Associations of chronic conditions, APOE4 allele, stress factors, and health behaviors with self-rated health.
Associations of chronic conditions, APOE4 allele, stress factors, and health behaviors with self-rated health.
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慢性病、APOE4 等位基因、压力因素和健康行为与自评健康的关联
DOI：
10.1186/s12877-015-0132-y
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发表时间：
2015-10-26
期刊：
影响因子：
4.1
通讯作者：
Lu J
中科院分区：
文献类型：
--
作者：
Hu W;Lu J
背景自评健康（SRH）已被广泛用于衡量老年人的整体健康状况。研究表明，SRH 是由多种因素决定的，例如慢性疾病状况、遗传标记（例如载脂蛋白 E、APOE、NM_000041）、压力因素和健康行为。然而，很少有研究将这些因素同时纳入SRH的分析框架中。本研究的目的是检验这四组因素与 SRH 的关联。方法使用 2000 年在台湾对 1,005 名 54-91 岁老年受访者进行的基于人群的随机整群调查的数据集，我们使用逻辑回归来检验慢性健康状况、APOE4 等位基因压力因素和健康行为与 SRH 的关联。这四种疾病包括糖尿病、心脏病、胃溃疡和慢性阻塞性肺病。压力因素通过创伤事件（房屋地震受损）和慢性生活压力（经济困难）来衡量。健康行为包括吸烟、饮酒、蔬菜和水果摄入量、每日牛奶摄入量和体育锻炼。结果发现糖尿病、心脏病、胃溃疡和慢性阻塞性肺病与 2.63 (95 % CI: 1.75–3.95)、1.72 (95 % CI: 1.15–2.58)、1.94 (95 % CI: 1.15–2.58)、1.94 (95 % CI: 1.75–3.95) 相关。 SRH 不良的比值比为 1.35–2.80) 和 2.54 (95% CI: 1.66–3.92)。 APOE4 等位基因被发现与 SRH 不良显着相关，奇数比为 1.58（95% CI：1.02-2.41）。经济困难与 SRH 不良的可能性增加相关，优势比为 1.76（95% CI：1.22–2.54）每周运动超过 5 次与 SRH 不良的可能性降低 44%（优势比为 0.56，95% CI：0.39–1.82）。性别与胃溃为了更好地理解人们如何自我评估整体健康的机制，慢性病和遗传因素应该与生活压力和健康行为等传统因素一起考虑。
BackgroundSelf-rated health (SRH) has been widely used to measure the overall health status of older adults. Research has shown that SRH is determined by a large array of factors, such as chronic disease conditions, genetic markers (e.g., Apolipoprotein E, APOE, NM_000041), stress factors, and health behaviors. However, few studies have incorporated these factors simultaneously in the analytic framework of SRH. The aim of this study is to examine the associations of these four sets of factors with SRH.MethodsUsing a dataset from a population-based, random-cluster survey of 1,005 elderly respondents aged 54–91 conducted in Taiwan in 2000, we use logistic regressions to examine associations of chronic health conditions, the APOE4 allele stress factors, and health behaviors with SRH. The four disease conditions include diabetes, heart diseases, gastric ulcers, and chronic obstructive pulmonary disease. Stress factors are measured by traumatic events (having an earthquake-damaged house) and chronic life stress (financial difficulty). Health behaviors include smoking, drinking alcohol, vegetable and fruit intake, daily milk intake, and physical exercise.ResultsDiabetes, heart diseases, gastric ulcers, and chronic obstructive pulmonary disease are found to be associated with 2.63 (95 % CI: 1.75–3.95), 1.72 (95 % CI: 1.15–2.58), 1.94 (95 % CI: 1.35–2.80), and 2.54 (95 % CI: 1.66–3.92) odds ratios of poor SRH. The APOE4 allele is found to be significantly associated with poor SRH with odd ratio of 1.58 (95 % CI: 1.02–2.41). Financial difficulty is associated with increased likelihood of poor SRH, with odds ratios of 1.76 (95 % CI: 1.22–2.54) Doing exercise more than 5 times per week are associated with reduced likelihood of poor SRH by 44 % (odds ratio is 0.56, 95 % CI: 0.39–1.82). The interaction term between gender and gastric ulcer showed that the impact of gastric ulcer on SRH is more pronounced in women than in men, with an odds ratio of 2.63 (95 % CI: 1.24–5.58).ConclusionsChronic conditions and the APOE4 allele are significantly associated with increased likelihood of reporting poor health, and the associations appear differently among women and men. To better understand the mechanism of how people self-assess their overall health, chronic conditions and genetic components should be considered together with conventional factors such as life stress and health behaviors.