Inflammatory cytokines, behaviour and age as determinants of self-rated health in women
Résumé
Self-rated health is a powerful and independent predictor of long-term health, but its biological basis is unknown. We have previously shown that self-rated health is associated with increased levels of circulating cytokines in women. The main aim of the present study was to increase the understanding of the association between markers of well-being such as self-rated health and cytokines and to investigate the impact of age on these associations. In 174 female consecutive primary health care patients divided into three age groups, we examined subjective ratings of health and aspects of well-being, and circulating levels of interleukin (IL)-1{beta}, IL-1 receptor antagonist (IL-1ra), IL-6 and tumour necrosis factor (TNF)-{alpha}. Poor self-rated health was significantly associated to higher levels of TNF-{alpha} in all age groups. For IL-1{beta} and IL-1ra, the correlations with self-rated health were significant only in the oldest age group. Lower ratings of other measures of health and well-being were related to higher levels of cytokines, most pronounced for TNF-{alpha} and IL-1{beta} and in the older age groups. More symptoms resembling a sickness response induced by inflammation were implicated to be associated with lower self-rated health. The strength in the association between inflammatory cytokines and poor health perception increases with higher age, indicating an increased vulnerability for inflammatory activity in ageing. It is suggested that higher levels of TNF-{alpha} is connected to a sickness response that in turn is connected to self-rated health. The results provide a possible psychobiological basis to better understand diffuse subjective symptoms and poor subjective health in women.
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