中国学校卫生

Birth cohort study on the impact of adverse maternal factors during pregnancy on children's physical growth and development

WANG Haijun, LÜ Jinlang

2025, 46(8): 1065-1069. doi: 10.16835/j.cnki.1000-9817.2025236

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Cohort studies characterized by clear temporal sequencing, rigorous control of confounding factors, and other methodological strengths, has effectively promoted scientific exploration of the effects of pregnancy exposure on children's health. The review focuses on the impacts of adverse maternal factors during pregnancy on children's physical growth and development, sorts out the scientific evidence on the longitudinal association between adverse exposures (such as endocrine and metabolic disorders, environmental pollutants, lifestyle factors, and psychological stressors) and children' s growth trajectories in existing cohort studies, explores the path of transforming high-quality research results into potential public health intervention strategies to promote the in-depth development of health protection for children and adolescents, thereby contributing to enhancing population health and the long-term goal of sustainable societal development.

Analysis of college students' physical exercise decision-making and intervention strategies from a behavioral economics perspective

SU Peilin, SHENG Tongtong, YUE Guofeng

2025, 46(8): 1070-1073. doi: 10.16835/j.cnki.1000-9817.2025245

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In recent years, Chinese college students have shown increased awareness of the importance of physical exercise. However, challenges such as insufficient health literacy, declining physical fitness, and low participation rates in physical activity still persist. To address these issues, the study applies behavioral economics theory and incorporates concepts such as anchoring effects, intertemporal decision-making, loss aversion, and herd behavior, to examine the irrational factors and decision-making preferences underlying college students' physical exercise behaviors. By analyzing the cognitive biases in their decision-making processes, the research aims to propose targeted and scientifically validated intervention strategies, so as to provide references for improving college students' engagement in physical exercise and promoting their overall well-being.

Association between maternal lipids during pregnancy and risk of offspring's overweight and obesity at 3 years of age

ZHANG Lifang, HE Zhaocong, WEI Dongmei, LU Jinhua, KUANG Yashu, LU Minshan, SHAO Dantong, QIU Xiu, HE Jianrong

2025, 46(8): 1074-1078. doi: 10.16835/j.cnki.1000-9817.2025237

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Objective To explore the association between maternal lipid levels during pregnancy and the risk of overweight and obesity in offspring at 3 years of age, providing scientific evidences for the prevention and control of childhood obesity. Methods A total of 2 432 mother-child pairs with maternal lipid tests during pregnancy and offspring's physical growth data at 3 years of age were included from the Borin in Guangzhou Cohort Study up to September 2021. Lipid indicators, including high density lipoprotein cholesterol (HDL-C), low density lipoprotein cholesterol(LDL-C), triglycerides (TG), and total cholesterol (TC), were measured at 13-19⁺⁶ weeks (mid-pregnancy) and 32-39⁺⁶ weeks (late pregnancy). Children's body mass index (BMI) Z score were calculated according to the World Health Organization's growth standards for children under 5 years old. The lipid Z score were divided into four quartiles: Q1, Q2, Q3 and Q4. Linear regression was used to analyze the relationship between maternal lipid levels during pregnancy and offspring's BMI Z score at 3 years of age. Poisson regression with a robust error variance was employed to evaluate the association between maternal lipid levels during pregnancy and the at-risk of overweight and obesity in offspring at 3 years of age, after adjusting for maternal age at conception, education level, parity, pre-pregnancy BMI and gestational diabetes mellitus. Results There was a statistically significnt difference in the detection rate of overweight and obesity risk among children with different mothers's pre-pregnancy BMI (χ²=22.85, P < 0.05). Linear regression analysis showed that TG levels in late-pregnancy were positively related to BMI Z score (β=0.10, 95%CI=0.02-0.18, P < 0.05). Poisson regression with a robust error variance indicated that, compared with the Q1 group of TC, the Q4 group of TC in mid-pregnancy was associated with an increased risk of overweight and obesity in offspring at 3 years of age (RR=1.59, 95%CI=1.04-2.44); compared with the Q1 group of TG, the Q4 group of TG during late-pregnancy increased the risk of overweight and obesity in offspring at 3 years of age (RR=1.79, 95%CI=1.02-3.12) (both P < 0.05). Conclusions Maternal serum TC level during mid-pregnancy can increase the risk of overweight and obesity in offspring at 3 years of age. Maternal serum TG levels during late-pregnancy is positively correlated with BMI and the risk of overweight and obesity in offspring at 3 years of age.

Meta-analysis of maternal overweight/obesity during pregnancy and offspring metabolic dysfunction-associated steatotic liver disease

WU Yuying, ENKAER Nuer, WANG Youxin, WANG Mingyue, YANG Yifan, YANG Shuhan, SUN Lingling, WANG Hui

2025, 46(8): 1079-1083. doi: 10.16835/j.cnki.1000-9817.2025259

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Objective To evaluates the association between maternal overweight/obesity during pregnancy and offspring risk of metabolic dysfunction-associated steatotic liver disease (MASLD), providing theoretical evidence for early-life MASLD prevention. Methods An online search was conducted across ten databases (CNKI, Wanfang, SinoMed, PubMed, Embase, Web of Science, Cochrane Library, PROSPERO, PQDT Global, ScienceDirect) for research literature on the association between maternal overweight/obesity during pregnancy and the development of MASLD in offspring, with the search period spanning from January 2014 to December 2024. Two researchers independently screened literature, extracted data, and assessed study quality. Statistical analysis was performed using R 4.3.3. Results Ten studies involving 10 229 participants were included, comprising 4 cohort studies and 6 case-control studies. Cohort studies showed that maternal overweight and obesity significantly increased offspring MASLD risk (RR=1.59, 95%CI=1.06-2.39, P < 0.05), with moderate heterogeneity (I²=56.9%, P=0.07). Case-control studies indicated a positive association between maternal overweight/obesity during pregnancy and offspring risk of MASLD(OR=2.00, 95%CI=1.68-2.39, P < 0.05), with low heterogeneity (I²=48.8%, P=0.08). Conclusions Maternal overweight/obesity during pregnancy positively correlates with offspring MASLD risk. Gestational weight management may reduce the risk.

Association between body mass index during pre-pregnancy and maternal lipid levels during early pregnancy with the risk of overweight and obesity in preschool children

GUO Xiru, LÜ Jinlang, SU Tao, HAN Na, WANG Lu, JI Yuelong, WANG Haijun

2025, 46(8): 1084-1087. doi: 10.16835/j.cnki.1000-9817.2025239

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Objective To analyze the relationship between body mass index(BMI) during pre-pregnancy, maternal lipid levels during early pregnancy and childhood overweight and obesity, as well as the mediating role of maternal lipid levels during early pregnancy in pre-pregnancy BMI and childhood overweight and obesity, providing scientific evidence for developing obesity prevention strategies in preschool children. Methods Using data from Peking University Birth Cohort in Tongzhou (PKUBC-T) collected between June 2018 and September 2022, the study included 1 292 mother-child pairs. Participants were stratified into two groups based on children's BMI-Z scores at age 3: an overweight/obesity risk group (BMI-Z>1, n=173) and a non-overweight/obesity risk group (BMI-Z≤1, n=1 119).Multivariate Logistic regression was conducted to analyze the associations between pre-pregnancy BMI, maternal lipid levels[total cholesterol(TC), triglyceride(TG), high density lipoprotein cholesterol(HDL-C), low density lipoprotein cholesterol(LDL-C), TC/HDL-C, TG/HDL-C, LDL-C/HDL-C] during early pregnancy and childhood overweight and obesity. The mediating effect of maternal lipid levels during early pregnancy on pre-pregnancy BMI and childhood overweight and obesity was further explored. Results There were statistically significant differences in pregnancy BMI levels, early pregnancy blood LDL-C, TC/HDL-C, LDL-C/HDL-C levels between the overweight and obesity risk group and the non overweight and obesity risk group (χ²/Z=19.01, 2.48, 2.48, 2.71, all P < 0.05). Multivariate Logistic regression analysis showed that pre-pregnancy BMI, LDL-C, TC/HDL-C and LDL-C/HDL-C in early pregnancy were significantly associated with childhood overweight and obesity (OR=1.09, 1.42, 1.49, 1.60, all P < 0.05). LDL-C, TC/HDL-C and LDL-C/HDL-C in early pregnancy played a significant mediating role on pre-pregnancy BMI and childhood obesity and the mediating effects accounted for 7.3%, 10.2%, 23.5% of the total effects, respectively (all P < 0.05). Conclusions Maternal hyperlipidemia during early pregnancy partially mediated the association between pre-pregnancy obesity and childhood obesity. Both pre-pregnancy obesity and maternal hyperlipidemia during early pregnancy are risk factors for obesity in preschool children.

