p <.001), IL-1ra (r = 0.19; p <.05) and TNF-alpha (r = 0.46; p <.001) in women but not in men. Thus, poorer subjective health was associated with higher levels of inflammatory cytokines. Even when controlling for age, education, physical health, and diagnoses in multiple regression analyses, self-rated health was an independent and more robust predictor of cytokine levels than physician-rated health.


CONCLUSIONS
The present findings suggest that an individual's health perception may be coupled to circulating cytokines. Because epidemiological research established that self-rated health predicts morbidity and mortality, the biological correlates and mechanisms of self-rated health need to be understood.
Department of Clinical Neuroscience, Section of Psychology, Karolinska Institute and Hospital, Stockholm, Sweden. Mats.Lekander@knv.ki.se
Mats
M
Lekander
Stig
S
Elofsson
Ing-Marie
IM
Neve
Lars-Olof
LO
Hansson
Anna-Lena
AL
Undén
D000328:Adult; D000368:Aged; D016207:Cytokines / Q000097:blood*; D004797:Enzyme-Linked Immunosorbent Assay; D005260:Female; D006304:Health Status; D006306:Health Surveys; D006801:Humans; D007375:Interleukin-1 / Q000097:blood; D015850:Interleukin-6 / Q000097:blood; D008297:Male; D008875:Middle Aged; D012737:Sex Factors; D011795:Surveys and Questionnaires; D014409:Tumor Necrosis Factor-alpha / Q000032:analysis
D016207:Cytokines; D007375:Interleukin-1; D015850:Interleukin-6; D014409:Tumor Necrosis Factor-alpha