Introduction Metabolic syndrome (MetS) poses a significant public health challenge among employed adults. Lifestyle modifications have been shown to be effective in preventing the onset and progression of MetS in employed adults, and the widespread adoption of mobile and wearable technologies introduces an appealing approach to mHealth lifestyle interventions. When widely implementing smartphone-based interventions for employed adults, enhancing equitable access and promoting wearable device use for those with MetS is a more cost-effective way to reduce health disparities, particularly in resource-limited settings. However, relevant evidence is currently lacking.Objective This study aims to design an mHealth-based Healthy Lifestyle Promotion (MYLIFE) trial, a three-arm randomised controlled trial (RCT), to evaluate the effectiveness of a smartphone-based lifestyle intervention and a combined smartphone-based lifestyle intervention with intensive intervention for MetS individuals using wearable devices, in reducing MetS risk among employed adults.Methods and analysis This is a three-arm, parallel, single-blind, cluster RCT with a 12-week intervention and a total follow-up of 1 year. The trial will recruit 120 workplaces from the Chinese Cohort of Working Adults in a 1:1:1 ratio to either a control group or one of two intervention groups. Within these workplaces, a total of at least 348 eligible participants will be enrolled. The regular mHealth group will receive smartphone-based intervention. The intensive mHealth group will receive smartphone-based intervention for all participants, and an additional wearable device-intensive intervention for those with MetS. The primary outcome is the Chinese MetS Z score at 12 weeks. Secondary outcomes include MetS Z score, prevalence of MetS, specific MetS components, questionnaire-based indicators, and clinical outcomes at 12 weeks and 1 years. The main analysis will follow the intention-to-treat principle, using mixed-effects models to assess between-group differences in outcomes.Ethics and dissemination The protocol has been approved by the Ethics Committee of the West China School of Public Health and the West China Fourth Hospital, Sichuan University (Gwll2025024). The findings will be published in peer-reviewed journals and presented at scientific conferences.Trial registration number ChiCTR2500101904.

This study investigated the associations between outdoor artificial light at night (ALAN) and type 2 diabetes (T2DM) and metabolic syndrome (MetS) and aimed to characterize the dose-response relationships and potential exposure thresholds. This cross-sectional study included 57,898 Chinese adults who underwent health examinations in Hubei, China, from January 2013 to June 2025 in T2DM analysis. A subset of 25,735 participants with complete data was analyzed for MetS. ALAN exposure was estimated using satellite-derived nighttime light intensity (NPP‑VIIRS‑like data) within a 500 m radius of each residence. Multivariable logistic regression models estimated odds ratios (ORs) and 95

Postmenopausal osteoporosis (PMOP) has high morbidity and devastating complications. However, few studies explored the modifying role of different types of physical activity (PA) in the associations between the number of pregnancies as well as livebirths and the odds of PMOP. This study aimed to investigate the associations of the number of pregnancies and livebirths with PMOP odds. This study used the baseline of the China Multi-Ethnic Cohort study, and a total of 27,459 postmenopausal women were recruited. Bone mineral density and quantitative ultrasound index were measured by quantitative ultrasound bone densitometer. Number of pregnancies and number of livebirths were collected by questionnaires. PA was classified into occupational, transportation, housework, and leisure PA. Logistic regression and multiple linear regression were used to analyze the associations between the number of pregnancies and livebirths and PMOP odds. The modifying effects of PA and its domain-specific types in the associations were analyzed by interaction analysis. A total of 1,539 (5.6

Blue space has been considered a key environmental determinant of metabolic health worldwide. However, the existing relevant studies have focused on only water quantity. Here we investigate the associations of water quantity and quality with metabolic syndrome (MetS) and the underlying potential mechanisms. Our results show that, within 1-km buffer zones around the participants' residence, a higher MetS risk was associated with lower water area percentage (odds ratio of 0.942 (0.895 to 0.992)) and higher frequency of appearance of black-odorous water (FABOW) (odds ratio of 1.220 (1.062 to 1.402)). At large spatial scales (3-5 km), FABOW reversed protective effects of water area percentage when water quality was poor. The association between higher FABOW and MetS risk was mediated partly by reduced moderate-to-vigorous physical activity at small scales (1-2 km) and by elevated particulate matter with aerodynamic diameter <2.5 & micro;m concentration at large scales (3-5 km). This study underscores the importance of considering water quality in assessing the health effects of blue space, advancing the progress towards several sustainable development goals (for example, good health and wellbeing, clean water and sanitation and sustainable cities and communities).