A prospective cohort study of association between maternal metal exposure during early pregnancy and physical development in offspring at ages 1 and 3

ZHANG Xiao, JIANG Yangqian, PANG Liya, DU Jiangbo, LIN Yuan, MA Hongxia

2025, 46(8): 1088-1092. doi: 10.16835/j.cnki.1000-9817.2025142

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Objective To analyze the impact of maternal metal exposure during early pregnancy on the physical development of offspring at 1 and 3 years of age, so as to provide scientific evidence for reducing the adverse effects of heavy metals on their health. Methods From 2024 to 2018, a total of 1 588 mother-child pairs from the Jiangsu Birth Cohort (JBC) were included in this study. Multiple linear regression models, generalized estimating equations (GEE), and weighted quantile sum (WQS) regression models were used to assess the associations between 24 urinary metal mass concentrations (adjusted for specific gravity, SG) during early pregnancy and offspring growth outcomes, including length/height-for-age Z-score(HAZ), weight-for-age Z-score(WAZ), weight-for-length/height Z-score(WHZ), and head circumference-for-age Z-score(HCAZ) at 1 and 3 years of age. Results After adjusting for confounders, GEE analysis revealed that each natural log-unit increase in maternal urinary concentrations of vanadium, tin, cerium, lead, and uranium during early pregnancy was associated with an average reduction in HCAZ by 14.29%, 4.82%, 2.62%, 5.04%, and 8.33%, respectively, at 1 and 3 years of age (FDR-P < 0.05). Multiple linear regression analysis revealed that increased urinary vanadium concentration was associated with reduced HAZ at 1 year of age, while increased urinary concentrations of vanadium, chromium, tin, antimony, and uranium were associated with reduced HCAZ at 1 year of age (FDR-P < 0.05). In the WQS regression model, each unit increase in the WQS index was associated with a 22.64% reduction in HCAZ at 1 year of age, with tin (22.2%) contributing the highest weight, followed by uranium (16.2%), lead (11.5%), vanadium (10.0%), arsenic (6.5%), and chromium (5.0%). Conclusions Prenatal exposure to specific metals and their mixtures may significantly impact the physical development of offspring at 1 and 3 years of age, particularly head circumference. These findings highlight the need to enhance monitoring of maternal metal exposure during early pregnancy to reduce the potential health risks posed by environmental metal pollution to infants and young children.

Association between 24-hour movement behavior composition and obesity indicators in children and adolescents

XIE Jichun, ZHAO Yang, XU Ruilin

2025, 46(8): 1093-1097. doi: 10.16835/j.cnki.1000-9817.2025224

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Objective To identify optimal recommendations for 24-hour movement behaviors in relation to obesity indicators among children and adolescents, so as to provide scientific evidences for targeted obesity prevention strategies. Methods From April to June 2024, 242 participants (96 children aged 6-11, 146 adolescents aged 12-18) were recruited from two schools(one combined junior and senior high school, one consistent school for 12 years) in Tianjin for performing physical examination. Obesity indicators including body mass index Z-scores (BMI Z), waist-to-hip ratio (WHR), body fat percentage (FAT), and fat mass index (FMI) were measured. Measurement of 24-hour movement behaviors using an accelerometer, comprised moderate-to-vigorous physical activity (MVPA), light physical activity (LPA), sedentary behavior (SB), and sleep (SLP). The optimal movement duration and interval for children and adolescents were determined through optimal time zone analysis. Results Significant associations were found between 24-hour movement behaviors and BMI Z(F=2.35) and WHR (F=3.55) in children, as well as BMI Z(F=3.57), FAT (F=2.44), and WHR (F=3.61) in adolescents (all P < 0.05). The results of optimal time zone analysis showed that optimal daily durations were MVPA 63(40-70) min, LPA 257(220-270) min, SB 467(390-600) min, SLP 653(590-680) min for children, and MVPA 65(40-70) min, LPA 262(220-270) min, SB 484(440-600) min, SLP 629(510-670) min for adolescents. Conclusion The recommended amount of 24-hour movement for children and adolescents based on obesity indicators could provide reference for informing the development of Chinese-specific guidelines, and promote healthy lifestyles among children and adolescents.

Association between bedroom nocturnal light exposure and objective sleep parameters in college students

ZHANG Anhui, YU Min, XU Yuxiang, SUN Ying

2025, 46(8): 1098-1101. doi: 10.16835/j.cnki.1000-9817.2025228

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Objective To investigate the cross-sectional association between bedroom nocturnal light exposure and objectively measured sleep parameters in college students, so as to provide evidence for promoting sleep health. Methods From September to October 2019, a convenience sampling method was used to recruit 365 healthy college students from two universities in Hefei, establishing a cohort. Bedroom nocturnal light exposure was measured at the individual level for two consecutive days using a portable illuminometer (TES-1339R; Taishi Corp, Taiwan, China). Sleep parameters were objectively measured over seven consecutive days using wrist-worn accelerometers (ActiGraph GT3X-BT, Pensacola, FL). Multiple linear regression models were employed to examine the association between nocturnal light exposure and sleep parameters. Results Compared to the low nocturnal light exposure (< 3 lx) group, the high-exposure (≥3 lx) group exhibited significantly lower sleep efficiency[(93.5±2.7)%, (92.2±2.9)%, t=3.93], longer wake after sleep onset (WASO)[(24.7±90.3)(29.2±11.2)min, t=-3.66], higher movement index(11.0±3.6, 12.2±3.8, t=-2.80), and higher sleep fragmentation index(20.5±6.5, 23.0±7.0, t=-3.24) (all P < 0.01). After adjusting for covariates, multiple linear regression showed that, compared to the low nocturnal light exposure group, the high-exposure group had reduced sleep efficiency (β=-1.15, 95%CI=-1.78 to -0.52), increased WASO [β(95%CI)=3.94(1.55-6.33)], higher movement index[β(95%CI)=1.05(0.20-1.89)], and elevated sleep fragmentation index[β(95%CI)=2.35(0.81-3.88)](all P < 0.05). Conclusions Light exposure at night negatively impacts college students' sleep. Optimizing bedroom lighting management may improve sleep quality in adolescents.

