general psychopathology factor in Chinese adolescents and its correlation with trans-diagnostic protective psycho-social factors.

BACKGROUND: Comorbidity in mental disorders is prevalent among adolescents, with evidence suggesting a general psychopathology factor ("p" factor) that reflects shared mechanisms across different disorders. However, the association between the "p" factor and protective factors remains understudied. The current study aimed to explore the "p" factor, and its associations with psycho-social functioning, in Chinese adolescents. METHODS: 2052 students, aged 9-17, were recruited from primary and secondary schools in Shanghai, China. Multiple rating scales were used to assess psychological symptoms and psycho-social functioning. Confirmatory factor analysis was conducted to verify the fit of models involving different psychopathology domains such as externalizing, internalizing, and the "p" factor. Subsequently, structural equation models were used to explore associations between the extracted factors and psycho-social functioning, including emotion regulation, mindful attention awareness, self-esteem, self-efficacy, resilience, and perceived support. RESULTS: The bi-factor model demonstrated a good fit, with a "p" factor accounting for 46 % of symptom variation, indicating that the psychological symptoms of Chinese adolescents could be explained by internalizing, externalizing, and the "p" factor. Psychologically, a higher "p" was positively correlated with emotion suppression and negatively correlated with mindful attention awareness, emotion reappraisal, self-esteem, and resilience. Socially, a higher "p" was associated with decreased perceived support. LIMITATIONS: Only common symptoms were included as this study was conducted at school. Furthermore, the cross-sectional design limited our ability to investigate causal relationships. CONCLUSIONS: A "p" factor exists among Chinese adolescents. Individuals with higher "p" factor levels were prone to experience lower levels of psycho-social functions.

Association between anxiety, depression symptoms, and academic burnout among Chinese students: the mediating role of resilience and self-efficacy.

BACKGROUND: To explore the associations between anxiety and depression symptoms and academic burnout among children and adolescents in China, and to examine the role of resilience and self-efficacy in addressing academic burnout. METHODS: A total of 2,070 students in grades 4-8 were recruited from two primary and three middle schools in Shanghai, completed the Elementary School Student Burnout Scale (ESSBS), the Multidimensional Anxiety Scale for Children-Chinese (MASC-C), the Center for Epidemiological Studies Depression Scale (CES-D), the Connor-Davidson Resilience Scale (CD-RISC), and the General Self-Efficacy Scale (GSES), with 95.04% effective response rate. Multivariable regression analyses examining the associations between anxiety / depression symptoms and academic burnout (as well as the associations between resilience / self-efficacy and academic burnout) were performed using STATA 16.0 and SmartPLS 3.0. RESULTS: Anxiety symptoms (ß = 0.124, p < 0.01) and depression symptoms (ß = 0.477, p < 0.01) were positively correlated with academic burnout. Resilience partially mediated the association between depression symptoms and academic burnout (ß = 0.059, p < 0.01), with a mediation rate of 12.37%. Self-efficacy partially mediated the associations between anxiety symptoms and academic burnout (ß = 0.022, p < 0.01) and between depression symptoms and academic burnout (ß = 0.017, p < 0.01), with mediation rates of 17.74% and 3.56%, respectively. Resilience and self-efficacy together (ß = 0.041, p < 0.01) formed a mediating chain between depression symptoms and academic burnout, with a mediation rate of 8.6%. CONCLUSIONS: Anxiety and depression symptoms were positively associated with academic burnout. Resilience and self-efficacy were found to mediate the associations partially.

Self-aware face emotion accelerated recognition algorithm: a novel neural network acceleration algorithm of emotion recognition for international students.

