Real-ambient bedroom light at night increases systemic inflammation and disrupts circadian rhythm of inflammatory markers.

BACKGROUND: Exposure to light at night (LAN) has been associated with multiple adverse health outcomes. However, evidence is limited regarding the impacts of LAN exposure on human inflammation. OBJECTIVES: To examine the association between real-ambient bedroom LAN exposure with systemic inflammation and circadian rhythm of inflammatory markers. METHODS: Using data from a prospective cohort study of Chinese young adults. At baseline, bedroom LAN exposure was measured with a portable illuminance meter; fasting blood sample for high-sensitivity C-reactive protein (hs-CRP) assay was collected. At 3-year follow-up, 20 healthy young adults (10 LANavg < 5 lx, 10 LANavg ≥ 5 lx) were recruited from the same cohort; time-series venous blood samples were sampled every 4 h over a 24 h-cycle for the detection of 8 inflammatory markers. Circadian rhythm of inflammatory markers was assessed using cosinor analysis. RESULTS: At baseline, the average age of the 276 participants was 18.7 years, and 33.3 % were male. Higher levels of bedroom LAN exposure were significantly associated with increased hs-CRP levels. The association between bedroom LAN exposure and systemic inflammation was only significant in the inactive group (MVPA < 2 h/d) but not in the physically active group (MVPA ≥ 2 h/d). In addition, exposure to higher levels of nighttime light (LANavg ≥ 5 lx) disrupted circadian rhythms (including rhythmic expression, circadian amplitude and circadian phase) of some inflammatory cytokines and inflammatory balance indicators. CONCLUSION: Exposure to bedroom nighttime light increases systemic inflammation and disrupts circadian rhythm of inflammatory markers. Keep bedroom darkness at night may represent important strategies for the prevention of chronic inflammation. Additionally, for people living a community with higher nighttime light pollution, regular physical activity may be a viable option to counteract the negative impacts of LAN exposure on chronic inflammation.

Association of sleep fragmentation with general and abdominal obesity: a population-based longitudinal study.

OBJECTIVE: To evaluate the causal relationship between sleep fragmentation (SF) parameters with general and abdominal obesity in free-living conditions. METHODS: SF parameters were assessed by ActiGraph accelerometers for 7 consecutive days. Obesity was measured at baseline and 1-year follow-up with InBody S10 body composition analyzer. RESULTS: At baseline, the mean age of the study population was 18.7 years old (SD = 0.9) and 139 (35.7%) were male. Each 1-unit increase of baseline sleep fragmentation index (SFI) was associated with 0.08 kg/m2-increase of body mass index (BMI) (95% CI: 0.03, 0.14), 0.20%-increase of percentage of body fat (PBF) (95% CI: 0.07, 0.32), 0.15 kg-increase of fat mass (FM) (95% CI: 0.03, 0.27), 0.15 cm-increase of waist circumference (WC) (95% CI: 0.03, 0.26) and 0.91 cm2-increase of visceral fat area (VFA) (95% CI: 0.36, 1.46) at the 1-year follow-up. In addition, each 1-unit increase of baseline SFI was associated with 15% increased risk of general obesity (OR = 1.15, 95% CI = 1.04-1.28; p = 0.006) and 7% increased risk of abdominal obesity (OR = 1.07, 95% CI = 1.01-1.13; p = 0.021) in the following year. CONCLUSIONS: Fragmented sleep is independently associated with an increased risk of both general and abdominal obesity. The result highlights SF as a modifiable risk factor for the prevention and treatment of obesity.

Exposure to real-ambient bedroom light at night delayed circadian rhythm in healthy Chinese young adults: A cross-sectional study.

BACKGROUND: Light at night (LAN) have attracted increased research attention on account of its widespread health hazards. However, the underlying mechanism remains unknown. The objective of this study was to investigate the effects of real-ambient bedroom LAN exposure on circadian rhythm among young adults and potential sex differences. METHODS: Bedroom LAN exposure was measured at 60-s intervals for 2 consecutive days using a portable illuminance meter. Circadian phase was determined by the dim light melatonin onset (DLMO) time in 7 time-series saliva samples. RESULTS: The mean age of the 142 participants was 20.7 ± 0.8 years, and 59.9% were women. The average DLMO time was 21:00 ± 1:11 h, with men (21:19 ± 1:12 h) later than women (20:48 ± 1:07 h). Higher level of LAN intensity (LANavg ≥ 3lx vs. LANavg < 3lx) was associated with an 81.0-min later in DLMO time (95% CI: 0.99, 1.72), and longer duration of nighttime light intensity ≥ 5lx (LAN5; LAN5 ≥ 45 min vs. LAN5 < 45 min) was associated with a 51.6-min later in DLMO time (95% CI: 0.46, 1.26). In addition, the delayed effect of LAN exposure on circadian phase was more pronounced in men than in women (all P-values <0.05). CONCLUSIONS: Overall, bedroom LAN exposure was significantly associated with delayed circadian rhythm. Additionally, the delayed effect is more significant in men. Keeping bedroom dark at night may be a practicable option to prevent circadian disruption and associated health implications. Future studies with more advanced light measurement instrument and consensus methodology for DLMO assessment are warranted.