Latent class characteristics and related factors of health-risk behaviors among higher vocational college students in the Wuling Mountain Area

WEN Lizhong, ZHANG Tiancheng, WANG Aolun, ZHANG Fulan, GUO Shuyuan

2025, 46(8): 1102-1106. doi: 10.16835/j.cnki.1000-9817.2025226

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Objective To explore the latent class characteristics and related factors of health-risk behaviors among higher vocational college students (referred to as vocational students) in the Wuling Mountain Area, so as to provide references for promoting their healthy development and formulating effective intervention measures. Methods From April to June 2024, a stratified random cluster sampling method was used to survey 1 737 students from three higher vocational colleges in the Wuling Mountain Area (Xiangxi in Hunan, Enshi in Hubei, and Tongren in Guizhou). The study employed the Health-risk Behavior Questionnaire for College Students, the Parent-Child Relationship Scale, the Social Support Scale, and the School Connection Scale for data collection. Latent class analysis (LCA) was used to examine the heterogeneous distribution characteristics of health-risk behaviors among vocational students, and multivariate Logistic regression was applied to analyze the related factors of latent classes. Results The LCA results identified three latent classes based on 12 health-risk behaviors: the comprehensive high-risk group (151 students, 8.7%), the psychological distress group (883 students, 50.8%), and the low-risk group (703 students, 40.5%). The distribution of latent classes showed statistically significant differences in gender and only-child status (χ²=121.25, 9.85, both P < 0.05). The low-risk group scored higher in parent-child relationship (29.26±6.19), social support (63.98±18.16), and school connection (35.97±7.71) compared to the comprehensive high-risk group (27.28±6.03, 57.67±15.60, 32.97±7.55) and the psychological distress group (27.52±5.19, 62.06±14.54, 33.80±6.14) (F=20.37, 23.51, 9.89, all P < 0.05). Multivariate Logistic regression revealed that boys(OR=3.29) were more likely to belong to the comprehensive high-risk group, social support (OR=0.03, 0.21) and school connection (OR=0.92, 0.96) were less likely to belong to both the comprehensive high-risk and psychological distress groups (all P < 0.05). Conclusions There are three potential categories of health-harmful behaviors among vocational college students in Wuling Mountain Area. Schools, families and society should enhance the levels of parent-child relationship, school connections and social support for vocational college students of different categories to promote their physical and mental health development.

Awareness of core tuberculosis knowledge and willingness for preventive intervention against latent tuberculosis infection among secondary school students in Lanzhou

KANG Liwen, ZHANG Lan, ZHAO Jianxi

2025, 46(8): 1107-1110. doi: 10.16835/j.cnki.1000-9817.2025253

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Objective To investigate the awareness of core tuberculosis (TB) knowledge and the willingness to TB preventive intervention among secondary school students in Lanzhou City, so as to provide a reference basis for the prevention and control of TB in schools. Methods From April to June 2024, a total of 1 127 secondary school students from 8 schools in 4 districts (counties) of Lanzhou City were recruited by stratified cluster sampling method to conduct a questionnaire survey on the awareness of core TB knowledge and the willingness for preventive intervention against latent tuberculosis infection. Data were analysed using χ² test and binary Logistic regression model. Results The overall awareness rate of core TB knowledge among secondary school students in Lanzhou City was 74.48%, while only 25.91% demonstrated awareness of all core knowledge items. The lowest awareness was observed for the item "tuberculosis is a chronic infectious disease" (61.84%). About 94.85% of the students reported willingness to receive preventive interventions after a diagnosis of latent tuberculosis infection. Multifactorial Logistic regression analysis showed that students whose father's education was junior high school (OR=3.14, 95%CI=1.22-8.08), senior high school or secondary vocational school (OR=3.55, 95%CI=1.16-10.86) had a higher willingness to receive preventive interventions than those whose father's education was primary school or below (both P < 0.05). In addition, students who recognized "suspected tuberculosis" were also more likely to express willingness to receive preventive interventions (OR=1.96, 95%CI=1.01-3.80, P < 0.05). Conclusions The total awareness rate of core TB knowledge among secondary school students in Lanzhou City is low; willingness to receive preventive interventions for latent tuberculosis infection is high and it is related to father's literacy and core TB knowledge level.

Compositional isotemporal substitution effects of recess physical activity on mental health among junior high school students

WANG Siji, ZHANG Xiubing, SONG Yingzhe, CHEN Jiu, WANG Yibing, LIN Yanmin, XIE Jun

2025, 46(8): 1120-1124. doi: 10.16835/j.cnki.1000-9817.2025240

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Objective To explore the isotemporal substitution effects among different intensities of physical activity within a 10-minute recess period on the mental health of junior high school students, aiming to provide evidence-based references for targeted practical interventions. Methods From May to November 2024, a total of 845 junior high school students from Tianjin, Taiyuan and LV Liang in Shaanxi Province, Puyang in Henan Province, Xi'an in Shaanxi Province, Quzhou in Zhejiang Province, and Chaoyang in Liaoning Province were selected by using a combination of stratified random sampling and convenience sampling. ActiGraph wGT3X-BT accelerometers was used to measure physical activity during a 10-minute recess period. Mental health status was assessed with the Depression Anxiety Stress Scale (DASS-21). An isotemporal substitution model was constructed in 1-minute increments to predict the effects of substituting different physical activity behaviors on students' mental health. Results During recess, sedentary behavior (SB) was predominant among junior high school students, with an average duration of [7.08(5.85, 7.98)] minutes, while moderate-to-vigorous physical activity (MVPA) accounted for the shortest duration at [0.42(0.21, 0.85)] minutes. There were statistically significant differences in MVPA, LPA and SB time between students of different genders and grades(Z/H=-9.08, -8.34, -9.51;84.87, 126.82, 135.27, all P < 0.01). Isotemporal substitution analysis, adjusted for gender and age, showed that replacing 1 minute of SB with 1 minute of MVPA significantly improved anxiety levels (β=-0.29, 95%CI=-0.53 to -0.04) and overall mental health (β=-0.72, 95%CI=-1.39 to -0.04), with both results reaching statistical significance (both P < 0.05). No significant effects were observed for other substitution patterns (both P>0.05). Conclusions Substituting SB with MVPA during a 10-minute recess period exerts a positive impact on the mental health of junior high school students. It is recommended to optimize the daily recess activity structure in schools to enhance students' mental well-being.

Association of family economic status and parent-child relationship with depressive symptoms in adolescents

LIAO Xiaoting, HUANG Jiongli, ZOU Zengli, LI Zhongyou, LI Hai

2025, 46(8): 1111-1115. doi: 10.16835/j.cnki.1000-9817.2025255

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Objective To analyse the influence path of family economic status on adolescent depressive symptoms, and to explore the chained mediation role of peer relationship and self-satisfaction, as well as the moderating effect of the parent-child relationship, so as to provide a theoretical basis for the prevention and control of adolescent depressive symptoms. Methods Data were obtained from the Database of Youth Health (DYH) in the National Population Health Science Data Center, and a total of 11 277 samples were included. Questionnaires were used to obtain information on family economic status, peer relationship, self-satisfaction, parent-child relationship and depressive symptoms. Spearman correlation analysis was used to examine correlations among variables. Hierarchical linear regression analysis was used to analyze effects of family economic status and parent-child relationship on depressive symptom scores. The Process macro program was adopted to test the chained mediating effects of peer relationship and self-satisfaction and the moderating effect of parent-child relationship. Results The prevalence rate of depressive symptoms among adolescents was 24.2%. The prevalence rates of depressive symptoms significantly differed among adolescents with different family economic status and places of residence(χ²=210.12, 4.18, both P < 0.05). Adolescents with depressive symptoms had significantly lower scores on peer relationship, self-satisfaction, and parent-child relationship compared to those without depressive symptoms (t=27.76, 42.43, 31.12, all P < 0.05). Family economic status were negatively correlated with adolescent depressive symptom scores (B=-0.12, P < 0.05).Parent-child relationship was negatively correlated with depressive symptom scores (B=-0.02, P < 0.05). After introducing the parent-child relationship, the negative effect of family economic conditions was reduced (B=-0.08, P < 0.01). Family economic conditions affected depressive symptoms through the chained mediating pathway involving peer relationship (B=2.07) and self-satisfaction (B=3.88)(both P < 0.05). The parent-child relationship moderated this pathway: under conditions of high-quality parent-child relationship, the effect of family economic status on peer relationships was weaker (B=0.15); under low-quality parent-child relationship, the positive effect of family economic status on peer relationships was enhanced (B=1.15) (both P < 0.01). Conclusions Family economic status exert both direct and chain-mediating effects on adolescent depression, and high-quality parent-child relationship can play a protective moderation role. For economically disadvantaged families, it is critical to synergistically enhance parent-child relationship and social support in order to reduce depression risk among adolescents.

