Perceived rather than objective weight status is associated with suicidal behaviors among Chinese adolescents: a school-based study.

BACKGROUND: We aimed to explore the relationship between body mass index (BMI) and body weight perception (BWP) with suicidal behaviors among mainland Chinese adolescents. METHODS: A nationally representative sample (N = 10 110) of Chinese adolescents was assessed in this study. Suicidal behaviors (ideation, plan and attempt) were evaluated by four self-reported questions. Generalized linear mixed model was used to estimate the adjusted odds ratios (ORs) for the association between BWP/BMI with suicidal behaviors. RESULTS: The prevalence of suicidal ideation, suicidal plan and suicidal attempt was 12, 5 and 2.1%, respectively. After adjusting potential covariates, perceiving oneself as obese was significantly associated with increased risks of suicidal ideation (OR: 2.4, 95% confidence intervals, CI: 1.6-4.0, P = 0.001), suicidal plan (OR: 3.1, 95% CI: 1.5-6.3, P = 0.002) and suicidal attempt (OR: 3.7, 95% CI: 1.5-9.1, P = 0.001) compared with perceiving as normal weight among male adolescents; the effect attenuated to null among female adolescents. Perceiving oneself as underweight and overweight both exhibited significant adverse effect on suicidal behaviors (only suicidal ideation and suicidal plan) compared with perceiving oneself as normal weight among male adolescents, but not among female adolescents. The actual measured BMI was not significantly associated with suicidal behaviors among neither gender. CONCLUSIONS: Self-perception of their body image rather than actual measured weight may have a gender-specific adverse effect on suicidal behaviors among Chinese adolescents.

Changes in BMI and waist circumference among primary and secondary school students from 2005 to 2010 in Anhui, China.

AIM: To examine the change in Body Mass Index (BMI) and waist circumference (WC) among primary and secondary school students aged 7-18 in Anhui Province between 2005-2010. SUBJECTS AND METHODS: A total of 15 812 primary and secondary school students aged 7-18 were included in two national surveys on students' constitution and health in 2005 and 2010 in Anhui Province. Measurements of height, weight and WC were taken by trained investigators. BMI was calculated for each subject. RESULTS: The mean BMI and WC were significantly increased from 2005 to 2010. For boys, mean increases were 0.85 kg/m(2) and 2.01 cm or 0.08 and 0.34 SD score units, while for girls those were 0.39 kg/m(2) and 2.10 cm or 0.20 and 0.39 SD score units (all p < 0.001). The standard deviation scores for WC increased much more than for BMI (0.34 units vs 0.08 units for boys and 0.39 units vs 0.20 units for girls). CONCLUSIONS: The average value of BMI and WC among primary and secondary school students has increased dramatically from 2005 to 2010 in Anhui, China. Changes in WC have greatly exceeded those in BMI, showing that WC is a good proxy for central fatness rather than BMI.

[Association between body mass index and physical fitness index among children and adolescents].

OBJECTIVE: To explore the relationship between body mass index (BMI) and physical fitness index (PFI) among children and adolescents. METHODS: The study sample included 8941 students aged 7 to 18 years in Anhui who attended the Physical Fitness and Health Surveillance program of Chinese School Students, in 2010. Within each sex- and age-specific group, students were classified into five BMI categories which were: very low, BMI<5th percentile; low, BMI≥5th but <15th percentiles; normal, BMI≥15th but <85th percentiles; high, BMI≥85th but <95th percentiles; and very high, BMI≥95th percentiles. Z-scores based on urban-rural, sex- and age-specific means and standard deviations were calculated, and the sum of Z-scores for the fitness tests was used as a PFI. Differences in PFI between BMI categories were compared with ANOVA. Sex- and grade-specific regressions of PFI on BMI were done by using a linear model. RESULTS: For 8941 students, the PFIs on very low, low, normal, high and very high group were -1.77, -0.91, 0.32, -0.17 and -0.54, respectively, and showed an inverted U shape. The normal BMI group students presented the highest PFI. Data from Linear regression analysis revealed that PFI was significantly positively correlated with BMI, while negatively associated with BMI square, which indicated that PFI was the quadratic function of BMI. When BMI was increasing, PFI showed a parabolic curvilinear. CONCLUSION: Relationships between BMI and PFI were parabolic curvilinear among the children and adolescents aged 7 to 18 in Anhui province.

[Psychopathological sub-healthy status as predictor on self-or unintentional injuries among Chinese adolescents: a school-based follow-up study].

OBJECTIVE: To investigate the association between psychological sub-healthy status and risks on injuries and related predictors among adolescents in China, in order to develop reasonable intervention programs. METHODS: Adolescents were selected from middle schools and colleges in eight cities. Baseline status on sub-healthy that related to psycho-pathology was measured using the Multidimensional Sub-health Questionnaire of Adolescents (MSQA). Data on Self- or unintentional injuries were collected using a standardized injury surveillance questionnaire every 3 months, for three times (T0, T1, T2 and T3). RESULTS: A total of 12 113 students completed the study. Prevalence rates related to self-injury among boys and girls were 19.4% and 19.9%, respectively. The rates of having more than 4 types of self-injuries in boys and girls were 4.7% and 4.2%, respectively. Boys had a significantly higher unintentional injury rate than that of girls (62.2% vs. 57.3%). The differences in the rates of having more than 4 types of unintentional injury between boys (3.8%) and girls (3.4%) were also statistically significant. Rates on self- and unintentional-injuries increased in T1, T2 and T3 when the psychological symptoms had an increase. Data from Multiple regression analysis demonstrated that the baseline psychological sub-healthy status was a predictive factor for higher risk of self- and unintentional-injuries at each of the follow-up waves. CONCLUSION: Sub-healthy status of psycho-pathology was associated with an increased risk on self- and unintentional injuries among adolescents. Integrative psycho-pathological and behavioral intervention programs might help in reducing the risk of injuries among the Chinese adolescents.