With an increasing number of human-computer interaction application scenarios, researchers are looking for computers to recognize human emotions more accurately and efficiently. Such applications are desperately needed at universities, where people want to understand the students' psychology in real time to avoid catastrophes. This research proposed a self-aware face emotion accelerated recognition algorithm (SFEARA) that improves the efficiency of convolutional neural networks (CNNs) in the recognition of facial emotions. SFEARA will recognize that critical and non-critical regions of input data perform high-precision computation and convolutive low-precision computation during the inference process, and finally combine the results, which can help us get the emotional recognition model for international students. Based on a comparison of experimental data, the SFEARA algorithm has 1.3× to 1.6× higher computational efficiency and 30% to 40% lower energy consumption than conventional CNNs in emotion recognition applications, is better suited to the real-time scenario with more background information.

Association between socioeconomic status and mental health among China's migrant workers: A moderated mediation model.

Mental health problems are prevalent among China's internal migrant workers. However, research on the relationship between socioeconomic status (SES) and mental health is insufficient. Therefore, this study, utilizing the China's National Dynamic Monitoring Survey data from a sample of 15,997 migrant workers aged 15-59 years to explore differences in the relationship between migrants' objective and subjective SES and mental health status in 2015. Both the mediating effect of perceived interpersonal discrimination and the moderating effect of age were examined through structural equation modeling. The results indicated that subjective SES has a stronger direct relationship with mental health than objective SES. Perceived interpersonal discrimination mediated the association between subjective SES and mental health. Furthermore, a much stronger relationship was found between subjective SES and perceived interpersonal discrimination among migrants older than 24 years of age than younger migrant groups. The results showed that, compared with traditional objective SES indicators, subjective SES could be a more sensitive index for identifying those migrant workers with a high risk of mental health problems. In addition, reducing interpersonal discrimination toward migrants can alleviate their mental health problems. And we should pay more attention to older migrant workers since they are more likely to prone to interpersonal discrimination and mental health issues.

ADHD Symptoms and Obesity in Chinese Children and Adolescents: A Longitudinal Study With Abnormal Eating Behaviors as Moderating Factors.

BACKGROUND: Emerging studies have explored the possibility of ADHD and associated abnormal eating behaviors as catalysts for obesity in children and adolescents. However, results were largely inconsistent. This study aims to explore the effects of ADHD and abnormal eating behaviors (including eating disorders, emotional eating, and bedtime eating) on obesity, and to assess the moderating role of abnormal eating behaviors between ADHD symptoms and BMI in Chinese children and adolescents. METHODS: We recruited 546 grade 3 to 11 students and their parents by stratified random sampling from three primary schools and four middle schools in Shanghai, China. This study used parent-reported versions of the ADHD Rating Scale-IV to assess ADHD symptoms, the Eating Attitudes Test and the Children's Eating Attitude Test to assess eating disorder (ED) symptoms, and the Child Eating Behavior Questionnaire to collect information about other abnormal eating behaviors at baseline and at a follow-up survey 1 year later. RESULTS: Hierarchical linear regression analysis revealed that ED played a moderating role in the relationship between ADHD symptoms and BMI in addition to age (ß = .003, p = .008). The simple slope test showed that ADHD symptoms positively correlated with BMI ofs in the older age group with a high level of ED symptoms (ß = .16, p < .001). Moreover, the baseline ED symptoms (ß = .03, p = .032) and ADHD symptoms (ß = .12, p = .015) increased the students' BMI one year later after controlling for confounding factors. CONCLUSION: Findings of this study suggest that ADHD and ED symptoms raised the students' BMI separately. Moreover, ADHD and ED symptoms raised the students' BMI separately. Moreover, a combined high level of ADHD and ED symptoms is correlated with students' high BMI in the older age group.

Reliability and validity of an observation-based parent-child interaction rating scale for Chinese children aged 0-6 years.