Association of college students' values, sense of life meaning and subjective well-being with depression

LAN Lili, WANG Xiaofeng

2025, 46(8): 1116-1119. doi: 10.16835/j.cnki.1000-9817.2025238

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Objective To explore the mediating effect of life meaning and subjective well-being during college students' values influence depression, providing insights for reducing college students' depression. Methods Utilizing a longitudinal approach, the study employed four scales of assessing Chinese adolescent values, sense of life meaning, subjective well-being, and depression to conduct a two-year follow-up survey of 576 university students (September 2021 T1; September 2023 T2). Three multiple chained mediation models were constructed and analyzed using PROCESS Model 6. Results Across the two waves, students' endorsement of collective responsibility [(3.74±0.67)(3.64±0.65)] and self-improvement [(3.78±0.75)(3.54±0.73)] decreased, while personal happiness [(3.46±0.77)(3.70±0.71)] and depression levels [(0.92±0.43)(0.99±0.50)] increased. Personal happiness T1 negatively predicted depression T2 (β=-0.21) by enhancing subjective well-being T2 (β=0.20), with a mediation effect of -0.04 (95%CI=-0.07 to -0.02)(all P < 0.01). Self-improvement T1 negatively predicted depression T2(β=-0.08, -0.20) by increasing sense of life meaning T2 (β=0.49) and through a serial mediation (sense of life meaning T2 →subjective well-being T2, β=0.29), with mediation effects of -0.04 (95%CI=-0.06 to -0.02) and -0.03 (95%CI=-0.04 to -0.02)(all P < 0.01). Collective responsibility negatively T1 predicted depression T2 (β=-0.08, -0.21) via separate pathways (sense of life meaning T2: β=0.29; subjective well-being T2: β=0.17) and a serial mediation (sense of life meaning T2→ subjective well-being T2, β=0.28), with mediation effects of -0.02 (95%CI=-0.04 to -0.01), -0.04 (95%CI=-0.07 to -0.01) and -0.02 (95%CI=-0.03 to -0.01)(all P < 0.01). Conclusion The three values influence depression through distinct psychological mechanisms, providing a basis for mental health interventions and values education.

Correlation between beverage dependence and sleep quality among college students

SHEN Jing, CHEN Junjun, LU Hongchun, XU Peipei, LI Guolian, NI Lin, DENG Zilong, WANG Fang, ZHAI Jinxia

2025, 46(8): 1125-1129. doi: 10.16835/j.cnki.1000-9817.2025250

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Objective To explore the relationship between beverage dependence and sleep quality among college students, providing empirical evidence for improving their sleep quality. Methods From December 2024 to January 2025, a convenience sampling method was used to conduct a questionnaire survey among 3 974 college students from four universities in Anhui Province. The Beverage Addiction Scale for College Students (BASCS) was used to assess beverage dependence, and the Self-rating Scale of Sleep(SRSS) was used to evaluate sleep quality. A multivariate Logistic regression model was employed to analyze the relationship between beverage dependence and sleep quality, and a restricted cubic spline model was used to examine the dose-response relationship between the two. Results The positive rate of beverage dependence symptoms among college students was 7.6%, with positive rates of 9.6%, 13.8%, and 7.4% for the withdrawal symptoms, health effects, and dependence symptoms dimensions, respectively. The detection rate of sleep disorders was 23.6%. Multivariate Logistic regression analysis showed that after adjusting for covariates such as grade, gender, and body mass index, compared with the no beverage dependence group, students with positive beverage dependence symptoms had a higher risk of sleep disorders(OR=3.71, 95%CI=2.87-4.80, P < 0.01). The OR(95%CI) for sleep disorders among students with positive symptoms in the withdrawal symptoms, health effects, and dependence symptoms dimensions were 2.80(2.22-3.53), 2.38(1.95-2.91), and 2.45(1.89-3.18)(all P < 0.01). Further analysis using a restricted cubic spline model revealed that the overall beverage dependence score and its three dimensional scores were approximately linearly related to the risk of sleep disorders among college students (all nonlinear P>0.05). Conclusions Beverage dependence is associated with sleep quality among college students. Schools should take multiple approaches, such as health education on beverage awareness, to improve students' sleep quality.

Association between parent-child relationship perceived by parents and students of junior high school and students' internalization problems

SUN Ji, BAN Yongfei, LUO Siliang

2025, 46(8): 1130-1133. doi: 10.16835/j.cnki.1000-9817.2025252

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Objective To explore the relationship between the parent-child relationship perceived by parents and students of junior high school and students' internalization problems, so as to provide a pathway for the prevention and control of students' internalization problems. Methods In June 2023, a convenience cluster sampling method and a matching method between students and their fathers/mothers were used to select 965 pairs of students and their fathers (or mothers) from three junior high schools in Guizhou Province, and the Middle School Student's Parent-Child Relationship Questionnaire (parent and student edition) and the Strengths and Difficulties Questionnaire (student edition) were used to measure the perception of parent-child relationship by parents and students and the internalization problems of students. The response surface analysis method was used to analyze the relationships between parents' and students' perceptions of parent-child relationship and students' internalization problems. Results The comparison of standardized scores revealed that 58.44% of parents and junior high school students had different perceptions of parent-child relationship. After controlling for students' gender, students' grade, and parents' education level, the results showed that when the parent-child relationship perceived by parents and students was congruent, the students' internalization problems increased with the decrease of parent-child relationship level (a₁=-0.43, 95%CI=-0.62 to -0.25, P < 0.05). When the parent-child relationship perceived by parents and students was incongruent, and the parent-child relationship perceived by parents was higher than that of students, students' internalization problems were more (a₃=-0.36, 95%CI=-0.51 to -0.19, P < 0.05). Conclusions Students' internalization problems are closely related to perceptions of parent-child relationship. Improving the quality of the parent-child relationship and paying attention to the differences in perception of the parent-child relationship are helpful for evaluating and intervening in the internalization problems of junior high school students.

Correlation of parent-child relationships with junior high school students bullying behaviors and social cohesion

YOU Lijun, LOU Chaohua, YU Chunyan, LIAN Qiguo, FANG Yuhang, TU Xiaowen, ZUO Xiayun

2025, 46(8): 1134-1137. doi: 10.16835/j.cnki.1000-9817.2025212

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Objective To examine the association between parent-child relationships and bullying behaviors among junior high school students, and to explore the moderating effect of community cohesion, so as to provide evidences for bullying intervention strategies. Methods From November to December 2017, a cluster sampling method was used to survey 1 589 students in grades 6-8 from three junior high schools in Jing'an District, Shanghai. Anonymous electronic questionnaires collected data on parent-child relationships, community cohesion, and bullying behaviors. Multivariate Logistic regression analyzed the associations and moderation effects. Results The prevalence of bullying behaviors among junior high school students was 7.80%. Spearman correlation analysis revealed negative associations between both parent-child relationships (r=-0.13) and community cohesion (r=-0.10) with bullying behaviors, while parent-child relationships positively correlated with community cohesion (r=0.29) (all P < 0.01). Junior high school students with positive parent-child relationships and higher perceived community cohesion showed lower risks of bullying behaviors (OR=0.51, 95%CI=0.36-0.72; OR=0.58, 95%CI=0.45-0.76), with a significant interaction effect between the two factors (all P < 0.05). Conclusions Positive parent-child relationships and community cohesion are negatively associated with bullying behaviors in middle school students. Supportive family relationships help reduce bullying, while stronger community cohesion enhances the protective effect of positive parent-child relationships against bullying.