Association Between Bedroom Light Pollution With Subjectively and Objectively Measured Sleep Parameters Among Chinese Young Adults.

PURPOSE: To investigate the cross-sectional associations between real-world multiperiod bedroom light at night and sleep parameters among 365 Chinese young adults. METHODS: Bedroom light exposure was estimated at the individual level for two consecutive days using a portable illuminance meter. Subjective sleep parameters were measured with the Pittsburgh Sleep Quality Index, and objective sleep parameters were assessed by wrist-worn ActiGraph accelerometers for seven consecutive days. RESULTS: Compared with the low-exposure group (average light intensity < 3lx), the high-exposure group (average light intensity ≥ 3lx) was associated with decreased 1.15% in sleep efficiency (sleep efficiency, 95% CI: -1.78, -0.52; p < .001), increased 3.94 minutes in wake after sleep onset (wake after sleep onset, 95% CI: 1.55, 6.33; p = .001), increased 1.05 unit in movement index (95% CI: 0.20, 1.89; p = .015), and increased 2.16 unit in sleep fragmentation index ( 95% CI: 0.63, 3.68; p = .006). In comparison, each interquartile increase in 2h-average and 1h-average intensity of preawake light (PAL) (PAL-2h and PAL-1h) was associated with 7.04 minutes of increases in total sleep time (95% CI: 0.87, 13.22; p = .025) and 6.69 minutes of increases in total sleep time (95% CI: 0.51, 12.87; p = .034), respectively. DISCUSSION: Altogether, our results support the role of bedroom light exposure in sleep and imply the importance of bedroom light exposure management as a potential strategy to reduce the public health burden of sleep problems. Keeping the bedroom environment dark at night and allowing moderate morning light exposure may be important measures for improving the sleep quality of young adults.

Case report: emergent endovascular treatment for carotid cavernous fistulas presenting as intracranial hemorrhage.

Objectives: This study aimed to discuss the clinical characteristics and emergent endovascular treatment of carotid cavernous fistulas presenting as intracranial hemorrhage. Methods: The clinical data of five patients with carotid cavernous fistulas, who presented with intracranial hemorrhage and who were admitted from January 2010 to April 2017, were analyzed retrospectively, and the diagnoses were confirmed by head computed tomography. Digital subtraction angiography was carried out in all the patients for the diagnosis and further emergent endovascular procedures. All patients were followed up to assess the clinical outcomes. Results: In total, five patients harbored five mono-lateral lesions; two of them were obliterated by detachable balloons, two by detachable coils, and one by detachable coils and Onyx glue. Only one patient was cured by another detachable balloon in the second session, and the other four patients were cured in the first session. At the 3- to 10-year follow-up, there was no intracranial re-hemorrhage in any of the patients; there was no recurrence of symptoms; and delayed occlusion of the parent artery was noted in one case. Conclusion: Emergent endovascular therapy is indicated for carotid cavernous fistulas presenting as intracranial hemorrhage. Individualized treatment according to the characteristics of different lesions is safe and effective.

[The role of mother-child relationship in the association between maternal parenting stress and emotional and behavioral problems in preschool children]. / æ¯å­å ³ç³»åœ¨æ¯äº²å »è‚²åŽ‹åŠ›ä¸Žå­¦é¾„å‰å„¿ç«¥æƒ ç»ªè¡Œä¸ºé—®é¢˜å ³è”ä¸­çš„ä½œç”¨.