We examined the psychometric properties of a parent-child interaction rating scale (IRS) in Chinese children. We recruited 346 dyads of children aged 0-6 years (Mage = 2.72 years, SD = 1.52 years) and their caregivers from four cities in China. Parent-child interactions were videotaped in a controlled laboratory and coded by two trained coders. Internal reliability and test-retest reliability were used to measure the reliability of test scores from the IRS in our sample. We performed confirmatory factor analysis (CFA) to examine the factor structure of the Chinese version of the parent-child interaction rating scale (IRS-C). The third version of the dyadic parent-child interaction coding system (DPICS) was applied to assess the convergent validity of the IRS-C. Test scores from the IRS-C exhibited strong internal consistency (Kuder-Richardson 20 score 0.855) and test-retest reliability (intraclass correlation coefficient 0.809 over a 1-month interval). Results of confirmatory factor analyses indicated that the five-factor structure for both the child's and caregiver's domains of the IRS-C was suitable for the Chinese sample. Convergent validity in interpretation was also verified with significant correlations between the IRS-C and DPICS. Our findings suggested that the IRS-C produces reliable and valid test scores in the evaluation of parent-child interactions among Chinese children. (PsycInfo Database Record (c) 2022 APA, all rights reserved).

The Reliability and Validation of the Children's Eating Attitude Test among Chinese Samples.

The purpose of this study was to examine the psychometric properties of the Children's Eating Attitude Test (ChEAT) in a Chinese sample. A total of 906 children (mean age = 10.55, SD = 1.08) from three primary schools were evaluated by the ChEAT. Factor analysis was performed to examine the factor structure of the ChEAT. The children's body mass index (BMI) was applied to assess the concurrent validity of the ChEAT. The ChEAT showed good internal consistency (Cronbach's α = 0.819) and split-half reliability (0.816) in Chinese children. Exploratory factor analysis suggested a four-factor structure, consistent with previous studies, which explained 41.16% of the total variance. Confirmatory factor analysis indicated good construct validity for the Chinese sample. The Chinese version of the ChEAT showed evidence for reliability and validity to evaluate the eating attitudes and behaviors for Chinese children. The mean score of each factor of the ChEAT differed significantly among different genders and BMI groups. Overweight girls had more eating disorder problems than normal-weight girls, and boys with lower BMI showed higher social eating pressure.

The Prevalence of Non-infectious Diseases Among Overseas Chinese Workers in 2018.

Background: With the "Belt and Road" initiative, more Chinese citizens have gone abroad to engage in overseas labor activities. Few studies have investigated the prevalence of non-infectious diseases among Chinese overseas workers. This study seeks to fill the gap and illustrate the relevant diseases in a population of Chinese overseas workers. Methods: The health records of 13,529 Chinese migrant workers (12,917 males, mean age 41.3 ± 8.7 years, and 612 females, mean age 33.1 ± 10.2 years) who visited the International Travel Health Care Center in Anhui province were obtained. Chi-square test and binary logistic regression models were used to analyze the associations between the prevalence of non-infectious diseases and sex, as well as the association between non-infectious diseases and length of stay abroad. Results: In this study, 34.6% of overseas workers were found to have one or more types of non-infectious diseases. Hypertension had the highest prevalence (9.58%). Hypertension, fatty liver, renal disease and abnormal liver function tests were more prevalent among male workers than among female workers, while anemia and abnormal urinalysis were more prevalent among female workers. The prevalence of hypertension, renal diseases, liver diseases and gallbladder diseases increased with the length of stay abroad. Conclusion: Non-infectious diseases including cardiovascular diseases, diabetes, and chronic respiratory diseases were highly prevalent among Chinese overseas workers. Hence the monitoring of non-infectious diseases needs to be enhanced to reduce China's overall disease burden in the future.

Factors moderating the link between early childhood non-parental care and ADHD symptoms.