Association of stress and psychological resilience with dietary behavior among middle school students

YU Xiaoyan, LU Weiyi, DU Landuoduo, ZHU Jingfen

2025, 46(8): 1138-1141. doi: 10.16835/j.cnki.1000-9817.2025232

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Objective To analyze the influence of stress and psychological resilience on the dietary behavior of middle school students so as to privide a basis for the development of policies and interventions aimed at improving middle school students dietary behavior. Methods A total of 8 874 middle school students in Shanghai were surveyed using stratified cluster random sampling method from November 2019 to January 2020. The questionnaire included general information, dietary behavior, Perceived Stress Scale (PSS-10) and Connor-Davidson Resilience Scale (CD-RISC-10). Factor analysis was used to analyze the dietary behavior model. Logistic regression model was used to explore the correlation between stress, psychological resilience and dietary behavior in adolescents. Besides, a structural equation model was established to analyze the mediating effect of psychological resilience on stress and dietary behavior. Results The total score of psychological resilience among middle school students was (27.99±9.83), and the total score of stress was (25.56±7.06). Factor analysis categorized dietary behavior into two types: the high-energy dietary behavior and balanced dietary behavior. High-energy dietary behavior exhibited statistically significant differences across genders and schooling stage (χ²=41.37, 204.03), while balanced dietary behavior showed statistically significant differences across schooling stage and socioeconomic status (χ²=130.23, 96.53) (all P < 0.01). Logistic regression analysis showed that adolescents with moderate and high stress levels had an increased risks of high-energy dietary behavior (OR=1.25, 95%CI=1.12-1.39; OR=1.58, 95%CI=1.39-1.79) and a reduced likelihood of reduced balanced dietary behavior (OR=0.73, 95%CI=0.65-0.81; OR=0.53, 95%CI=0.47-0.60); adolescents with high levels of psychological resilience had a decreased risk of high-energy dietary behavior (OR=0.73, 95%CI=0.65-0.83), and those with moderate and high resilience levels showed improved balanced dietary behavior (OR=1.45, 95%CI=1.29-1.62; OR=2.50, 95%CI=2.21-2.84) (all P < 0.01). The mediating effect of psychological resilience between stress and high-energy dietary behavior or balanced dietary behavior accounted for 15.61% and 56.10% of the total effects, respectively. Conclusions Stress and psychological resilience are the influencing factors of dietary behavior in middle school students. Psychological resilience have a partial mediating effect between stress and high-energy dietary behavior or balanced dietary behavior.

Effects of cumulative family risk on internalizing problems in university students

LU Fan, ZHAI Hongkun, HUO Qingqing, HUANG Bijuan

2025, 46(8): 1142-1146. doi: 10.16835/j.cnki.1000-9817.2025243

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Objective To explore effects of cumulative family risk in university students on individuals' internalizing problems, to elucidate the mediating roles of perceived social support and self-esteem in the relationship, so as to provide a basis for promoting university student's mental health. Methods Using longitudinal design, 1 207 freshmen from a university in Tianjin were randomly selected and surveyed in November 2023 (T1) and November 2024 (T2). The instruments included the Cumulative Family Risk Scale, the Perceived Social Support Scale, the Self-esteem Scale, and the College Student Mental Health Screening Scale. Structural equation modeling (SEM) was constructed, with Bootstrap method used to test mediating effects and to examine gender differences. Results The results showed that cumulative family risk at T1 with internalizing problems at T1(r=0.30) and internalizing problems at T2 (r=0.32) were significantly positively correlated (both P < 0.01). Mediation analysis indicated that the independent mediating effect of perceived social support at T1, cumulative family risk at T1 and internalizing problems at T2 was 0.03 (95%CI=0.02-0.05), and the independent mediating effect of self-esteem at T1 was 0.08 (95%CI=0.06-0.10) (both P < 0.05). The chain mediating effect of perceived social support and self-esteem at T1 was 0.02 (95%CI=0.02-0.03) (P < 0.05). Significant gender differences were observed in the path from cumulative family risk to self-esteem (β_male=-0.24, β_female=-0.35) and in the path from perceived social support to self-esteem (β_male=0.41, β_female=0.25) (all P < 0.05). Conclusion Cumulative family risk reduces internalizing behaviors in university students via internal and external development resources, with gender-specific mechanisms.

Association of physical exercise willingness and insomnia with depressive symptoms among college students

YIN Wenlong, CHAI Yehong, CHENG Tianbao, JIANG Zhihua, SUN Xiaolong, ZHANG Yi, WAN Yuhui

2025, 46(8): 1147-1150. doi: 10.16835/j.cnki.1000-9817.2025234

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Objective To understand the association of physical exercise willingness and insomnia with depressive symptoms among college students, so as to provide reference for improving depressive symptoms of college students. Methods From October 2022 to April 2023, cluster sampling was used to recruit 11 101 college students from four colleges in Anhui Province. The questionnaire survey was conducted to investigate the willingness to engage in physical exercise, insomnia and depressive symptoms of college students. The multivariate Logistic regression model was used to analyze the association of physical exercise willingness and insomnia with depressive symptoms of college students. Results The prevalence of depressive symptoms among college students was 9.24%. Multivariate Logistic regression analysis showed that college students who were passive participants/non-participants in physical activity, or who experienced insomnia, had a higher likelihood of depressive symptoms compared to those who were active participants or did not experience insomnia (OR=1.84, 2.07, 4.02, all P < 0.01). College students who were passive participants or non-participants in physical activity and concurrently experienced insomnia had a higher risk of depressive symptoms compared with those who were active participants or did not experience insomnia (OR=1.87-8.39, all P < 0.01). Gender stratified analysis showed that the combined effect of passive physical exercise and insomnia increased the risk of depressive symptoms in both male (OR=1.81-9.87) and female college students (OR=1.67-7.39) (all P < 0.05). Conclusions Both physical exercise willingness and insomnia are associated with depressive symptoms in college students. In order to improve the depressive symptoms of college students, it is necessary to improve the enthusiasm of physical exercise and strengthen the education of sleep health awareness.

Application of guided self-help intervention in college students with non-suicidal self-injury behaviors

GAO Chang, YAN Yehao, YANG Zhenzhen, ZHANG Cuicui, LIU Chuanxin

2025, 46(8): 1151-1155. doi: 10.16835/j.cnki.1000-9817.2025248

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Objective To explore the application effect of a guided self-help intervention based on dialectical behavior therapy (DBT) to address non-suicidal self-injury (NSSI) behavior among college students, so as to provide a reference for reducing the occurrence of NSSI behavior in this population. Methods A total of 106 college students with NSSI admitted to the Department of Child and Adolescent Psychology, the Second Affiliated Hospital of Jining Medical University from January 2021 to January 2023 were selected and divided into an observation group and a control group, with 53 cases in each group, using a random number table method. The control group received routine medication treatment and psychological intervention, while the observation group, on the basis of the interventions provided to the control group, implemented dialectical behavior therapy-based guided self-help. The approach combines group activities, individual counseling, and self-directed learning, covering four core modules: mindfulness training, distress tolerance, interpersonal effectiveness, and emotion regulation. Meanwhile, data collection, skill check-ins, and personalized recommendation pushes were conducted through a WeChat. Both groups were intervented for 12 weeks. Before the intervention and after the intervention, the Adolescent Non-suicidal Self-injury Behavior Questionnaire, Ottawa Self-injury Inventory (OSI), and Barratt Impulsiveness Scale (BIS) were used to evaluate the patients, and the levels of serum neurotransmitters were detected. The χ² test, t test, and Cochran's Q test were used for data comparison and analysis. Results The incidence rates of NSSI in the observation group after 3, 6, and 12 weeks of intervention were 47.17%, 16.98%, and 5.66%, respectively, all lower than those in the control group (67.92%, 35.85%, 20.75%) (χ²=4.67, 4.85, 5.27, all P < 0.05). After 12 weeks of intervention, in the NSSI Behavior Questionnaire, the total score of the observation group was (17.94±2.69) points, which was lower than that of the control group (23.04±5.11) points; in the Function Questionnaire, the total score of the observation group was (53.24±8.94) points, which was higher than that of the control group (47.74±8.00) points(both P < 0.05). In terms of the OSI, the total score of the observation group was (4.49±0.62) points, lower than that of the control group (6.25±0.81) points; in the BIS, the total score of the observation group was (80.76±7.94) points, lower than that of the control group (87.74±9.34) points, and the differences between groups were statistically significant(both P < 0.05). After the intervention, the level of 5-hydroxytryptamine in the observation group was (67.93±5.42) ng/mL, higher than (44.72±5.54) ng/mL of the control group; the levels of substance P and cortisol in the observation group were (35.82±4.47) ng/L and (75.64±8.02) μg/L, respectively, both lower than (48.14±5.32) ng/L and (94.53±10.78) μg/L of the control group, and the differences were statistically significant (all P < 0.05). Conclusion The guided self-help intervention based on DBT is helpful for reducing NSSI behavior among college students.