OBJECTIVES: To study the moderating effect of mother-child relationship in the association between maternal parenting stress and emotional and behavioral problems in preschool children, and to provide reference for the prevention and control of emotional and behavioral problems in preschool children. METHODS: Using a stratified cluster sampling method, 2 049 preschool children were surveyed from November to December 2021, who sampled from 12 kindergartens in Wuhu City, Anhui Province. The emotional and behavioral problems of preschool children were assessed with the Strength and Difficulties Questionnaire. Pearson correlation analysis was used to evaluate the relationship of maternal parenting stress and mother-child relationship with children's emotional and behavioral problems. The PROCESS Macro was used to analyze the moderating effect of conflicted and dependent mother-child relationships in the association between maternal parenting stress and emotional and behavioral problems in these preschool children. RESULTS: Among these preschool children, maternal parenting stress was positively correlated with the scores of emotional symptoms, conduct problems, hyperactivity, and peer problems subscales and total difficulty scores (P<0.001); intimate mother-child relationships were negatively correlated with the scores of conduct problems, hyperactivity, and peer problems subscales and total difficulty scores (P<0.001); conflicted and dependent mother-child relationships were positively correlated with the scores of emotional symptoms, conduct problems, hyperactivity, and peer problems subscales and total difficulty scores (P<0.001). After controlling for relevant confounding factors, conflicted mother-child relationship (ß=0.05, P=0.001) and dependent mother-child relationship (ß=0.04, P=0.012) were found to have a moderating effect on the association between maternal parenting stress and total difficulty scores in these preschool children. CONCLUSIONS: Negative mother-child relationships play a moderating role in the association between maternal parenting stress and emotional and behavioral problems in preschool children. Prevention of emotional and behavioral problems in preschool children should focus on reducing maternal parenting stress and improving negative mother-child relationships.

Intergenerational continuity of parent-child separation among mother-offspring dyads: Implication for child cognitive development in rural China.

The labor migration in China often leads to parent-child separation. Research to date has primarily focused on understanding mental and cognitive outcomes for children exposed to parent-child separation, with little consideration for the cumulative effects of intergenerational continuity of parent-child separation. A total of 2729 children between the ages of 4 and 6, along with one parent (primarily mothers, 86.2%) and/or one primary caregiver (if the child is separated from both parents), were recruited in the rural area of Anhui Province, China. A unique subsample of children (n = 249) with persistent experience of parent-child separation or whose mother reported being left behind by her parents during early childhood were enrolled for cognitive assessment. A total of 239 age-, gender- and residence-matched children without any parent-child separation experience were selected as the control group. Child cognitive performance was examined with the Chinese version of the Wechsler Preschool and Primary Scale of Intelligence, Fourth edition (WPPSI-IV). The association between intergenerational continuity of parent-child separation and child cognition was described using multivariate OLS regression models. Compared to mother-offspring dyads without any history of parent-child separation, girls (n = 236/450, 52.4%) who experienced the intergenerational continuity of parent-child separation showed a significant decrease of 5.73 points (95% CI: -9.83, -1.62; p = 0.006) on full-scale intelligence quotient (FSIQ) and a decrease of 5.71 points (95% CI: -9.80, 1.63; p = 0.006) on verbal comprehension index. No similar result was observed in boys. The cumulative effects of parent-child separation among mother-offspring dyads on child cognitive development highlight the need for effective early intervention to break the intergenerational cycle of disadvantage. Sex differences and possible epigenetic mechanisms underlying the intergenerational effects of parent-child separation warrant further investigation.

Physical activity alleviates negative effects of bedroom light pollution on blood pressure and hypertension in Chinese young adults.

Excessive exposure to light at night (LAN) has become a serious public health concern. However, little is known about the impact of indoor LAN exposure on blood pressure, particularly among young adults. We aimed to investigate the effects of bedroom individual-level LAN exposure in real-world environment on blood pressure and hypertension among vulnerable young adults, and to evaluate the possible buffering effect of physical activity. In this cross-sectional study, a total of 400 healthy young adults aged 16-22 years were included. Bedroom LAN exposure was recorded at 1-min intervals for two consecutive nights using a TES-1339 R illuminance meter. Blood pressure was measured three times (8-11 a.m. in the physical examination day) in the seated position using an Omron HEM-7121 digital sphygmomanometer. A wrist-worn triaxial accelerometer (ActiGraph GT3X-BT) was used to assess physical activity for seven consecutive days. Each 1 lx increase of bedroom LAN intensity was associated with 0.55 mmHg-increase in SBP (95% CI: 0.15, 0.95), 0.30 mmHg-increase in DBP (95% CI: 0.06, 0.54), and 0.38 mmHg-increase in MAP (95% CI: 0.12, 0.65). Higher levels of LAN exposure were associated with increased risk of hypertension (LAN ≥ 3lx vs. LAN < 3lx: OR = 3.30, 95%CI = 1.19-9.19; LAN ≥ 5lx vs. LAN < 5lx: OR = 3.87, 95%CI = 1.37-10.98). However, these detrimental effects of bedroom LAN exposure on blood pressure and hypertension were not observed among young adults with high MVPA (≥2 h/day) level. MVPA can alleviate negative effects of bedroom LAN exposure on blood pressure and hypertension. Maintaining bedroom settings darkness at night may be an important strategy for reducing the risk of hypertension. Furthermore, for individuals living with high levels of indoor LAN exposure, regular physical activity may be a good option for preventing cardiovascular disease and hypertension.