Background:The impact of moderate drinking on the risk of liver fibrosis in non-alcoholic fatty liver disease (NAFLD) remains controversial worldwide. Notably, China, with the fastest-growing incidence of NAFLD and the highest number of alcohol-attributable deaths globally, has relatively few studies addressing this issue. This study aimed to explore the association between alcohol consumption and liver fibrosis in Chinese men with metabolic dysfunction-associated steatotic liver disease (MASLD). Methods:We recruited 4,683 male employees diagnosed with MASLD from southwest China, including 4,287 with pure MASLD and 396 with metabolic and alcohol-related liver disease (MetALD) who consumed increased alcohol (30-60 g/d). Advanced fibrosis was defined as a fibrosis-4 index (FIB-4) ≥ 2.67, and FIB-4 ≥ 1.30 indicated an intermediate/high probability of hepatic fibrosis. Logistic regression models were used to assess the association between alcohol consumption and hepatic fibrosis, and analyze the modification effect of body mass index (BMI) and waist-to-hip ratio (WHR) on the association. Propensity score matching method was used to test the robustness of the regression results. Results:Compared with non-drinkers, both moderate (OR = 3.02, 95% CI: 1.16-10.31) and increased alcohol consumption (OR = 4.64, 95% CI: 1.60-16.82) were significantly associated with an increased risk of advanced fibrosis in males with MASLD. Additionally, moderate (OR = 1.33, 95% CI: 1.07-1.66) and increased drinking (OR = 1.74, 95% CI: 1.28-2.34) were associated with intermediate/high probability of hepatic fibrosis, with similar results from logistic regression analysis in propensity score-matched cases. Trend analysis revealed the risk of hepatic fibrosis increased with increasing alcohol intake (FIB-4 ≥ 1.30, p for trend < 0.001; FIB-4 ≥ 2.67, p for trend = 0.007). Further subgroup analysis showed that the association between moderate drinking and intermediate/high probability of hepatic fibrosis was predominantly observed in males with BMI ≥ 23 kg/m2 (OR = 1.35, 95% CI: 1.08-1.69) and those with WHR ≥ 0.9 (OR = 1.40, 95% CI: 1.11-1.78). Conclusion:In China, moderate alcohol intake may heighten the risk of hepatic fibrosis in males with MASLD who are overweight/obese or have abdominal obesity. Moreover, males with MetALD may have a higher risk of fibrosis compared to those with pure MASLD.

Whether the role of gut microbial features lies in the pathways from lifestyles to dyslipidemia remains unclear. In this cross-sectional study, we conducted a metagenome-wide association analysis and fecal metabolomic profiling in 994 adults from the China Multi-Ethnic cohort. A total of 26 microbial species were identified as mediators between lifestyle factors and risk for dyslipidemia. Specifically, the abundance of [Ruminococcus] gnavus mediated the associations between lifestyles and risks for dyslipidemia, elevated low-density lipoprotein cholesterol, elevated total cholesterol, and elevated triglycerides. [Ruminococcus] gnavus, Alistipes shahii, and Lachnospira eligens were replicated to be associated with dyslipidemia in an external validation cohort. The potential metabolic pathways included arachidonic acid, bile acid, and aromatic amino-acid metabolism.

