Lifestyle behaviors and stress are risk factors for overweight and obesity in healthcare workers: a cross-sectional survey.

BACKGROUND: Overweight and obesity have become major public health concerns worldwide. Persistent stress can activate the human hypothalamic‒pituitary‒adrenal axis (HPA) and increase the intake of "self-rewarding food", thereby raising the incidence of obesity. Health care workers (HCWs) experience higher workloads and mental stress than workers in many other industries, which may put them at increased risk for overweight/obesity. However, few studies have been carried out on overweight and obesity among HCWs in China, and the overall scenario and behind-the-scenes factors of their overweight and obesity are unknown. The aim of this study is to understand the epidemic of overweight and obesity and risk factors among Chinese HCWs. METHODS: Based on a cross-sectional web survey design, 23,234 HCWs from 100 health institutions in 5 provinces/autonomous regions/municipalities across China were sampled to answer a self-administered questionnaire that was purposely developed using a multi-staged clustered random-sampling method. Chi-square test and ANOVA were performed to compare variables between two or more groups. Univariate analyses were conducted to identify the influence of self-reported persistent stress and/or recurrent anxiety/depressed mood on lifestyle behaviors. A multivariate binary logistic regression model was used to analyse the risk factors of overweight/obesity. RESULTS: Among the respondents, 34.26% were overweight, and 11.22% were obese. Most of the respondents had regular exercise habits (68.17%), had habitually stayed-up late (65.06%) and had been affected by persistent stress and/or recurrent anxiety/depressed mood (62.04%). A higher proportion of those with persistent stress and/or recurrent anxiety/depressed mood than those without habitually staying-up late (76.18%); consumed take-out food (54.92%), fried food (49.93%), snacks or desserts (50.51%); drank sugary drinks (46.57%); smoked (14.27%); and drank alcohol (23.34%). Gender (Female) (OR: 0.314, 95%CI: 0.292-0.336), age (OR: 1.742-2.334, 95%CI: 1.544-2.858), education (OR: 0.620-0.728, 95%CI: 0.445-0.973), living and working area (OR: 1.271, 95%CI: 1.192-1.355), breakfast (OR: 0.898, 95%CI: 0.839-0.960), fried food (OR: 1.133, 95%CI: 1.048-1.224), and alcohol consumption (OR: 1.111, 95%CI: 1.017-1.214) were factors for overweight/obesity. All of the aforementioned results were significant (P < 0.05). CONCLUSIONS: The overweight/obesity rate of Chinese HCWs is rather high, which might be directly associated with lifestyle behaviors. However, these behaviors fundamentally originated from persistent stress and/or recurrent anxiety/depression, mediated by lifestyle behaviors. Substantial measures should be taken for stress reduction and mental health promotion for overweight/obesity prevention and control among HCWs.

Analysis of the role of Frizzled 2 in different cancer types.

Frizzled 2 (FZD2) is an important receptor in the Wnt pathway, which is highly expressed in malignant tumors and helps regulate multiple tumor behaviors. Its expression level is related to prognosis. Here, bioinformatic analysis was performed to understand the expression of FZD2 in different tumors. We examined FZD2 expression using pan-cancer data of 33 cancer types from The Cancer Genome Atlas (TCGA). Differential expression analysis (Wilcoxon's test) was used to compare tumor and normal tissues. Univariate Cox proportional hazard regression was performed to compare gene expression and overall patient survival. COSMIC, cBioPortal, and CCLE were used to examine FZD2 mutations in human cancers. Dryness index was calculated using one-class logistic regression (OCLR). Spearman's correlation was performed based on gene expression and dryness score and used to analyze the correlation between gene expression and stemness score, matrix score, immune score, estimated score, tumor mutation burden (TMB), microsatellite instability (MSI), and drug sensitivity. STRING website was used to construct an FZD2 protein interaction network and identify genes that interact with FZD2. We report that FZD2 is highly expressed in most tumors, differing between cancer types. Expression was related to patient overall survival (OS), disease-specific survival, disease-free interval (DFI), mutations, drug sensitivity, tumor microenvironment, immune cell infiltration, immune checkpoint gene expression, immunotherapy indicators (TMB, MSI), and tumor cell stemness. FZD2 influenced drug sensitivities, including cobimetinib (r = -0.553, P < 0.001), selumetinib (r = -0.539, P < 0.001), bafetinib (r = -0.538, P < 0.001), tamoxifen (r = -0.523, P < 0.001), alvespimycin (r = -0.520, P < 0.001), and nilotinib (r = -0.502, P < 0.001). FZD2 has the most significant correlation with ROR2 (r = 0.4, P < 0.001), Wnt2 (r = 0.37, P < 0.001), and Wnt4A (r = 0.34, P < 0.001). The results confirm the importance of FZD2 expression in cancer prognosis and treatment, and provide new clues for treatment strategies.