Association between bedroom light exposure at night and allostatic load among Chinese young adults.

Light at night (LAN) has received increasing attention for its potential health hazards to human and animals. However, to our knowledge, no study has explored the specific effects of bedroom nighttime light exposure on allostatic load (AL). To investigate the association between bedroom individual-level LAN exposure and AL among young adults, an integrative index manifests multiple system dysregulation. Using data from a cohort of 484 Chinese young adults aged 16-22 years. Bedroom light was objectively recorded at 1-min intervals for two nights using a portable illuminance meter. Fasting blood samples were collected at one-year follow-up for the detection of AL parameters. AL score was derived as sum of the top quartile of twelve physiological biomarkers in four systems: metabolic system (BMI, WC, TC, HDL, LDL, TG, HbA1c, INS, GLU); cardiovascular system (SBP, DBP); immune and inflammatory systems (hs-CRP), with HDL was lowest quartile. Univariate and multivariate linear regression models were used to evaluate the association between LAN intensity with AL score and separate AL parameters. The average age of subjects was 18.7 years, 64.3% were female. The mean AL score of LAN group (average LAN intensity ≥ 3lx) was significantly higher than Dim group (3.6 ± 2.6 vs. 2.7 ± 2.1; P = 0.007). For each 1 lx increase of LAN intensity was associated with 0.15-unit increase in AL score (95% CI: 0.06, 0.24; P = 0.001). Moreover, LAN group was associated with increased 1.01-unit in AL score (95% CI: 0.36-1.66; P = 0.003) compared to Dim group. Significant associations between bedroom LAN exposure with allostatic load and separate AL biomarkers were observed in our study. Keeping bedroom darkness at night may be a practicable option to reduce the wear of multiple body systems and improve human cardiometabolic health from early in life.

Exposure to bedroom light pollution and cardiometabolic risk: A cohort study from Chinese young adults.

Indoor light environment has altered dramatically and exposure to light at night (LAN) potential leads to the progression of cardiometabolic conditions. However, few studies have investigated the effect of bedroom LAN exposure on cardiometabolic risk. To estimate the associations between multi-period bedroom LAN exposure with cardiometabolic risk among Chinese young adults. We objectively measured multi-period bedroom LAN intensity using portable illuminance meter in an ongoing prospective cohort (n = 484). At one-year follow-up, 230 young adults provided fasting blood samples for quantification of cardiometabolic parameters. Cardiometabolic (CM)-risk score was derived as the sum of standardized sex-specific z-scores for waist circumference (WC), mean arterial pressure (MAP), high-density lipoprotein cholesterol (HDL-C), triglyceride (TG) and homeostasis model assessment for insulin resistance (HOMA-IR), with HDL-C multiplied by - 1. Multivariate and univariable linear regression models were used to examine associations of multi-period bedroom LAN exposure with cardiometabolic risk. Exposure to higher bedroom LAN intensity is associated with 1.47-unit increase in CM-risk score (95% CI: 0.69-2.25; P < 0.001). Besides, post-bedtime light exposure was associated with elevated fasting insulin (PBL-1h: ß = 0.06, 95% CI: 0.01-0.10; PBL-4h: ß = 0.33, 95% CI: 0.19-0.47) and HOMA-IR (PBL-1h: ß = 0.013, 95% CI: 0-0.03; PBL-4h: ß = 0.07, 95% CI: 0.04-0.11) while pre-awake light exposure was associated with elevated total cholesterol (PAL-1h: ß = 0.03, 95% CI: 0.02-0.04; PAL-2h: ß = 0.02, 95% CI: 0.01-0.03), triglyceride (PAL-1h: ß = 0.015, 95% CI: 0.01-0.02; PAL-2h: ß = 0.01, 95% CI: 0-0.02) and low-density lipoprotein cholesterol (PAL-1h: ß = 0.02, 95% CI: 0.01-0.03; PAL-2h: ß = 0.02, 95% CI: 0.01-0.03). Among young adults, bedroom LAN exposure was significantly associated with higher cardiometabolic risk. Furthermore, different periods of bedroom light exposure have time-dependent effect on cardiometabolic risk. Further research is needed to confirm our findings and to elucidate potential mechanisms.

Sex-specific association of exposure to bedroom light at night with general and abdominal adiposity in young adults.