Physical activity (PA) engagement can improve bone mineral density (BMD), while how varying PA patterns affect BMD in adults and the potential mechanisms remain unclear. This study investigated the associations between PA trajectories and BMD and examined whether skeletal muscle and body fat partially explained these associations. In total, 393 participants from the Healthy Lifestyle Promotion Cohort completed three waves of surveys from 2018 to 2023. PA trajectories were identified using an optimal Latent Class Trajectory Modeling method. Areal BMD (aBMD) at the hip and volumetric BMD (vBMD) at the lumbar spine were derived from Quantitative Computed Tomography, and skeletal muscle index (SMI) and percent body fat (PBF) were measured using multi-frequency bioelectrical impedance analysis. The associations between PA trajectories and current BMD were estimated by regression models, and indirect associations through SMI and PBF were determined using a regression-based mediation analysis. Four PA trajectories were observed, including steady low-PA (44.53

BACKGROUND:Mental health issues are severe public health problems, inevitably affected by, also affecting, sleep. We used network analysis to estimate the relationship among various aspects of sleep and mental health simultaneously, and identify potential action points for improving sleep and mental health among employees.METHODS:We used data from the baseline survey of the Chinese Cohort of Working Adults that recruited 31,105 employees between October 1st and December 31st, 2021. The mental health included anxiety (measured by the Generalized Anxiety Disorder-7), depression (Patient Health Questionnaire-9]), loneliness (Short Loneliness Scale), well-being (Short Scales of Flourishing and Positive and Negative Feelings), and implicit health attitude (Lay Theory of Health Measures). Seven dimensions of sleep were assessed by the Pittsburgh Sleep Quality Index. An undirected network model and two directed network approaches, including Bayesian Directed Acyclic Graphs (DAGs) and Evidence Synthesis for Constructing-DAGs (ESC-DAGs), were applied to investigate associations between variables and identify key variables.RESULTS:Depression, daytime dysfunction, and well-being were the "bridges" connecting the domains of sleep and mental health in the undirected network, and were in the main pathway connecting most variables in the Bayesian DAG. Anxiety constituted a gateway that activated other sleep and mental health variables, with sleep duration and implicit health attitude forming end points of the pathway. Similar directed pathways were confirmed in the ESC-DAG.CONCLUSION:Our network study suggests anxiety, depression, well-being, and daytime dysfunction may be potential action points in preventing the development of poor sleep and mental health outcomes for employees.

BACKGROUND:Cardiovascular diseases are among the most common and clinically significant comorbidities of chronic obstructive pulmonary disease (COPD). Exercise has been shown to reduce the risk of cardiovascular diseases, and high-intensity inspiratory muscle training (H-IMT) has emerged as a promising intervention for improving arterial stiffness in individuals with COPD. Yet, there is limited evidence from randomized controlled trials (RCTs) regarding the impact of H-IMT alone or in combination with exercise on reducing arterial stiffness in COPD. We designed a three-arm RCT to evaluate the effectiveness of H-IMT, both alone and in combination with exercise, in reducing brachial-ankle pulse wave velocity (baPWV) in individuals with stable COPD within a community setting. METHODS:This is a three-arm, parallel-group, assessor-blinded, randomized controlled trial with an eight-week intervention period and a 24-week follow-up. The trial will recruit a total of at least 162 participants with stable COPD. All participants will undergo arterial stiffness assessment using an atherosclerosis detector. Eligible participants will then be randomized into either a control group or one of two intervention groups: an H-IMT group combined with aerobic and resistance trainin, or an H-IMT group alone. The primary outcome is the baPWV at eight weeks. Secondary outcomes include baPWV at 4, 16, and 32 weeks, along with self-reported lifestyle factors, sleep quality, mental health outcomes, self-efficacy, implicit health attitudes, quality of life, and clinical outcomes at 4, 8, 16, and 32 weeks. The main analysis will follow the intention-to-treat principle, with the difference in outcome between groups analyzed using multi-level regression at eight weeks. DISCUSSION:This study will provide evidence on the effects of H-IMT and combined exercise interventions for individuals with COPD in a community setting, offering insights into the use of integrated approaches to enhance cardiovascular health among community-dwelling residents. TRIAL REGISTRATION NUMBER:ChiCTR2400085483. Date of registration: June 7, 2024. https://www.chictr.org.cn/index.aspx .