INTRODUCTION: There is little known about the association between non-parental care in early childhood and attention-deficit/hyperactivity disorder (ADHD) symptoms in preschoolers. Therefore, we examined the association between childcare from grandparents/babysitters during infancy/preschool and ADHD symptoms in preschoolers. METHODS: Using stratified random sampling, we developed a sample comprising 1597 parents of children aged 1.6-7 years who were enrolled in preschool in rural and urban areas of China. Parental reports of ADHD symptoms were assessed using the preschool version of the ADHD Rating scale-IV. A regression analysis was used to examine the association between childcare from grandparents/babysitters and ADHD symptoms. RESULTS: Childcare from grandparents during infancy was associated with ADHD symptoms in childhood (ß = 1.03, P < 0.0001). Significant associations between grandparental care and ADHD symptoms were also observed in children from families with more than one child (ß = 0.64, P = 0.0035) and children living in rural areas (ß = -0.78, P = 0.0032). A babysitter as the primary child caregiver in preschool was especially strongly correlated with ADHD symptoms in girls (ß = 7.95, P = 0.0042). Moreover, region was strong factor associated with ADHD symptoms without adjustment for the non-parental caregivers' age and education, whereas family income was not strongly associated with ADHD symptoms. CONCLUSION: Non-parental caregiving (i.e., from grandparents or babysitters) in early childhood was associated with more ADHD symptoms in children. Certain characteristics in children, such as female gender and the existence of siblings, were stronger moderating factors than were family income and region.

Effect of intensive intervention for improving the referral rate among preschoolers with vision abnormalities / 中国学校卫生

Objective@#To explore effect of intensive intervention for improving the referral rate of children with visual refractive disorders, and to provide a reference for myopia prevention and control of children and adolescents.@*Methods@#A total of 4 464 preschool children were selected from Zhuanqiao county, Minghang district in Shanghai for the eyesight investigation during April to June in 2019. Stratified random cluster sampling method was used to divide 1 724 children into intervention group and (896) control group (828) depending on the type of kindergartens. The intervention group was provied with an intensive intervention, including children s vision health assessment, parental self management guidance for children s eye care, and community based eye care services, while the control group carried out routine intervention measures.@*Results@#In 2019, the incidence of visual and primary refractive screen abnormalities in preschoolers of Zhuanqiao community was 38.62%. The incidence of naked eye vision abnormalities was 4.40%, the incidence of myopia risk group, hyperopia risk group and astigmatism risk group was 37.10%, 2.20%, and 6.10 %, respectively. After the intervention, the referral rate of the intervention group (68.75%) was significantly higher than that of the control group (17.15%)( χ 2=465.09, P <0.01). The differences between two groups were statistically significant in choosing the hospital for treatment ( χ 2=10.01, 51.51, 15.40, 27.79, 19.96, 24.24, P <0.01).@*Conclusion@#The vision and refractive status of preschoolers worths further attention. Intensive intervention can improve the referral rate for children with screened vision abnormalities, which facilitates the prevention and early diagnosis of vision problems among preschoolers.

Experiences of discrimination and self-reported health in Chinese migrants: a structural equation model.

BACKGROUND: Many migrants suffer from discrimination and poor health in China. We sought to examine the associations between experiences of discrimination and self-reported health among internal migrants in China, as well as the mediators of social integration and perceived stress. METHODS: The data was obtained from a specific survey of migrants, as a part of the National Health and Family Planning Dynamic Monitoring for Migrants conducted in 2014. A total of 15,999 migrants aged 15 to 59 years were recruited by a stratified, multistage clustered sampling procedure in eight Chinese cities. Structural Equation Modeling (SEM) was conducted. RESULTS: The results indicated that experiences of discrimination were associated with worse self-reported health (ß = - 0.32, P < 0.001), less social integration (ß = - 0.25, P < 0.001), as well as higher perceived stress (ß = 0.21, P < 0.01). Both objectively measured socioeconomic status (ß = 0.21, P < 0.001) and subjective social status (ß = 0.21, P < 0.01) had significantly positive correlations with self-reported health. CONCLUSIONS: The discrimination, social exclusion and perceived stress experienced by migrants have significant implications on their health.

The factors associated with being left-behind children in China: Multilevel analysis with nationally representative data.

