The associations of self-rated health with cardiovascular risk proteins: a proteomics approach

Xue Bao,Yan Borné,Jan Nilsson,Olle Melander,Songjiang Yin,Marju Orho-Melander,Kaijun Niu,Gunnar Engström

doi:10.1186/s12014-019-9258-9

Abstract

BackgroundThough subjective, poor self-rated health (SRH) has consistently been shown to predict cardiovascular disease (CVD). The underlying mechanism is unclear. This study evaluates the associations of SRH with biomarkers for CVD, aiming to explore potential pathways between poor SRH and CVD.MethodsBased on the Malmö Diet and Cancer Cardiovascular Cohort study, a targeted proteomics approach was used to assess the associations of SRH with 88 cardiovascular risk proteins, measured in plasma from 4521 participants without CVD. The false discovery rate (FDR) was controlled using the Benjamini and Hochberg method. Covariates taken into consideration were age, sex, traditional CVD risk factors (low-density lipoprotein cholesterol, systolic blood pressure, anti-hypertensive medication, diabetes, body mass index, smoking), comorbidity, life-style and psycho-social factors (education level, living alone, alcohol consumption, low physical activity, psychiatric medication, sleep duration, and unemployment).ResultsAge and sex-adjusted associations with SRH was found for 34 plasma proteins. Nine of them remained significant after adjustments for traditional CVD risk factors. After further adjustment for comorbidity, life-style and psycho-social factors, only leptin (β = − 0.035, corrected p = 0.016) and C–C motif chemokine 20 (CCL20; β = − 0.054, corrected p = 0.016) were significantly associated with SRH.ConclusionsPoor SRH was associated with raised concentrations of many plasma proteins. However, the relationships were largely attenuated by adjustments for CVD risk factors, comorbidity and psycho-social factors. Leptin and CCL20 were associated with poor SRH in the present study and could potentially be involved in the SRH–CVD link.

Highlights

Though subjective, poor self-rated health (SRH) has consistently been shown to predict cardiovascular disease (CVD)
In models adjusted for age, sex, traditional CVD risk factors, comorbidity, life-style and psycho-social factors, participants in the poor SRH scores had a markedly elevated risk of CVD (HR, 1.64; Table 1 Participants’ characteristics according to their self-rated health (n = 4521)
The relationships were largely attenuated by adjustments for traditional CVD risk factors and factors related to comorbidity, life-style and psycho-social factors

Summary

Introduction

Poor self-rated health (SRH) has consistently been shown to predict cardiovascular disease (CVD). This study evaluates the associations of SRH with biomarkers for CVD, aiming to explore potential pathways between poor SRH and CVD How people rate their own health is a subjective but surprisingly sensitive and reliable assay for evaluation of general well-being. The mechanisms underlying the association between poor SRH and CVD remain unclear. Bao et al Clin Proteom (2019) 16:40 with material, behavioral, personality and psycho-social factors [10, 11] These socioeconomic inequalities affect individual’s healthcare resource use and predisposition to better or worse health, including CVD risk and mortality [12,13,14,15], which could be one important reason behind the association between poor SRH and CVD. For people with poor SRH, certain circulating inflammatory markers have been observed to be elevated, including the more commonly studied interleukin (IL)-6 and C-reactive protein [17, 22,23,24,25] and others (IL-1β, IL-1rα, erythrocyte sedimentation rate, tumor necrosis factor-α, etc.) [16, 19, 26]

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