目的 昼夜节律综合征(Circadian Syndrome,CircS)对认知功能影响尚未明确,本研究探讨我国中老年人群CircS变化与认知功能的关系.方法 基于中国健康与养老追踪调查全国调查数据队列,采用2011年的基线数据和2015年的随访数据,共纳入4055名中老年人作为研究对象,根据基线和随访均未患有CircS、仅随访诊断为患有CircS、基线患有CircS但随访时康复、基线和随访均患有CircS四种变化状态,以随访时认知功能为结局变量,采用广义估计模型分析CircS状态变化对认知功能的影响.结果 以基线和随访均未患有CircS的人群为参照组,仅随访患有CircS中老年人群认知功能平均得分下降最多(0.598分,x2=9.780,P=0.002),其次是基线和随访均患有CircS的人群(0.529分,x2=11.460,P=0.001),基线患有CircS但随访时康复人群认知功能平均得分也呈现降低,但无统计学意义(0.284分,x2=3.400,P=0.065).亚组分析显示,在基线和随访均患有CircS人群中,农村中老年人(0.954分,x2=7.030,P＜0.05)、有饮酒史的中老年人(0.931分,x2=13.540,P＜0.05)认知功能平均得分下降最多;日常生活活动能力限制的人群中,仅随访诊断为患有CircS的人群认知功能显著下降(0.804分,x2=10.970,P＜0.05).结论 我国中老年人群中仅随访诊断患有以及基线和随访均患有CircS人群认知功能损害较为严重,尤其在农村人群、有饮酒史和日常生活能力受限人群中表现更为明显.

Objective:To explore the relationship between illness perceptions and disability, and the relative importance of association of illness perceptions items and disability in HIV-infected people aged ≥50 years in Sichuan Province.Methods:By using multi-stage cluster sampling, the baseline data of a cohort of HIV-infected people aged ≥50 years in 5 counties (district) in Sichuan were obtained from 2018 to 2021. The disability was evalauted with instrumental activities of daily living scale (IADL), and the illness perception was evaluated by using brief illness perception questionnaire. General additive model and general linear model were used to analyze the association between illness perceptions and IADL. Weighted sum quartile sum regression was used to find the dominant items on the association. Software R was used for statistical anlysis.Results:A total of 1 587 HIV-inbfected peoeple aged ≥50 years were included in this study. The prevalence of disability was 26.1% ( n=414). The median score of illness perception was 33. The illness perceptions had a negative effect on the IADL score ( β=-0.15, P<0.001) and the partial score of IADL declined when illness perception score was larger than 38 ( P<0.05). Personal control (32.98%) and consequence (22.50%) whose weight were higher than average (12.50%) were the dominant items on the association between the score of illness perception and IADL score. Conclusions:The prevalence of disability in HIV-infected people aged ≥50 years in Sichuan was high. It is necessary to intervent on personal control and consequence in HIV-infected people aged ≥50 years when their illness perception scores are high to prevent the incidence and development of disability.

目的 探索四川省中老年HIV/AIDS患者抑郁症状、焦虑症状和抗逆转录病毒治疗服药依从性的关系,为改善该人群服药依从性提供科学依据.方法 在四川省的艾滋病高发县区,对符合纳入标准的对象进行调查,采用抑郁症筛查量表(PHQ-9)和广泛性焦虑障碍量表(GAD-7)测量心理健康,自我报告法判断服药依从性,单因素分析,多因素二元logistic回归分析抑郁、焦虑症状和服药依从性的关系,亚组分析探索不同人群间是否存在差异.结果 共1 288人完成了调查,抑郁症状总分的均分为(4.43±4.90)分,焦虑症状总分的均分为(2.75±4.24)分,调查对象中依从的占85.56％,不依从的占14.44％.多因素分析显示,抑郁症状与服药依从性呈负相关,且症状越明显关联强度越大(轻度:OR=0.58,95％CI:0.38～0.89;中度:OR=0.51,95％CI:0.28～0.94;重度:0R=0.42,95％CI:0.18～0.95).轻度焦虑与依从性正相关(OR=1.71,95％CI:1.01～2.93).亚组分析显示,抑郁、焦虑症状对服药依从性的影响在不同户口性质的人群间存在差异.结论 中老年HIV/AIDS患者的心理健康是其抗病毒治疗服药依从性的重要影响因素,不同程度的抑郁、焦虑症状和不同人群间对依从性的影响也不同.可以根据不同人群提供相应的心理支持,提高其服药依从性,改善健康状况.