There are 69.7 million left-behind children (LBC) in China. Using nationally representative monitoring data for migrant workers aged 15 to 59 years in China, this study sought to estimate the prevalence of LBC in each province, and to examine risk factors being left behind at both the individual and provincial level. Data on a total of 117,573 children less than 18 years of age were included in the multilevel analysis. At individual and family level, children's gender, age, family income, migration distance, parental separation, and housing condition in host cities were associated with being LBC. The average household monthly income in the host province was significantly associated with the migrant parents' arrangement to leave their children behind. Comprehensive supportive policies and strategies on schooling, housing for the migrant family in host cities might be beneficial to reduce the number of LBC in China.

The moderating roles of bedtime activities and anxiety/depression in the relationship between attention-deficit/hyperactivity disorder symptoms and sleep problems in children.

BACKGROUND: Children with attention-deficit/hyperactivity disorder (ADHD) often experience sleep problems, but the comorbidity mechanism has not been sufficiently studied. This study aimed to determine the comorbidity of ADHD symptoms and sleep problems as well as the moderating effects of bedtime activities and depression/anxiety symptoms on the relationship between ADHD symptoms and sleep problems. METHODS: We recruited 934 primary students from third to fifth grade and their parents by stratified random sampling from three primary schools in Shanghai, China. This study used parent-reported versions of the ADHD Rating Scale-IV, Children's Sleep Habits Questionnaire, and Achenbach Child Behavior Checklist. We used hierarchical linear regression analysis to clarify the moderating effects of bedtime activities and depression/anxiety symptoms. RESULTS: We found that children with more ADHD symptoms had shorter sleep durations and more sleep problems on weekdays. Screen time before bedtime strengthened the relationship between ADHD symptoms and sleep-disordered breathing. Children with more screen time were more likely to have sleep onset delay, while those with less screen time had more sleep onset problems with increasing ADHD symptoms. The high bedtime eating group experienced more night waking with increasing ADHD symptoms compared with the low bedtime eating group. Anxiety/depression exacerbated total sleep problems and further interacted with ADHD symptoms to predict sleep length and sleep duration problems. CONCLUSIONS: Bedtime activities and emotional problems had important moderating effects on the relationship between ADHD symptoms and sleep problems. These findings indicate that appropriate bedtime management and emotional management may reduce sleep problems and improve sleep duration for children with ADHD symptoms.

The Prevalence of Attention Deficit/Hyperactivity Disorder among Chinese Children and Adolescents.

Updating the worldwide prevalence estimates of attention-deficit hyperactivity disorder (ADHD) has significant applications for the further study of ADHD. However, previous reviews included few samples of Chinese children and adolescents. To conduct a systematic review of ADHD prevalence in Mainland China, Hong Kong, and Taiwan to determine the possible causes of the varied estimates in Chinese samples and to offer a reference for computing the worldwide pooled prevalence. We searched for PubMed, Embase, PsycINFO, Web of Science, China National Knowledge Infrastructure, VIP, WANFANG DATA, and China Science Periodical Database databases with time and language restrictions. A total of 67 studies covering 642,266 Chinese children and adolescents were included. The prevalence estimates of ADHD in Mainland China, Hong Kong, and Taiwan were 6.5%, 6.4%, and 4.2%, respectively, with a pooled estimate of 6.3%. Multivariate meta-regression analyses indicated that the year of data collection, age, and family socioeconomic status of the participants were significantly associated with the prevalence estimates. Our findings suggest that geographic location plays a limited role in the large variability of ADHD prevalence estimates. Instead, the variability may be explained primarily by the years of data collection, and children's socioeconomic backgrounds, and methodological characteristics of studies.

Mechanism of Water Oxidation Catalyzed by a Mononuclear Iron Complex with a Square Polypyridine Ligand: A DFT Study.