Association of pet ownership and daily outdoor activity duration with depressive symptoms among middle school students

YANG Tian, ZHANG Xiuhong, GAO Jianqiong, WEI Nana, LI Yiman, KANG Zhaoting

2025, 46(8): 1156-1159. doi: 10.16835/j.cnki.1000-9817.2025257

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Objective To examine the associations of pet ownership and daily outdoor activity duration with depressive symptoms in middle school students, so as to provide evidence for targeted prevention strategies of depressive symptoms in middle school students. Methods Using a stratified cluster random sampling method, 83 601 middle and high school students from 103 districts and counties in Inner Mongolia Autonomous Region were selected in 2024. A questionnaire survey was conducted to collect demographic data, household pet ownership, outdoor activity duration, and depressive symptoms of the research subjects. The comparison of reporting rates of depressive symptoms among different groups of middle school students was conducted using a χ² test. The association between pet ownership and outdoor activity duration and depressive symptoms among middle school students was evaluated using a Logistic regression model, and stratified analysis was conducted among different genders and regions to control for potential confounding factors and evaluate the stability of the association. Results The prevalence of depressive symptoms among middle-school students in Inner Mongolia was 17.2%. Significant differences in depressive symptom reporting rates were observed across sex, grade, ethnicity, surveillance site, parental education, menarche/spermarche status, boarding status, smoking and alcohol use, daily breakfast consumption, school bullying, continuous 30-minute headphone use in a noisy environment, and often use the Internet (χ²=8.07-2 672.57, all P < 0.01). Both pet ownership (OR=0.78, 95%CI=0.75-0.81) and ≥2 h/d of outdoor activity(OR=0.81, 95%CI=0.78-0.84) were inversely associated with depressive symptoms; compared to the without owning pets and < 2 h of outdoor activity daily group, students who both owned pets and engaged in ≥2 h of outdoor activity daily had an even lower risk (OR=0.83, 95%CI=0.78-0.87)(all P < 0.05). Conclusion Pet ownership and increased daily outdoor activity duration may help mitigate depressive symptoms among middle school students.

Association of poor sleep characteristics with coexistence of negative emotions and overweight/obesity among college students

ZHANG Lisha, LI Huihua, ZHANG Lifang, SONG Yongjing, SONG Jiancai, HUANG Bo

2025, 46(8): 1160-1165. doi: 10.16835/j.cnki.1000-9817.2025244

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Objective To analyze the association between poor sleep characteristics and the coexistence of negative emotions and overweight/obesity among college students, so as to provide a scientific basis for improving their physical and mental health. Methods From November to December 2023, a convenience sampling method was used to survey 6 600 college students from nine universities in Jiangxi, Hunan, and Hubei provinces. The Depression Anxiety and Stress Scale-21 (DASS-21), Insomnia Severity Index (ISI), Pittsburgh Sleep Quality Index (PSQI), and physical examinations were employed to assess negative emotions, poor sleep characteristics, and overweight/obesity. Chi-square test and Logistic regression were used to analyze the impact of poor sleep characteristics on the coexistence of negative emotions and overweight/obesity. Results The coexistence rates of different categories of negative emotions (depression, anxiety, stress) and overweight/obesity were 6.1% (n=405), 8.0% (n=529), and 3.3% (n=217), respectively. Gender, grade level, major, maternal education level, annual family income, physical activity level, only-child status, and carbonated beverage consumption were statistically associated with the coexistence rates of different categories of negative emotions and overweight/obesity (χ²=4.01-35.18, all P < 0.05). Logistic regression analysis showed that after adjusting for gender, grade level, major, only-child status, maternal education level, annual family income, physical activity level, and carbonated beverage consumption, poor sleep characteristics were significantly associated with an increased risk of the coexistence of negative emotions and overweight/obesity (OR=1.41-6.65); moderate and poor sleep quality levels were significantly associated with an increased risk of the coexistence of different categories of negative emotions and overweight/obesity among female students (OR=1.99-4.71) (all P < 0.05). Conclusions Poor sleep characteristics are associated with the coexistence of negative emotions and overweight/obesity among college students. Greater attention should be paid to sleep issues in this population, and sleep education should be actively promoted to reduce the risk of comorbid negative emotions and overweight/obesity.

Association of mother-child relationship with sleep quality and executive function among preschool children

CUI Xiaochen, HE Haiyan, ZHU Min, LI Ruoyu, WU Jun, WAN Yuhui

2025, 46(8): 1166-1169. doi: 10.16835/j.cnki.1000-9817.2025256

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Objective To investigate the mediating role of children's sleep quality in the association between mother-child relationship and the executive function of preschool children, providing a reference for promoting the development of the executive function of preschool children. Methods A stratified cluster sampling method was used to select 842 preschoolers from 12 kindergartens in Wuhu City, Anhui Province in December 2021 as the subjects of the first follow-up study with follow-up every six months thereafter. Finally, 746 children were included in the study after 3 follow-up. Spearman correlation analysis was used to explore the associations among mother-child relationship, sleep quality and executive function in preschool children. Bootstrap program and PROCESS software were applied to test the mediating effect of sleep quality in the association between mother-child relationship and the executive function of preschool children. Results Conflictual mother-child relationship was positively correlated with the total score of executive function, as well as scores of inhibitory, shifting, emotional control, working memory, and organizational planning (r=0.40, 0.37, 0.36, 0.41, 0.38, 0.34, all P < 0.05). Dependent mother-child relationship was positively correlated with the total score of executive function, as well as scores of inhibitory, shifting, emotional control, working memory, and organizational planning (r=0.23, 0.20, 0.21, 0.22, 0.22, 0.19, all P < 0.05). Sleep quality was positively correlated with the total executive function score (r=0.27, P < 0.01). After adjusting for confounding factors, sleep quality played a partial mediating role in the associations between dependent and conflictual mother-child relationships and executive function, the mediating effects were 19.40% and 11.22% respectively. Conclusions Sleep quality plays a mediating role in the association between mother-child relationship and the executive function of preschool children. Improving sleep quality in the early stage can promote the executive function of preschool children.

Associations between weekday-weekend screen time and subjective sleep quality among adolescents

CAO Runze, ZHAO Min, WANG Mingming, XI Bo

2025, 46(8): 1170-1174. doi: 10.16835/j.cnki.1000-9817.2025231

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Objective To explore the association between the joint association of screen time on weekdays and weekends with self-rated sleep quality among adolescents, providing scientific basis for improving adolescent sleep health. Methods Using data from "Huantai Children's Cardiovascular Health Follow-up Cohort" survey conducted during November to December 2023, a total of 1 197 adolescents aged 12-17 years with complete demographic characteristics, physical measurements, and questionnaire data were included. The dose-response relationship between screen time and sleep quality was evaluated by restrictive cubic splines (RCS). Based on screen time on weekdays and weekends (normal: < 2 h/d; excessive: ≥ 2 h/d), adolescents were categorized into 4 groups. Multivariate Logistic regression models were used to analyze the association between the combined effect of screen time on weekdays and weekends and sleep quality. Results The RCS analysis results showed that there was a linear dose-response relationship between average daily screen time and poor sleep quality in adolescents (non-linear P>0.05). The results of multiple Logistic regression analysis showed that adjusting for potential covariates, compared with adolescents having normal screen time on both weekdays and weekends, those with excessive screen time on both weekdays and weekends had increased risk of poor sleep quality (OR=2.51, 95%CI=1.33-4.62, P < 0.01). Sex-stratified analysis revealed that girls with excessive screen time on both weekdays and weekends had increased odds of poor sleep quality (OR=3.03, 95%CI=1.23-7.14, P=0.01), compared to girls who had normal screen time on both weekdays and weekends. Conclusions A linear dose-response relationship exists between daily screen time and poor sleep quality in adolescents. Excessive screen time on both weekdays and weekends is positively associated with poor sleep quality, particularly more pronounced among female adolescents.