Experimental animal studies and limited epidemiologic evidence among elder population suggest that exposure to light at night (LAN) may be obesogenic. Nevertheless, little is known about the possible impact of bedroom LAN exposure on subsequent adiposity and the distribution pattern of the accumulated fat, especially in younger population. Here, we estimated longitudinal associations of objectively assessed bedroom LAN exposure with general and abdominal adiposity among young adults. We measured 2-night bedroom LAN exposure using a portable illuminometer in a cohort of young adults (n = 482). Body composition using multifrequency bioelectrical impedance analysis was evaluated at baseline and 1-year follow-up visit. Significant increases in fat mass (2.4 kg, P = 0.015 in male; 1.9 kg, P < 0.001 in female), visceral fat area (10.7 cm2, P < 0.001 in male; 5.0 cm2, P = 0.01 in female), waist circumference (3.8 cm, P = 0.039 in male; 2.5 cm, P = 0.047 in female) and percentage of body fat (3.6%, P = 0.002 in male; 3.0%, P = 0.001 in female) were observed among individuals with bedroom LAN higher than 5 lx. Compared to the lowest quartile group of bedroom LAN exposure, the highest quartile group was associated with an increase of 0.64 kg/m2 in BMI (95% CI: 0.18-1.09 kg/m2; P = 0.006) and 1.22 kg increase in fat mass (95% CI: 0.10-2.34 kg; P = 0.025) among female participants, and 10.58 cm2 in visceral fat area (95% CI: 4.85-16.31 cm2; P = 0.001) and 2.59 cm in waist circumference (95% CI: 0.37-4.81 cm; P = 0.023) among male participants. In this cohort of Chinese young adults, significant associations were observed between bedroom LAN exposure and adiposity in a sex- and fat depot-specific fashion. Further intervention and longitudinal studies could help elucidate the actual effects and develop sex-specific strategies against lifetime obesity and related metabolic disorders.

Pubertal recalibration of cortisol reactivity following early life parent-child separation.

BACKGROUND: The hypothalamic-pituitary-adrenocortical (HPA) axis had been proved to calibrate to early-life adversity and puberty may reverse the calibration. This study examines the consequences of prolonged parent-child separation on HPA axis reactivity and the pubertal recalibration hypothesis. METHODS: Totally of 144 participants aged 8.75 to 15.25 (mean age 12.50 years, SD: 1.32) were enrolled from rural areas of Chizhou city, Anhui Province of China in 2019. Data on parent-child separation was collected from parents. Self-reported Peterson Pubertal Development Scale was used to assess pubertal maturation and HPA axis stress reactivity was measured using the Trier Social Stress Test for Children. RESULTS: For children at early stage of puberty, childhood parent-child separation experiences were associated with blunted HPA axis reactivity (B = -1.888, p = 0.034); while for those at later stage of puberty, HPA axis reactivity was similar between children experienced early childhood separation and those without separation (AUCi: B = -0.426, p = 0.878). In contrast, for children experienced persistent parent-child separation, blunted HPA axis reactivity was observed (all p < 0.05). LIMITATIONS: Due to the cross-sectional nature of this study, conclusions about causality remain speculative. CONCLUSIONS: The effect of parent-child separation on dysregulation of HPA axis acts in a time-dependent manner. This finding provides support for the pubertal recalibration hypothesis suggesting that a focus of improving environment in adolescence would help those individuals reared initially in non-supportive conditions.

Developmental Pattern of Diurnal Cortisol Rhythm and Sex-Specific Associations With Psychopathological Symptoms During Pubertal Transition.

OBJECTIVE: This study aimed to examine the developmental pattern of diurnal cortisol rhythm during pubertal transition and its prospective association with psychopathological symptoms. METHODS: A cohort of 1158 children consisting of 608 boys and 550 girls aged 7 to 9 years (mean [standard deviation] age = 8.04 [0.61] years) were recruited in the Anhui Province of China in 2015 (wave 1). A single awakening sample was collected at baseline, and three additional samples were collected at one weekday in wave 2 to wave 4. Four indices of cortisol activity were evaluated and calculated across the day: awakening cortisol level, cortisol awakening response, the area under the curve with respect to ground (AUC), and the diurnal cortisol slope. In each wave, pubertal development was assessed by testicular size in boys and Tanner scales in girls. Psychopathological symptoms were ascertained in waves 2 to 4. RESULTS: Multilevel mixed models revealed no significant pubertal changes in diurnal cortisol activity in girls. In boys, awakening cortisol (ß = -0.005, p = .004) and total cortisol output (lnAUC, ß = -0.005, p = .040) significantly decreased across pubertal transition. Higher awakening cortisol and total cortisol output (lnAUC) were associated with higher scores on internalizing symptoms in girls (ß = 0.82, p < .001; ß = 0.62, p = .012) and externalizing symptoms in boys (ß = 0.73, p = .001; ß = 0.55, p = .019) during the 3-year follow-up. In contrast, no associations were found between cortisol awakening response and diurnal cortisol slope with psychopathological symptom scores in boys or girls. CONCLUSIONS: Development of diurnal cortisol activity during pubertal transition occurs in a sex-specific manner. Awakening cortisol level and daily total cortisol output may serve as markers for psychopathology during pubertal transition.