The mononuclear [Cl-FeIII(dpa)-Cl]+ (1Cl) complex containing a square planar tetradentate polypyridine ligand has been reported to catalyze water oxidation in pH = 1 aqueous medium with ceric ammonium nitrate (CAN) as a chemical oxidant. The reaction mechanism of the oxygen evolution driven by this catalyst was investigated by means of density functional calculations. The results showed that one chloride ligand of 1Cl has to exchange with a water molecule to generate 1, [Cl-FeIII(dpa)-OH2]2+, as the starting species of the catalytic cycle. The initial one-electron oxidation of 1 is coupled with the release of two protons, generating [Cl-FeIV(dpa)═O]+ (2). Another one-electron transfer from 2 leads to the formation of an FeV═O complex [Cl-FeV(dpa)═O]2+ (3), which triggers the critical O-O bond formation. The electronic structure of 3 was found to be very similar to that of the high-valent heme-iron center of P450 enzymes, termed Compound I, in which a π-cation radical ligand is believed to support a formal iron(IV)-oxo core. More importantly, 3 and Compound I share the same tendency toward electrophilic reactions. Two competing pathways were suggested for the O-O bond formation based on the present calculations. One is the nitrate nucleophilic attack on the iron(V)-oxo moiety with a total barrier of 12.3 kcal mol-1. In this case, nitrate functions as a co-catalyst for the dioxygen formation. The other is the water nucleophilic attack on iron(V)-oxo with a greater barrier of 16.5 kcal mol-1. In addition, ligand degradation via methyl hydrogen abstraction was found to have a barrier similar to that of the O-O bond formation, while the aromatic carbon hydroxylation has a higher barrier.

Associations among ADHD, Abnormal Eating and Overweight in a non-clinical sample of Asian children.

Attention-deficit/hyperactivity disorder (ADHD) has been found to be comorbid with obesity in adults, but the association in children is uncertain. Because the underlying mechanism of comorbidity in children has not been researched sufficiently, this study aims to explore the associations among ADHD, abnormal eating, and body mass index (BMI), as well as the mediating effect of depression in children. We conducted a cross-sectional study of 785 primary students in China. The parent-report version of ADHD Rating Scale-IV (ADHDRS-IV), the Child Eating Behaviour Questionnaire (CEBQ) and the Children's Eating Attitude Test (ChEAT) were used to identify ADHD symptoms and abnormal eating. The Child Behavior Checklist (CBCL) was applied to assess depression. Structural Equation Modeling was carried out to clarify the associations between ADHD symptoms, depression, abnormal eating, and overweight of students. We found that ADHD positively contributed to emotional eating and Bulimia Nervosa symptoms. However, neither emotional eating nor Bulimia Nervosa symptoms was related to BMI in children. We also found that ADHD significantly contributed to depression, and depression directly predicted emotional eating. In conclusion, ADHD increased the risk of abnormal eating in children, while no significant relationship existed between ADHD and BMI. Comorbid depression raised the risk of emotional eating, rather than Bulimia Nervosa symptoms.

Attention-Deficit/Hyperactivity Disorder and Lifestyle-Related Behaviors in Children.

Attention-deficit/hyperactivity disorder (ADHD) has been associated with obesity in children. Lifestyle-related behaviors (external eating, screen time and physical inactivity) are well known to be associated with increased risk of obesity, but their associations with ADHD are unclear. The objectives of this study were to clarify the associations between ADHD symptoms in children and their associated lifestyle. A cross sectional study was carried out with a total of 785 primary students aged 9 to 13 years old and their parents were recruited by stratified random sampling from primary schools of China. The Cochran-Mantel-Haenszel (CMH) test was used to examine the relationships between ADHD symptoms and health related behaviors. We found that children with ADHD symptoms were likely to spend more time using a computer during school days; they were also more likely to eat while using a computer. These children were also more likely to eat while seated in a car, using a smart phone, using a computer at bedtime, and snacking before going to sleep than children without ADHD symptoms. An increased risk of obesity in children with ADHD symptoms was associated with the overuse of electronic devices, eating while using electronic devices, and delaying bedtimes to snack and use electronic devices.

