Sex differences in the association between self-rated health and high-sensitivity C-reactive protein levels in Koreans: a cross-sectional study using data from the Korea National Health and Nutrition Examination Survey

Se-Won Park,Won-Suk Sung,In-Hyuk Ha,Eun-Jung Kim,Seong-Sik Park,Boyoung Jung

doi:10.1186/s12955-020-01597-5

Se-Won Park, Won-Suk Sung + Show 4 more

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https://doi.org/10.1186/s12955-020-01597-5

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Abstract

BackgroundNo studies have investigated the association between self-rated health (SRH) and high-sensitivity C-reactive protein (hs-CRP) levels in South Koreans. We explored this association and analyzed differences between sexes.MethodsUsing cross-sectional data from the 2015–2017 Korea National Health and Nutrition Examination Survey, we analyzed the association between SRH and high hs-CRP levels (> 1.0 mg/L) in 14,544 Koreans aged ≥ 19 years who responded to the SRH survey and had available hs-CRP test results. Differences in sociodemographic factors were analyzed using the Pearson’s chi-square test for categorical variables or the Mann–Whitney U test for continuous variables. Multiple logistic regression analysis was used to measure the association between hs-CRP levels and SRH according to sex while adjusting for other possible confounders.ResultsThe percentage of very poor to poor SRH was higher in the high hs-CRP group (22.4%) than in the low hs-CRP group (17.66%). Among men, the risk of a high hs-CRP level increased with worse SRH (adjusted for confounders; P for trend < 0.001). After adjusting for all confounders, including chronic diseases, men with very poor SRH showed a higher odds ratio (OR) for high hs-CRP levels than those with very good SRH (fully adjusted OR, 1.74; 95% CI, 1.04–2.90). Significant correlations were absent among women.ConclusionsPoor SRH was correlated with low-grade inflammation (high hs-CRP levels) among Korean male adults. These findings could be useful for developing health improvement programs and in goal setting at a national scale.

Highlights

No studies have investigated the association between self-rated health (SRH) and high-sensitivity C-reactive protein levels in South Koreans
The percentage of those with very poor to poor SRH was higher in the high high-sensitivity C-reactive protein (hs-C-reactive protein (CRP)) group (22.47%) than in the low hs-CRP group (17.66%)
For both men and women, the percentages of participants with very poor to poor SRH were higher in the high hs-CRP groups than in the low hs-CRP groups, whereas the percentages of participants with good to very good SRH were lower in the low hs-CRP groups than in the high hs-CRP groups (P < 0.001) (Fig. 2)

Summary

Introduction

No studies have investigated the association between self-rated health (SRH) and high-sensitivity C-reactive protein (hs-CRP) levels in South Koreans. We explored this association and analyzed differences between sexes. Hs-CRP is used as an indicator to assess the risk of cardiovascular disease (CVD), and several studies have suggested hs-CRP as a predictor of mortality. In assessing CVD risk, the American Heart Association (AHA) and Centers for Disease Control and Prevention (CDC) defined hs-CRP levels of > 3.0 mg/L to indicate high risk, 1.0–3.0 mg/L to indicate average risk, and < 1.0 mg/L to indicate low risk [4, 5]

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