BACKGROUND:Perceived noise at work may contribute more to worsening mental health than objectively measured noise. However, evidence regarding this association is scarce. We investigated the associations of perceived noise at work with anxiety and depression and identified vulnerable subpopulations. METHODS:Data from 28,661 participants of the Chinese Cohort of Working Adults (CCWA) were analyzed. Logistic or multinomial logistic regression models were used to determine associations between perceived noise at work and the severity of probable anxiety, depression, and their comorbidity. The generalized additive model with restricted cubic splines was applied to estimate the non-linear trend of associations. RESULTS:The mean age of participants was 36.55 ± 10.42 years. We observed that a higher level of perceived noise at work was associated with a higher risk of severe anxiety (OR = 1.55. 95%CI: 1.51-1.59) and severe depression (OR = 1.77. 95%CI: 1.72-1.84). More perceived noise at work was further associated with increased odds of comorbid anxiety and depression (OR = 1.28, 95%CI: 1.26-1.30). We observed an approximately J-shaped curve for the association between perceived noise at work with anxiety, depression, and their comorbidity. Participants, who were male, aged <45 years, had high education levels, and worked on trains were characterized by a greater impact of perceived noise at work on mental health problems. CONCLUSION:Increased perceived noise at work was associated with an elevated risk of anxiety, depression, and their comorbidity. These associations were moderated by sex, age, education level and occupation. Interventions targeting perceived noise at work may promote employed adults' mental health.

Abstract Background Little is known about the epidemiologic features of syndactyly (SD) in Chinese newborns. Methods Using 2007–2019 data from the Chinese Birth Defects Monitoring Network, we conducted a prevalence analysis on overall, isolated and associated syndactyly according to birth year, maternal age, maternal residence, geographic region and infant sex, with special interests in time trends, perinatal outcomes and clinical phenotypes. Results A total of 13,611 SD cases were identified among 24,157,719 births in the study period, yielding the prevalence of 5.63, 4.66 and 0.97 per 10,000 for overall, isolated, and associated SD, respectively. The prevalence of each type of SD exhibited an upward trend over the period. The prevalence of overall SD varied significantly by maternal residence (urban vs. rural, 6.69/10,000 vs. 4.35/10,000), maternal age (< 20 years, 5.43/10,000; 20–24 years, 5.03/10,000; 25–29 year, 5.65/10,000; 30–34 years, 6.07/10,000; ≥ 35 years, 5.76/10,000), geographic region (central, 5.07/10,000; east, 6.75/10,000; west, 5.12/10,000), and infant sex (male vs. female, 6.28/10,000 vs. 4.86/10,000). Newborns with associated SD were more likely to be born prematurely (29.2% vs. 10.6%) or with low birthweight (30.5% vs.9.8%) than those with isolated SD. The bilaterally, and unilaterally affected cases accounted for 18.4% and 76.7%, respectively. The feet were more frequently involved (64.3%) in those bilaterally affected cases, while right side preference (right vs left: 53.8% vs 46.2%) and upper limbs preference (hand vs foot: 50.8% vs 48.0%) were found in unilateral cases. Conclusions The prevalence of syndactyly in China is on the rise and notably higher than that in other Asian and European countries, highlighting the importance of investigating the etiology, epidemiology, and clinical implications of this condition in the Chinese population.