[Relationship between waist circumference development curve of children and hypertension and risk of hypertension].

OBJECTIVE: The 85th percentile of waist circumference (WC) is considered an appropriate cutoff for Chinese children in the prediction of cardiovascular risks in previous researches, but the risk for hypertension of moderate WC maybe underestimated. The purpose of this study was to understand the characteristics of the WC curve trajectory of children with hypertension and to determine the appropriate cutoffs for waist circumference for Chinese school-age children and adolescents for predicting hypertension risk factors. METHODS: A total of 8194 Han children aged 7 - 17 years were selected from schools in Suzhou, Hefei, and Chizhou cities in Anhui province by stratified cluster sampling. WC and blood pressure were accurately measured in all subjects. LMS (lambda-mu-sigma) method was used to construct WC centile curves. Optimal WC cutoffs were determined by comparing the performance of different percentile sets of WC cutoffs in predicting hypertension risk factors. RESULTS: The fitted LMS curves of WC for the group of boys with hypertension deviate in parallel from that for the corresponding curve in the entire boy study population with higher WC. The WC curves for the group of girls with hypertension gradually upward deviated from the corresponding curve before 12 years of age and then gradually returned to the corresponding curve. WC of boys at the percentiles of 60 was already associated with an increased risk of hypertension and hazard ratio of WC at percentiles of 60, 70, 80, and 90 increased from 1.88(95%CI: 1.18 - 2.99) to 4.87 (95%CI: 3.31 - 7.16). WC of girls at the percentiles of 70 was already associated with an increased risk of hypertension and hazard ratio of WC at percentiles of 70, 80, and 90 increased from 1.71 (95%CI: 1.07 - 2.73) to 3.32 (95%CI: 2.16 - 5.09). CONCLUSIONS: The WC growth trajectory of children with hypertension varies with gender. WC is an independent predictor of childhood hypertension, even when it is well within what is now defined as the normal range of WC. Thus, it is helpful to prevent the risk of cardiovascular disease of children using the parameter that WC cut-off level lower than 85th percentile.

[Association between self-assessed somatotypes and symptom depression among children and adolescents].

OBJECTIVE: To examine the association between self-assessed somatotypes and depression related symptoms. METHODS: The study sample included 5555 students aged 9 to 18 years who had attended the Physical Fitness and Health Surveillance of Chinese School Students (2010) in Chizhou city, Anhui province. Association between self-assessed somatotypes, body mass index (BMI) and depression symptom were examined. RESULTS: There was a slight consistency between self-assessed somatotypes and BMI in both boys and girls (Kappa = 0.217, P = 0.000; Kappa = 0.203, P = 0.000). Significant difference in the prevalence of depression was found among weight misperception groups in both genders (χ(2) = 145.223, P = 0.000). The prevalence of underestimation of somatotypes was significantly higher in boys than in girls, while the result was reversive on the prevalence of overestimation. Additionally, the prevalence of depression was higher in girls than in boys (χ(2) = 5.199, P = 0.023). Through logistic regression, data showed that self-assessed somatotypes and miscalculated groups were significantly associated with depressive symptoms. Compared to the group that self-assessment as being normal, those students when self-assessed as being slim, overweight or obesity were more likely to be depressive, with odds ratio (ORs) as 1.255 (95%CI: 1.066 - 1.478), 1.538 (95%CI: 1.275 - 1.856) and 1.713 (95%CI: 1.035 - 2.834), respectively. Overestimated and underestimated somatotypes appeared to be risk factors causing symptoms of depression (OR = 1.705, 95%CI: 1.382 - 2.105; OR = 1.241, 95%CI: 1.059 - 1.454). CONCLUSION: Slight consistency was found between self-assessed somatotypes and BMI, while the misjudged somatotypes were the risk factor related to depressive symptoms. It was suggested that life skills education should be carried out as preventive intervention approach, to improve the physical and mental health well-being of children and adolescents.

Plasma L-ENK, AVP, ANP and serum gastrin in patients with syndrome of Liver-Qi-stagnation.

AIM:To investigate the pathophysiologic basis of syndrome of Liver-Qi stagnation and parameters for clinical differentiation.METHODS:Plasma L-ENK, AVP, ANP and serum gastrin were determined by RIA in 84 patients with neurasthenia, mastodynia,chronic gastritis, and chronic cholecystitis presenting the same syndrome of Liver-Qi stagnation in traditional Chinese medicine (TCM). Healthy subjects served as controls in comparison with patients having the same syndrome but with different diseases.RESULTS:Among the patients with Liver-Qi stagnation, the plasma L-ENK, ANP and gastrin levels were 38.83ng/L ± 6.32ng/L, 104.11ng/L ± 29.01ng/L and 32.20ng/L ± 6.68ng/L, being significantly lower than those in the healthy controls (P < 0.01, t = 3.34, 6.17, 4.48). The plasma AVP of the patient group (52.82ng/L ± 19.09ng/L) was significantly higher than that of the healthy controls (P <0.01, t = 5.79 =. The above changes in patients having the same symptom complex but different diseases entities showed no significant differences, P >0.05.CONCLUSION:The syndrome of Liver-Qi stagnation is closely related to the emotional modulatory abnormality of the brain, with decrease of plasma L-ENK, ANP and gastrin, and increase of plasma AVP as the important pathophysiologic basis.