Self-rated health and C-reactive protein in young adults

Background: Poor self-rated health (SRH) and elevated inflammation and morbidity and mortality are robustly associated in middle- and older-aged adults. Less is known about SRH-elevated inflammation associations during young adulthood and whether these linkages differ by sex. Methods: Data came from the National Longitudinal Study of Adolescent Health. At Wave IV, young adults aged 24-34 reported their SRH, acute and chronic illnesses, and sociodemographic and psychological characteristics relevant to health. Trained fieldworkers assessed medication use, BMI, waist circumference, and also collected bloodspots from which high-sensitivity CRP (hs-CRP) was assayed. The sample size for the present analyses was N = 13,236. Results: Descriptive and bivariate analyses revealed a graded association between SRH and hs-CRP: Lower ratings of SRH were associated with a higher proportion of participants with hs-CRP >3 mg/L and higher mean levels of hs-CRP. Associations between SRH and hs-CRP remained significant when acute and chronic illnesses, medication use, and health behaviors were taken into account. When BMI was taken into account, the association between SRH and hs-CRP association fully attenuated in females; a small, but significant association between SRH and hs-CRP remained in males. Conclusion: Poor SRH and elevated hs-CRP are associated in young adults, adjusting for other health status measures, medication use, and health behavior. In males, SRH provided information about elevated hs-CRP that was independent of BMI. In females, BMI may be a better surrogate indicator of global health and pro-inflammatory influences compared to SRI-I. (C) 2013 Elsevier Inc. All rights reserved.