The association between health literacy and psychosomatic symptoms of adolescents in China: a cross-sectional study.

BACKGROUND: Lower health literacy (HL) has been known to be involved in a range of common mental and physical disorders among adolescent students. Ample studies indicated low HL is associated with a series of chronic diseases even psychological diseases, nevertheless, little is known about this relationship among adolescents. In this context, the study aimed to examine associations between psychosomatic symptoms (physical and psychological symptoms) and HL in junior and senior high school students in China, and to provide guidance for improving the physical and mental health in Chinese adolescents. METHODS: A total of 22,628 junior and high school students in China were enrolled in this study. HL and psychosomatic symptoms were measured by self-report validated questionnaires. Multiple linear regression analyses were conducted to examine the associations between six sub-scales of HL and physical / psychological symptoms. RESULTS: Multiple linear regression analysis demonstrated that the sub-scales of HL showed a significantly negative association with physical symptoms and psychological symptoms (P <  0.05 for each). Physical symptoms was most strongly associated with IR (ß = - 0.134), followed by SM (ß = - 0.093), DB (ß = - 0.059), SA (ß = - 0.058) and PA (ß = - 0.054). No statistically significant difference was found between HA and physical symptoms (P > 0.05). Meanwhile, psychological symptoms were most strongly associated with IR (ß = - 0.160), followed by SA (ß = - 0.129), SM (ß = - 0.069), DB (ß = - 0.031), HA (ß = - 0.026) and PA (ß = - 0.021). CONCLUSION: These results indicated the importance of identifying the association of HL with physical and psychological symptoms, and provided the evidence that lower HL may serve as a critical and independent risk factor for poor health outcomes. Meanwhile, to maintain students' desirable healthy status public health efforts for enhancing their HL level are urgently needed in adolescents.

Association of health literacy and sleep problems with mental health of Chinese students in combined junior and senior high school.

OBJECTIVES: The aim of this study was to examine the association between health literacy (HL) and sleep problems with mental health of Chinese students in combined junior and senior high school. METHODS: A cross-sectional study was conducted among seven hundred and seventy-five students from a combined junior and senior high school in Shenyang on December 16, 2016. HL, sleep problems, anxiety symptoms and depressive symptoms were measured by self-reported validated instruments. Multiple logistic regression models were used to examine the association of HL and sleep problems with mental health problems. RESULTS: The prevalence of anxiety symptoms and depressive symptoms was 24.6% and 45.2%, respectively. Low HL was significantly associated with anxiety symptoms (OR = 2.457, 95%CI: 1.493-4.045) and depressive symptoms (OR = 5.164, 95%CI: 3.233-8.250). Sleep problems were significantly positively correlated with anxiety symptoms (OR = 4.237, 95%CI: 2.831-6.341) and depressive symptoms (OR = 3.170, 95%CI: 2.084-4.823). The students who had sleep problems with low HL had the highest risks of anxiety symptoms (OR = 11.440, 95%CI: 5.564-23.520) and depressive symptoms (OR = 19.470, 95%CI: 8.143-46.558). CONCLUSION: Our findings suggest that Chinese students in combined junior and senior high school who had sleep problems with low HL are at risk of exhibiting anxiety symptoms and depressive symptoms. Intervention programs of mental health problems should enhance HL level and improve sleep quality.

Longitudinal effects of psychological symptoms on non-suicidal self-injury: a difference between adolescents and young adults in China.

PURPOSE: Few longitudinal studies have examined the psychological symptoms that may lead to non-suicidal self-injury (NSSI) among Chinese adolescents and young adults. This study determined the predictive effects of psychological symptoms for NSSI during a 9-month follow-up period. METHODS: Data from 17,622 students, 12-24 years of age, were analyzed in a cross-sectional fashion with respect to associations between psychological symptoms and NSSI. Follow-up surveys were performed 3, 6, and 9 months later. Incident cases of NSSI during follow-up were correlated with the psychological symptoms at baseline. RESULTS: A total of 3,001 (17.0%) students reported that they had NSSI in the 12 months before the initial assessment. The total rate of NSSI revealed no statistically significant differences by gender, but marked differences between grades. The response rate 3, 6, and 9 months later was 91.8, 81.8, and 79.1%, respectively. Our cross-sectional study demonstrated statistically significant associations between emotional problems, conduct problems, social adaptation problems, psychological problems, and NSSI (P < 0.01). In the longitudinal study, emotional problems, conduct problems, social adaptation problems, and psychological problems at baseline had statistically significant associations with incident NSSI in follow-up involving the adolescents, while the association in young adults was attenuated after adjustment for confounding variables. Moreover, psychological symptoms at baseline showed a monotonic dose-response relationship with NSSI in follow-up involving adolescents. CONCLUSIONS: The findings suggest that adolescents with psychological symptoms are a group with elevated risks for later NSSI. The prevention programs of NSSI should target attenuating the severity of psychological symptoms.