Predicting model for the impact of Internet usage characteristics on suicidal ideation among vocational high school students

YU Bin, YAN Jingyan, ZHANG Liqun, XIAO Chenchang, LI Fang, GUO Yan, YAN Hong

2025, 46(8): 1175-1179. doi: 10.16835/j.cnki.1000-9817.2025242

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Objective To explore the association between the Internet usage characteristics and suicidal ideation among vocational high school students, so as to provide a theoretical basis for precise intervention of suicide among vocational high school students. Methods A total of 1 781 students were recruited from three vocational high schools in Wuhan and Xianning in March 2023 by using the cluster random sampling method. The Columbia-Suicide Severity Rating Scale and Revised Chen Internet Addiction Scale were used to measure suicidal ideation and Internet addiction, respectively. LASSO regression model was used to select influential factors related to suicidal ideation, and the gradient boosting decision tree algorithm XGBoost was used to develop prediction models and evaluate predictive performance. By calculating the SHAP values, the contribution of each influential factor was quantified. Results The prevalence of suicidal ideation among vocational high school students was 42.22% and prevalence of Internet addiction was 26.39%. LASSO regression results indicated that age, gender, experience of being left behind, parental relationship, holding a class cadre position, using the Internet for learning, Internet use during dawn, morning and late night, Internet addiction, and depressive symptoms were all the influential factors of suicidal ideation among vocational high school students (β=-0.05, 0.29, 0.09, 0.27, 0.10, -0.01, 0.09, 0.05, 0.24, 0.28, 0.78, all P < 0.05). The AUC of the prediction model was 0.75. The results based on SHAP values indicated that all influential factors identified through multivariate analysis contributed positively to the model predictions (SHAP>0). Among these, depressive symptoms and parental relationship had the greatest impact on suicidal ideation (SHAP=0.77, 0.26), and the joint effect of features with higher contribution could improve the prediction probability. Conclusions Depressive symptoms, parental relationships, Internet addiction, and time of Internet use are most important risk factors of suicidal behaviors for vocational high school students. Thus, effective interventions should be conducted to reduce their suicidal ideation.

Association of serum alanine aminotransferase level with left ventricular hypertrophy in adolescents

JIA Peng, ZHAO Min, SUN Jiahong, XI Bo

2025, 46(8): 1180-1184. doi: 10.16835/j.cnki.1000-9817.2025258

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Objective To investigate the association of serum alanine aminotransferase (ALT) with left ventricular hypertrophy (LVH) in adolescents, and to provide scientific evidence for the early screening and intervention strategy of cardiac structure damage. Methods Data were obtained from the third follow-up survey (October 2023) of the "Huantai Childhood Cardiovascular Health Cohort Study", including 1 156 healthy adolescents aged 12-17 with complete information. The sample population was stratified into low (Q1 group), medium (Q2 group), and high (Q3 group) ALT levels based on tertiles within the same gender and age groups. Inter-group comparisons were conducted using analysis of variance and trend test. A multivariate Logistic regression model was used to analyze the association between ALT levels and LVH, and stratified analyses were performed by gender and age groups. Results With the increase of ALT quantile level, the detection rate of LVH showed an increasing trend (Q1: 3.7%; Q2: 10.6%; Q3: 16.7%, Z=5.89, P < 0.01). After adjusting for potential covariates, compared with the ALT group (Q1), the group (Q3) increased the risk of developing LVH in adolescents (OR=2.09, 95%CI=1.21-4.12). Stratified analyses by age and sex showed a significant association only in boys and younger individuals aged 12 to 14 years [OR (95%CI) were 2.64(1.04-7.67) and 3.24(1.35-9.06), both P < 0.05)]. Conclusion Elevated serum ALT levels are associated with an increased risk of LVH in adolescents, and early detection and control of abnormal liver enzyme levels can help reduce early vascular structural damage and prevent adverse cardiovascular events.

Effects of exercise combined with dietary intervention on vascular endothelial function and ferroptosis in obese female university students

YANG Mei, CHEN Anping, WANG Jingjing, SU Xiaoyun

2025, 46(8): 1185-1189. doi: 10.16835/j.cnki.1000-9817.2025235

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Objective To compare the effects of aerobic exercise at maximal fat oxidation (FATmax) and FATmax intensity exercise combined with resistance training (RT), and dietary restriction on the body composition, vascular endothelial function and ferroptosis in obese female university students, so as to provide a reference for exploring the mechanisms by which exercise improves vascular endothelial function. Methods From February to May 2024, 70 obese female university students were recruited from Shanxi University and randomly divided into control group (n=24), FATmax group (n=24) and FATmax+RT group (n=22). From March 4 to May 26, 2024 control group maintained their normal living habits, FATmax group performed aerobic exercise at FATmax intensity three times per week for 60 minutes per session; FATmax +RT group performed combined aerobic and resistance exercise at FATmax intensity three times per week for 60 minutes per session. The daily dietary calorie intake for all groups was determined according to resting energy expenditure. Body composition, vascular endothelial function and ferroptosis were measured before and after the intervention. Results After 12 weeks of intervention, there were statistically significant differences in body mass, BMI, body fat, waist-hip ratio and muscle mass among the three groups (F=10.93, 5.88, 65.28, 21.14, 2.25, all P < 0.05). Compared with the control group, participants in both the FATmax group and the FATmax+RT group showed significant reductions in body weight, BMI, body fat and waist-hip ratio (all P < 0.05). Body fat and waist-hip ratio in FATmax+RT group were lower than those in FATmax group, and muscle mass was higher than those in FATmax group and control group (both P < 0.05). After 12 weeks of intervention, significant differences were observed among the three groups in serum NO, GSH, serum ferritin levels and FMD (F=9.14, 9.67, 4.78, 135.70, all P < 0.05). Compared with the control group, the serum NO, GSH levels and FMD significantly increased, and the serum ferritin level decreased (all P < 0.05) of obese female university students in FATmax group and FATmax+RT group. Serum GSH level and FMD increased and serum ferritin level decreased in FATmax +RT group when compared with FATmax group (all P < 0.05). Conclusions With the same exercise training duration and frequency, FATmax intensity aerobic exercise, alone or combined with resistance and dietary restriction, can significantly improve the body composition, vascular endothelial function and inhibit ferroptosis of obese female university students. However, FATmax intensity aerobic exercise combined with resistance training has more pronounced effects.

Relationship between home reading-writing illuminance and screening myopia among children and adolescents

ZHANG Jingji, LUO Chunyan, YANG Huijuan, YANG Dongling, HUANG Shenglei, ZHENG Keyang, QU Shuangxiao

2025, 46(8): 1190-1193. doi: 10.16835/j.cnki.1000-9817.2025225

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Objective To understand the home reading-writing levels among children and adolescents in Shanghai after school, and to explore its association with screening myopia, so as to provide a scientific basis for the prevention and control of myopia. Methods From April to December 2024, 641 primary and middle school students were recruited from 2 urban schools and 1 rural school in Shanghai to participate in the survey. An illuminance meter was used to measure the illuminance of home reading-writing activities after school. Screening myopia was determined through visual acuity examination and refractive detection under non ciliary muscle paralysis conditions among children and adolescents. A binary Logistic regression model was used to analyze the association between home reading-writing illuminance and screening myopia. Results The detection rate of screening myopia among children and adolescents in Shanghai was 59.9%. The median home reading-writing illuminance after school was 340.9(112.2, 753.5) lx, and 45.4% was found of less than 300 lx. The family illuminance in the primary school stage [432.0 (136.9, 837.0) lx] was higher than that in the junior high school stage [113.1(53.7, 375.1) lx], and main urban area group [503.9 (212.6, 969.5) lx] was higher than that in the rural group [141.6 (53.7, 416.9) lx], the differences were statistically significant (Z=-7.56, -9.95, both P < 0.05). The results of Logistic regression analysis showed that compared with the family illuminance of 150-500 lx, children and adolescents with family illuminance < 150 and >500 lx had increased risks of screening myopia detection[OR(95%CI)=1.56(1.01-2.42), 1.74(1.15-2.62), both P < 0.05]. Conclusions The home reading-writing illuminance after school is suboptimal. Both excessively low and high home reading-writing illuminance levels are associated with screen-detected myopia. It is necessary for children and adolescents to improve lighting conditions during evening reading-writing activities, and strengthen health education according to different regions and school stages.

