Investigating the Associations of Self-Rated Health: Heart Rate Variability Is More Strongly Associated than Inflammatory and Other Frequently Used Biomarkers in a Cross Sectional Occupational Sample

Marc N Jarczok,Kristina Hoffmann,Raphael M Herr,Marcus E Kleber,Yael Benyamini,Julian F Thayer,Julian Koenig,Adrian Loerbroks,Joachim E Fischer,Bert N Uchino

doi:10.1371/journal.pone.0117196

Abstract

The present study aimed to investigate the possible mechanisms linking a single–item measure of global self-rated health (SRH) with morbidity by comparing the association strengths between SRH with markers of autonomic nervous system (ANS) function, inflammation, blood glucose and blood lipids. Cross–sectional comprehensive health–check data of 3947 working adults (age 42±11) was used to calculate logistic regressions, partial correlations and compare correlation strength using Olkins Z. Adjusted logistic regression models showed a negative association between SRH (higher values indicating worse health) and measures of heart rate variability (HRV). Glycemic markers were positively associated with poor SRH. No adjusted association was found with inflammatory markers, BP or lipids. In both unadjusted and adjusted linear models Pearson’s correlation strength was significantly higher between SRH with HRV measures compared to SRH with other biomarkers. This is the first study investigating the association of ANS function and SRH. We showed that a global measure of SRH is associated with HRV, and that all measures of ANS function were significantly more strongly associated with SRH than any other biomarker. The current study supports the hypothesis that the extent of brain–body communication, as indexed by HRV, is associated with self-rated health.

Highlights

Self-rated health (SRH), a simple question asking individuals to rate their health in general, has consistently been found to predict mortality, morbidity, and other health outcomes [1]
We showed that a global measure of self-rated health (SRH) is associated with heart rate variability (HRV), and that all measures of autonomic nervous system (ANS) function were significantly more strongly associated with SRH than any other biomarker
We found some differences between the full sample and the analysis sample regarding blood lipids and glucose levels but the magnitudes of the differences are below clinically relevant levels (e.g. fasting plasma glucose (FPG)-difference = 2.08mg/dl) (Table 2)

Summary

Introduction

Self-rated health (SRH), a simple question asking individuals to rate their health in general, has consistently been found to predict mortality, morbidity, and other health outcomes [1]. This is not surprising in itself, as SRH is associated with many indicators of physical and mental health (see meta-analysis by Pinquart [2]), such as functional ability, depression, and chronic pain, as well as with social risk factors such as socioeconomic status (e.g. income disparities), demographics (age and gender), work stress and leadership [3]. A 22-year follow up of the General Social Survey showed an increasing predictive validity of self-rated health on of mortality [8]

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Discussion

Conclusion