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NPJ Prim Care Respir Med. 2017 Dec 18;27(1):67. doi: 10.1038/s41533-017-0068-0.

Associations between self-rated health, sickness behaviour and inflammatory markers in primary care patients with allergic asthma: a longitudinal study.

Author information

1
Department of Neurobiology, Care Sciences and Society, Karolinska Institute, Stockholm, Sweden. karin.lodin@ki.se.
2
Department of Clinical Neuroscience, Karolinska Institute, Stockholm, Sweden. karin.lodin@ki.se.
3
Department of Clinical Neuroscience, Karolinska Institute, Stockholm, Sweden.
4
Stress Research Institute, Stockholm University, Stockholm, Sweden.
5
Department of Neurobiology, Care Sciences and Society, Karolinska Institute, Stockholm, Sweden.
6
Centre for Allergy Research, Karolinska Institute, Stockholm, Sweden.
7
Academic Primary Health Care Centre, Stockholm, Sweden.
8
Department of Women's and Children's Health, Uppsala University, Uppsala, Sweden.
9
Department of Psychology, Macquarie University, North Ryde, Australia.

Abstract

Allergic asthma is a chronic inflammatory disorder associated with elevated levels of immunoglobulin E (IgE), serum eosinophilic cationic protein (S-ECP), plasma eosinophil-derived neurotoxin (P-EDN) and fraction of exhaled nitric oxide (FENO). Poor self-rated health and sickness behaviour has repeatedly been associated with inflammatory markers, but the nature of this relationship in chronic inflammatory disease is not known. Likewise, such findings largely rely on cross-sectional investigations. Self-rated health (How would you rate your general state of health?), sickness behaviour (mean rating of satisfaction with energy, sleep, fitness, appetite and memory), IgE, S-ECP, P-EDN, and FENO were assessed in 181 non-smoking primary care patients with asthma in a 1-year longitudinal study. Associations between repeated measurements were calculated using mixed regression models and Spearman's correlations for change scores. Poor self-rated health was associated with high levels of seasonal IgE (p = 0.05) and food IgE (p = 0.04), but not total IgE or inflammatory markers. An increase over 1 year in perennial IgE was associated with a worsening of self-rated health (ρ = 0.16, p = 0.04). Poor self-rated health was associated with more pronounced sickness behaviour (p < 0.001), and a worsening in sickness behaviour was associated with a worsening of self-rated health over time (ρ = 0.21, p = 0.007). The study corroborates the importance of sickness behaviour as a determinant of self-rated health by showing that these factors co-vary over a 1-year period in a group of patients with allergic asthma. The importance of specific IgE for perceived health in primary care patients with mild to moderate asthma needs further investigation.

PMID:
29255205
PMCID:
PMC5735192
DOI:
10.1038/s41533-017-0068-0
[Indexed for MEDLINE]
Free PMC Article

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