Distribution of pupil diameter and its association with myopia in school-age children

GONG Yizhuo, YU Junli, YAO Xianwei, HUO Huanhuan, MA Xiaohui, LIU Guoyong, XU Qian, HU Yuanyuan, BI Hongsheng

2025, 46(8): 1194-1197. doi: 10.16835/j.cnki.1000-9817.2025233

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Objective To investigate the distribution of pupil diameter and its association with myopia in school-age children, providing ideas into the mechanisms of the role of pupil diameter in the onset and development of myopia. Methods Adopting a combination of stratified cluster random sampling and convenience sampling method, 3 839 children from six schools in Shandong Province were included in September 2021. Pupil diameters distribution was analyzed by age, sex, and myopic status. Pearson correlation analysis was used to assess the relationship between pupil diameter and cycloplegic spherical equivalent (SE), as well as axial length (AL) and other variables. Propensity score matching (PSM) was applied to match myopic and non-myopic children at a 1∶1 ratio based on age and sex. A generalized linear model (GLM) was constructed with pupil diameter as the dependent variable to identify independent factors influencing pupil size and its association with myopia. Results The mean pupil diameter of school-age children was (5.77±0.80)mm. Pupil diameter exhibited a significant increasing trend with age (F=49.34, P_trend < 0.01). Myopic children had a significantly larger mean pupil diameter compared to non-myopic children with a statistically significant difference(t=18.10, P < 0.01). Multivariable GLM analysis, adjusted for age, amplitude of accommodation, and uncorrected visual acuity, revealed a negative correlation between pupil diameter and cycloplegic SE (before PSM: β=-0.089, after PSM: β=-0.063, both P < 0.01). Conclusions Myopic school-age children exhibite larger pupil diameters than their non-myopic counterparts. Pupil diameter may serve as a potential indicator for monitoring myopia development in school-age children.

Determinants and prediction model construction of coexistence of myopia, overweight/obesity and depressive symptoms among middle school students in Quzhou City

XU Haoxuan, WANG Shengxian, REN Fei, DAI Liping, LAI Shiming, ZHAO Shiguang

2025, 46(8): 1198-1202. doi: 10.16835/j.cnki.1000-9817.2025229

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Abstract:
Objective To investigate the coexistence of comorbidity of myopia, overweight/obesity and depressive symptoms among middle school students in Quzhou and its associated factors, so as to provide evidence for integrated prevention and control of common multiple health issues in students. Methods From September to November 2023, a total of 5 867 middle school students from 6 counties (cities and districts) in Quzhou City were selected by stratified random cluster sampling. Physical and visual examinations were conducted, and the Center for Epidemiological Studies - Depression Scale (CES-D) along with a questionnaire on health status and influencing factors were completed. Multivariate Logistic regression was used to analyze the related factors of coexistence of myopia, overweight/obesity, and depressive symptoms among middle school students, and a nomogram model was constructed based on the results. Results A total of 161 middle school students in Quzhou City were identified as having comorbid myopia, overweight/ obesity and depressive symptoms, with a detection rate of 2.74%. The results of multivariate Logistic regression analysis showed that the coexistence of myopia, overweight/obesity and depressive symptoms increased among middle school students with older age (OR=1.11), a greater number unhealthy dietary behaviors (1, 2, ≥3; OR=2.40, 2.70, 4.63), insufficient sleep(OR=1.78) and alcohol consumption (OR=2.11)(all P < 0.05). Compared with no homework after class, those whose homework duration after class was 1 to < 2 hour had a lower risk of comorbidity of myopia, overweight/obesity and depressive symptoms (OR=0.53, P < 0.05). The results of the nomogram model showed that the AUC (95%CI) was 0.71 (0.67-0.74). Conclusions The coexistence of myopia, overweight/obesity and depressive symptoms among middle school students in Quzhou City is related to age, sleeping, alcohol consumption, poor dietary behavior and the duration of after-school homework. The nomogram model can assist in the early screening and intervention of multiple health issues among students.

Epidemiological analysis of alcohol poisoning among minors in Zhengzhou City

XUE Yingying, LU Libin, MEI Shiyue, LI Muzi, CHENG Yibing

2025, 46(8): 1203-1206. doi: 10.16835/j.cnki.1000-9817.2025195

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Abstract:
Objective To analyze the characteristics of alcohol poisoning cases among minors receiving pre-hospital 120 emergency services in Zhengzhou, providing evidence for regional management strategies of alcohol poisoning among minors. Methods A retrospective study was conducted on 1 630 alcohol poisoning cases (aged 0-18 years) from Zhengzhou's 120 emergency system during 2017-2019 and 2023. Data on gender, age, occurrence timeframes were analyzed using t-test and χ² test for intergroup comparisons. Results Annual cases were 291 (2017), 353 (2018), 483 (2019), and 503 (2023). Compared with 2017, male alcohol poisoning cases increased by 66.94% while female cases surged 104.35% by 2023. The peak incidence of alcohol poisoning among minors occurred among 16-18-year-olds (85.40%), followed by 13-15-year-olds (13.74%). Most cases clustered between 21:01-03:00 (60.43%), with male cases peaking at 22:01-23:00 (12.73%) and female cases peaking at 02:01-03:00 (11.25%). Between 00:01-03:00, male cases progressively decreased while female cases increased. Severity distribution showed 355 mild cases (21.78%), 1 035 moderate cases (63.50%), and 240 severe cases (14.72%). Conclusions Zhengzhou region has experienced sustained growth in underage alcohol poisoning cases, predominantly occurring from evening to early morning with moderate severity, female cases demonstrate faster growth rates. Multifaceted regulatory measures should be implemented to strengthen supervision of underage drinking behaviors.

Research progress on the influence of prenatal exposure to per- and polyfluoroalkyl substances and offspring physical growth

LÜ Jinlang, WANG Haijun

2025, 46(8): 1207-1211. doi: 10.16835/j.cnki.1000-9817.2025230

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Abstract:
Exposure to per- and polyfuloroalkyl substances(PFASs) during pregnancy may pose hazards to fetuses at the sensitive early stage of life, impacting intrauterine and postnatal growth and development. By reviewing existing domestic and international studies, the article summarizes the internal exposure levels of PFASs in pregnant women from different countries and regions, and clarifies the impact of prenatal PFASs exposure on the growth and development of offspring and potential biological mechanisms, so as to provide a basis for subsequent cohort studies and the formulation of protective policies.

Impact of sports participation on suicide risk among adolescents and countermeasures

SHI Peng, XU Heng, HUANG Meirong

2025, 46(8): 1212-1216. doi: 10.16835/j.cnki.1000-9817.2025254

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Abstract:
To clarify the relationship between sports participation and adolescent suicide risk, as well as its underlying mechanisms for preventing suicidal behaviors, the study employs a literature review approach to analyze, synthesize, and summarize relevant research. The findings reveal that physical exercise can reduce suicide rates among middle school students, with high-intensity aerobic exercise performed 5-7 days per week demonstrating the most significant effect. However, daily physical activity and muscle-strengthening exercises show no significant correlation with suicide-related behaviors. The mechanisms through which physical activity reduces the risk of suicide among adolescents include emotional release leading to self-help skills, helping adolescents build social connections, and improving physical and brain function. It is recommended that families and schools help adolescents discover the joy of participating in sports, assist in forming sports teams, and ensure at least 60 minutes of moderate to vigorous physical activity daily to reduce the risk of suicidal behavior among adolescents.

Current Issue 2025 Vol. 46, No. 8

Current Issue
2025 Vol. 46, No. 8