目的 了解四川省某县中老年HIV/AIDS患者污名化感知与焦虑、抑郁症状的现况及其关系,为提高中老年HIV/AIDS患者的心理健康水平提供科学依据.方法 将截至2019年6月在四川省泸州市泸县符合纳入标准的HIV/AIDS患者作为研究对象,采用面对面问卷调查,线性回归分析中老年HIV/AIDS患者污名化感知与焦虑、抑郁症状的关系.结果 共有498例HIV/AIDS患者纳入到本研究中,经问卷评估后,结果显示HIV/AIDS患者污名化感知总分为(33.33±7.94)分;63人(12.65％)存在焦虑症状;97人(19.48％)存在抑郁症状.多重线性回归分析发现,HIV/AIDS患者的焦虑症状与个人耻辱、负面自我形象、污名化感知总分呈正相关.其抑郁症状与个人歧视、负面自我形象、污名化感知总分呈正相关.结论 中老年HIV/AIDS患者的污名化感知总分与其焦虑、抑郁症状得分存在明显的相关关系,且污名化感知得分越高,其焦虑、抑郁症状越严重.中老年HIV/AIDS患者的污名化感知是其心理健康状况的重要影响因素,对中老年HIV/AIDS患者进行心理疏导降低其污名化感知,将有利于提高老年HIV/AIDS患者的心理健康水平.

目的 探讨四川省泸县中老年HIV/AIDS患者艾滋病疾病感知与心理健康的关系,为改善其心理健康状况提供新思路.方法 2019年6月,抽取四川省泸县20个乡镇中≥50岁的HIV/AIDS患者进行现场调查,调查工具选用病人健康问卷抑郁量表(PHQ-9)、广泛性焦虑障碍量表(GAD-7)、疾病感知问卷简化版(BIPQ),分析患者疾病感知现状及其与焦虑、抑郁症状的关系.结果 共调查498例中老年HIV/AIDS患者,焦虑总分为(2.93±5.07)分,存在焦虑症状者占12.65％;抑郁总分为(5.16±5.08)分,存在抑郁症状者占19.48％;BIPQ总分为(74.10±21.42)分.多因素分析结果显示,BIPQ总分与抑郁总分(β=0.26,P＜0.001)、焦虑总分(β=0.33,P＜0.001)呈正相关关系.结论 中老年HIV/AIDS患者焦虑、抑郁发生率高于社区老年人,BIPQ总分较高,而疾病感知与焦虑抑郁存在正相关关系,应对中老年HIV/AIDS患者采取综合干预措施,帮助其提高疾病正向感知力,降低焦虑、抑郁的发生率,从而改善其心理状况.

目的 调查四川省大学生成瘾物质使用情况,分析各类成瘾物质使用的影响因素及其相关关系,为高校更好地开展健康教育与禁毒工作提供科学依据.方法 采用分层整群抽样方法,对四川省9所高校的3939名大学生进行成瘾物质进行调查,分析不同特征学生成瘾物质使用差异,并构建四类成瘾物质使用行为的作用路径.结果 吸烟、饮酒、擅用镇静睡眠类药物和使用违法毒品的发生率分别为7.6％、19％、3.4％和0.3％.性别、民族、年级、专业、大学前生活地、母亲学历、家庭组成结构、学校和是否独生子女是成瘾物质使用的影响因素.四类成瘾物质使用行为间存在相关性,各路径均有统计学意义(P＜0.05).结论 大学生使用成瘾物质的行为不容忽视,应开展针对成瘾物质危害的宣传教育活动.

目的 构建和实践基于人工智能的医院咨询服务模式,提升就医体验和满意度,促进医患关系和谐发展.方法 于2019年5月至2020年3月,构建并实施基于人工智能的医院咨询服务模式,包括成立服务模式构建与实践小组,基于人工智能的医院咨询模式技术研发、开发微信智能客服功能、智能客服数据库建设等流程.结果 咨询服务模式持续完善,人机交互量不断上升,提升了医患对咨询服务的满意度.结论 满足患者多维度的咨询需求,能有效降低医院的人力成本,共创和谐就医环境.