title: Self-rated health is associated with elevated C-reactive protein even among apparently healthy individuals.
abstract: BACKGROUND
  A single self-rated health (SRH) assessment is associated with clinical outcome and mortality, but the biological process linking SRH with immune status remains incompletely understood.
  
  
  OBJECTIVE
  To examine the association between SRH and inflammation in apparently healthy individuals.
  
  
  METHODS
  Our analysis included 13,773 apparently healthy individuals attending the Tel Aviv Sourasky Medical Center for periodic health examinations. Estimated marginal means of the inflammation-sensitive biomarkers [i.e., highly sensitive C-reactive protein (hs-CRP) and fibrinogen] for the different SRH groups were calculated and adjusted for multiple potential confounders including risk factors, health behavior, socioeconomic status, and coexistent depression.
  
  
  RESULTS
  The group with the lowest SRH had a significantly higher atherothrombotic profile and significantly higher conentrations of all inflammation-sensitive biomarkers in both genders. Hs-CRP was found to differ significantly between SRH groups in both genders even after gradual adjustments for all potential confounders. Fibrinogen differs significantly according to SRH in males only, with low absolute value differences.
  
  
  CONCLUSIONS
  A valid association exists for apparently healthy individuals of both genders between inflammation-sensitive biomarker levels and SRH categories, especially when comparing levels of hs-CRP. Our findings underscore the importance of assessing SRH and treating it like other markers of poor health.
authors.forename: Eran
authors.initials: E
authors.lastname: Leshem-Rubinow
authors.forename: Shani
authors.initials: S
authors.lastname: Shenhar-Tsarfaty
authors.forename: Assi
authors.initials: A
authors.lastname: Milwidsky
authors.forename: Sharon
authors.initials: S
authors.lastname: Toker
authors.forename: Itzhak
authors.initials: I
authors.lastname: Shapira
authors.forename: Shlomo
authors.initials: S
authors.lastname: Berliner
authors.forename: Yael
authors.initials: Y
authors.lastname: Benyamini
authors.forename: Samuel
authors.initials: S
authors.lastname: Melamed
authors.forename: Ori
authors.initials: O
authors.lastname: Rogowski
mesh_terms: D000328:Adult; D001294:Attitude to Health; D002097:C-Reactive Protein / Q000032:analysis; D015331:Cohort Studies; D003863:Depression / Q000453:epidemiology / Q000503:physiopathology; D059026:Diagnostic Self Evaluation; D005260:Female; D005340:Fibrinogen / Q000032:analysis*; D015438:Health Behavior; D006304:Health Status; D006305:Health Status Indicators; D006801:Humans; D007249:Inflammation / Q000097:blood / Q000453:epidemiology / Q000523:psychology; D007557:Israel / Q000453:epidemiology; D008297:Male; D008875:Middle Aged; D012307:Risk Factors; D012923:Social Class
chemical_list: D005340:Fibrinogen; D002097:C-Reactive Protein