[Relationship between deliberate self-harm and suicidal behaviors in college students].

OBJECTIVE: To describe the prevalence of deliberate self-harm (DSH) and suicidal behaviors (SIB) as well as the relationship between them in a college student population. METHODS: A total of 4063 medical students were selected under the cluster sampling method in Anhui province. Data were analyzed by Pearson Chi-square and logistic regression. RESULTS: A total of 4063 (13.4%) students reported that they had deliberately harmed themselves during the past 12 months. The acts of DSH with 1 and more than or equal to 2 times occurrence accounted for 3.7% and 9.6% among all the respondents. The act of DSH was significantly higher among boys than that among girls. Rates of suicide ideation, suicide plan, attempted suicide and SIB in the last year were 4.5%, 1.4%, 0.6% and 4.9%, respectively. However no statistically significant difference was found in different sex. Students in the DSH group that with SIB were found to have lower positive coping levels (OR=0.5, 95%CI: 0.3-0.8), getting less support from friends (3-5 vs. less than or equal to 2: OR=0.6, 95%CI: 0.3-0.9; more than or equal to 6 vs. less than or equal to 2: OR=0.4, 95%CI: 0.2-0.8), with higher negative coping levels (OR=2.1, 95%CI: 1.2-3.7), having more serious depressive symptoms (OR=2.9, 95%CI: 1.6-5.2) and anxiety symptoms (OR=2.2, 95%CI: 1.2-3.8), having more serious sleeping problems (OR=1.7, 95%CI: 1.1-2.8) and perceived fat (fat vs. moderate: OR=2.0, 95%CI: 1.1-3.6) than the DSH group without SIB. The rates of SIB in students with DSH behavior were significantly higher than those in students without those behaviors (OR=4.7, 95%CI: 3.5-6.4). Psychosocial variables could attenuate the relationship between the DSH status and suicidal events (OR=3.3, 95%CI: 2.4-4.5). The DSH frequency exhibited a curvilinear relationship to SIB (OR=3.1-10.0) and psychosocial variables also attenuated this relationship (OR=2.4-5.9). CONCLUSION: It was well known that SIB was not a suicidal gesture but our findings suggested that the presence of DSH might trigger the suicidal attempts.

[Situation of common psychosomatic symptom in adolescent and its influence on 6 months later suicide and self-injurious behavior].

OBJECTIVE: To investigate the prevalence of common psychosomatic symptoms among Chinese adolescents and the influence on 6 months later suicide and self-injurious behavior. METHODS: Based on the cluster sampling method, the participants who were recruited from 8 cities from 3 areas in China, including Eastern areas (Beijing, Shaoxing and Guangzhou), Middle areas (Ezhou, Harbin and Taiyuan) and Western areas (Guiyang and Chongqing), were administered by multidimensional sub-health questionnaire of adolescents (MSQA) in March 2008. Demographics, life style, psychosomatic symptoms, suicide and self-injurious behavior were also assessed. A total of 17 622 questionnaires were valid at baseline. Six months later, 14 407 questionnaires were eligible for two waves investigation. Analysis of Pearson chi-square and logistic model regression analysis were employed to compare the incidence of psychosomatic symptoms, suicide and self-injurious behaviors among different areas and to explore the possible risk factors of those symptoms and behaviors. RESULTS: At baseline, rates of total common physiological and psychological symptoms were 24.1% (4255/17622) and 30.9% (5447/17622), respectively, with the highest being eating and drinking too much (6.4%, 1130/17622) and hardly feel ease to learn at home (11.8%, 2087/17 622). In males, the rate of common psychological symptoms (30.7%, 2637/8599) was higher than physiological symptoms (24.0%, 2061/8599) (P < 0.05); in females, the rate of common psychological symptoms (31.1%, 2810/9023) was higher than physiological symptoms (24.3%, 2194/9023) (P<0.05). The rate of the common psychosomatic symptoms in senior high school students (46.8%, 2905/6208) were significantly higher than those in middle high school students (37.3%, 2337/6262) and college students (33.2%, 1711/5152) (all P values <0.05). Students from Western areas had the highest incidences of the common physiological and psychological symptoms (30.2%, 1471/4871; 40.6%, 1979/4871), higher than students from Middle areas (22.4%, 1443/6453; 27.0%, 1743/6453) and Eastern areas (21.3%, 1341/6298; 27.4%, 1725/6298) (all P values <0. 05). Results from multiple logistic regression showed that physical symptoms > or = 2 at baseline were shared risk factors for suicidal ideation (RR = 1.44, 95% CI:1.16 - 1.79), attempted suicide (RR = 1.79, 95% CI: 1.22 - 2.61) and self-injurious behaviors (RR = 1.39, 95% CI: 1.17 - 1.66) 6 months later. Psychopathological symptoms > or = 4 at baseline was the shared risk factors for suicide ideation (RR = 1.74, 95% CI: 1.39 -2.17), attempted suicide (RR = 2.08, 95%CI: 1.39 - 3.11) and self-injurious (RR = 1.90, 95%CI: 1.59 - 2.28) 6 months later. CONCLUSION: It is common in Chinese adolescents who have multiple psychosomatic symptoms simultaneously. What's important is that those common psychosomatic symptoms are shared risk factors of later suicidal and self-injurious behaviors.

