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

Abstract

Background: 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. Methods: Using 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 hs-CRP test results. Differences in sociodemographic factors were analyzed using 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. Results: The percentage of having a very poor to poor SRH was higher in the high hs-CRP level group (22.4%) than in the low hs-CRP level 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 a very poor SRH showed a higher odds ratio (OR) for high hs-CRP levels than those with a very good SRH (fully adjusted OR, 1.74; 95% confidence interval, 1.04-2.90). Significant correlations were absent among women. Conclusions: A poor SRH was correlated with low-grade inflammation (high hs-CRP level) among male Korean adults. The findings could be useful for developing health improvement programs and in goal setting at a national scale.