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

Laura Kananen ,J Bernhardt,Jani Raitanen ,Nicolle Breusing ,Martijn E.t Dollé ,Claude Libert ,Eugène Jansen ,Duncan Talbot ,Juulia Jylhävä ,Aslak Hansen ,Wolfgang Stuetz ,María Moreno‐Villanueva ,Miriam Capri ,Sebastiano Collino ,Andrea Basso ,P Eline Slagboom ,Ewa Sikora ,Daniela Weber ,Alexander Bürkle ,Seppo Koskinen ,Claudio Franceschi ,Helle Bruunsgaard ,Marco Malavolta ,Rikke Lund ,Olivier Toussaint ,Mikko Hurme ,Tilman Grune ,Beatrix Grubeck‐Loebenstein ,Andreas Simm ,Daniela Grădinaru ,Francesco Piacenza ,Michel Salmon ,Efstathios S Gonos ,Linda Enroth ,Marja Jylhä

doi:10.1038/s41598-021-85668-7

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.

Highlights

Self-rated health (SRH) is one of the most frequently used indicators in health and social research
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
We addressed the following questions: (i) to what extent are the biomarkers available in the study associated with SRH; (ii) to what extent are the associations between biomarkers and SRH explained by disease diagnoses and physical functioning; and (iii) do the biomarkers associated with SRH explain part of the association between SRH and mortality? Analyses i) and iii) were performed for individuals without diagnosed diseases

Summary

Introduction

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. Self-rated health (SRH) is one of the most frequently used measures in epidemiological, clinical and social research. Jylhä (2009) has suggested that when asked to evaluate their general health status, respondents will take into account any individual relevant information that they think describes their “health” This information is considered in the context of the social and psychological situation. It is possible to hypothesize that the level of and changes in some biomarkers may, through interoceptive processes, be associated with sensations and symptoms that individuals take into account in their self-ratings of health. Little is known about the experiential counterparts of variations in blood biochemistry, the connections of fatigue with peripheral inflammation for example, are well d escribed[21,22]

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Conclusion