Higher waist-to-height ratio and waist circumference are predictive of metabolic syndrome and elevated serum alanine aminotransferase in adolescents and young adults in mainland China.

OBJECTIVES: The prevalence of overweight and obesity continue to increase among children and adolescents worldwide. This study examined whether waist circumference (WC), waist-to-hip ratio (WHpR) and waist-to-height ratio (WHtR) are predictive of metabolic syndrome and elevated serum alanine aminotransferase (ALT) among adolescents and young adults in mainland China. STUDY DESIGN: Cross-sectional study. METHODS: In total, 6997 students aged 12-24 years from nine Chinese cities participated in this study. Anthropometric and biochemical data were collected. A logistic regression model was performed to determine the association between anthropometric indicators and metabolic syndrome components and abnormal liver function. RESULTS: This study found prevalence rates for the metabolic syndrome and elevated ALT of 1.4% and 3.1%, respectively, among adolescents and young adults in mainland China. A multivariate logistic regression model found that WHtR ≥0.50 was more strongly associated with metabolic syndrome components and elevated ALT than WC values at or above the 90th percentile (P(90)) or WHpR ≥P(90). Odds ratios for elevated ALT were 2.03 [95% confidence interval (CI) 1.46-2.81], 4.56 (95% CI 3.07-6.78) and 13.43 (95% CI 7.67-23.51) in adolescents and young adults with one, two and three or more components of metabolic syndrome, respectively (P < 0.001 for all). CONCLUSIONS: Higher WC and WHtR were found to be predictive of metabolic syndrome components and elevated ALT among adolescents and young adults in mainland China, and the association was stronger for WHtR. Furthermore, adolescents and young adults with more metabolic syndrome components were more likely to suffer from elevated ALT.

Deliberate self-harm behaviors in Chinese adolescents and young adults.

The aim of this paper was to describe the prevalence of deliberate self-harm (DSH) and to determine the socio-demographic, behavioral, and psychological correlates of DSH behaviors in Chinese adolescents and young adults in a representative sample of the general population. The data were obtained from an epidemiologic study involving adolescents and young adults from junior and senior schools and colleges located in eight provinces of China. A total of 17,622 cases were retained for analysis. The relationship between the explanatory variables with self-harm was analyzed using a Pearson χ (2) test and a multinomial logistic regression model. A total of 3,001 (17.0%) students reported that they had harmed themselves deliberately in the past 12 months. The act of DSH occurring 1 and >2 times accounted for 4.2% (742) and 12.8% (2,259) of all respondents, respectively. The most frequently reported form of DSH was self-hitting. If the reference category was No DSH, the findings indicated that family composition, father's education, perceived family economic status, cigarette use, perceived body image, and higher scores in depression scales were important concomitants of repeat-incidents of DSH. The students, in western areas, who were younger, reported that having unhealthy weight control behaviors, and alcohol use had a higher risk for both types of DSH. Regarding students of age 15-18 years perceived body image (too fat), having unhealthy weight control behaviors or a high level of depression symptoms demonstrated an elevated risk for repeat-incident DSH when single-incident DSH was used as the reference category, whereas the students in middle area reported family composition (both parents), education of the father (less than college) or alcohol use had a decreased risk for repeat-incident DSH. The results of this study suggest that both types of DSH are associated with other wide-ranging problems in the students' lives. Despite their common features, these phenomena also differed from each other. It is necessary to investigate the possible neurobiologic underpinnings of DSH within a longitudinal study to enhance the knowledge of this behavior.