Mediating effect of anxiety and depression on the relationship between Attention-deficit/hyperactivity disorder symptoms and smoking/drinking.

Attention-deficit/hyperactivity disorder (ADHD) has been often found to be comorbid with other disorders, including anxiety, depression, and unhealthy behaviors such as drinking alcohol and smoking. These factors were often discussed separately, and the mediating effects of mental health on substance use are unknown. To study the mediating effects of anxiety and depression on the relationship between ADHD and drinking/smoking behaviors, we conducted a cross-sectional study of 1870 college students from Shanghai, China. The Adult ADHD Self-Report Scale (ASRS-v1.1) and Wender Utah Rating Scale (WURS) were used to identify the current and past ADHD. Structural Equation Modeling was carried out to clarify the mediating effect of anxiety and depression on the relationship between core ADHD symptoms and smoking/drinking behaviors. We found that inattention as one of the core symptoms of ADHD was associated with an increased risk of depression as a direct effect, as well as slightly increased risk of smoking/drinking behaviors by an indirect effect of depression. Hyperactivity-impulsivity, as another core symptom of ADHD had a robust impact on smoking and drinking behaviors, while being mediated by anxiety and depression. In conclusion, anxiety and depression was associated with further increased risk behaviors of smoking/drinking alcohol among those students with ADHD.

[Industrial ecological development of Jilin Province, Northeast China based on structure optimization vision.] / 基于结构调整视角的吉林省产业生态化发展.

Based on the interactive coercing mechanism between the industrial system and the ecosystem, we evaluated Jilin's ecologicalization of industrial structure, employing the systematic ana-lysis method and the comprehensive index evaluation method, and explored the spatio-temporal cha-racteristics.The result showed that the ecological level of industrial structure as well as the industrial structure optimization and resource-environmental efficiency had been significantly improved in 2000-2013. The regional difference showed a trend of resource-environmental efficiency > industrial structure optimization > ecologicalization of industrial structure. Spatially, it demonstrated a "higher in west, lower in east" pattern, and at city scale, it showed a decreasing trend from the core (Changchun) to outside. According to the coordination of industrial structure optimization and resource-environmental efficiency, we categorized the nine cities in Jilin Province into four ecologica-lization types: high coordination type, low coordination type, economic development ahead, and ecological development ahead.

CYP3A4∗18B and CYP3A5∗3 polymorphisms contribute to pharmacokinetic variability of cyclosporine among healthy Chinese subjects.

AIM: Cyclosporine is an immunosuppressant drug used to prevent allograft rejection. It is metabolized by CYP3A4 and CYP3A5, has a narrow therapeutic index, and variable pharmacokinetics. Here, we investigated whether CYP3A5∗3 and CYP3A4∗18B polymorphisms contribute to inter-individual pharmacokinetic variability in healthy subjects. PATIENTS AND METHODS: Fifty-six healthy Chinese subjects were enrolled in the study after signing a written consent. The subjects received 5mgkg(-1) of cyclosporine orally and were genotyped for CYP3A5∗3 and CYP3A4∗18B using polymerase chain reaction-restriction fragment length polymorphism (PCR-RFLP). Blood concentrations of cyclosporine were measured by high-performance liquid chromatography for up to 30h post-dose. RESULTS: The mean cyclosporine AUC0→30 and AUC0→∞ in the male group was significantly higher than that in the female group (P=0.037 and 0.035); the CL/F in the male group was significantly lower than that in the female group (P=0.033). The Cmax of cyclosporine in CYP3A4∗1/∗1 was significantly greater than that in CYP3A4∗1/∗18B in the male group (P=0.023), but not the female group. In addition, the Cmax in CYP3A5∗1/∗3 was significantly lower than that in CYP3A5∗3/∗3 in the male group (P=0.01). CONCLUSIONS: The results indicate that gender and polymorphism in CYP3A4∗18B and CYP3A5∗3 significantly affect cyclosporine pharmacokinetics in healthy subjects.