Neurodevelopmental outcome at 1 year in offspring of women with gestational diabetes mellitus.

OBJECTIVE: To study the metabolic derangements in the second half of pregnancy caused by gestational diabetes mellitus(GDM), on the short term neurodevelopment of infants. DESIGN: A prospective cohort study of 555 mother-child pairs were recruited, which included 177 GDM patients and 378 pregnant women with normal glucose tolerance as controls. Clinical and demographic characteristics were obtained at enrollment, birth and follow-up. Neurodevelopment was examined with the Bayley Scales of Infant Development V.1 mental development index (MDI) and psychomotor development index (PDI). Fatty acids (FA) were analyzed by gas chromatography mass spectrometry (GC-MS). RESULTS: Statistically significant differences were found between the two groups in fasting plasma glucose (FPG) and triglyceride (TG). The scores of MDI and PDI of control group were higher than those of GDM group. The regression analysis showed that maternal age and saturated fatty acid (SFA) were independently associated with lower scores on the MDI whereas gestational age and docosahexaenoic acid (DHA) were associated with higher scores; in addition, lower scores on the PDI were associated with FPG and neonatal weigh associated with higher scores. CONCLUSION: SFA, DHA and FPG as indicators of lipid metabolism were associated with neurodevelopmental outcome at 1 year in offspring of women with gestational diabetes mellitus. Control the level of blood glucose and lipid during pregnancy and the appropriate supplementation of DHA during pregnancy in the second half of pregnancy may be beneficial to the neurodevelopment of infants.

Maternal prepregnancy overweight and obesity and the risk of preeclampsia: A meta-analysis of cohort studies.

OBJECTIVE: The aim of our meta-analysis was to explore whether overweight and obesity was associated with preeclampsia or not. DESIGN: Three databases were systematically reviewed and reference lists of relevant articles were checked. Meta-analysis of published cohort studies comparing whether overweight and obesity was associated with preeclampsia and adjusting for potential confounding factors. Calculations of pooled estimates were conducted in random-effects models. Heterogeneity was tested by using Chi-square test with Cochrane and heterogeneity was explored with meta-regression. Publication bias was estimated from Egger's test (linear regression method) and Begg's test (rank correlation method). RESULTS: Nineteen studies met the inclusion criteria. The meta-analysis showed that overweight and obesity was associated with an increased risk of preeclampsia. The aOR calculated for 13 studies (compared overweight to normal weight) was 1.71, 95% CI (1.52, 1.91) for random-effects models and 19 studies (compared obesity to normal weight) was 2.48, 95% CI (2.05, 2.90) for random-effects models, stratified analyses showed no differences regarding quality grade, location of study and period of anthropometric measurement. There was no indication of a publication bias either from the result of Egger's test or Begg's test. CONCLUSIONS: Our results suggested that prepregnancy maternal overweight and obesity are significantly associated with an increased risk of preeclampsia.

The Association between Advanced Maternal Age and Macrosomia: A Meta-Analysis.

PURPOSE: The aim of our meta-analysis was to explore whether advanced maternal age (AMA) is regarded as an important risk factor for predicting macrosomia or not. METHODS: Three databases were systematically reviewed and reference lists of relevant articles were checked. Meta-analysis of published cohort studies was done comparing whether AMA was associated with macrosomia and adjusting for potential confounding factors. Calculations of pooled estimates were conducted in random-effects models. Heterogeneity was tested by using chi-square test and I2 statistics. Publication bias was estimated from Egger's test (linear regression method) and Begg's test (rank correlation method). RESULTS: Twelve cohort studies met the inclusion criteria. The meta-analysis showed that AMA was associated with macrosomia as an important risk factor. The adjusted odds ratio calculated for 12 studies (compared aged 35-39 years to aged <30 years) was 1.42, 95% confidence interval (CI) (1.25-1.60) for random-effect model and 6 studies (compared aged ≥40 years to aged <30 years) was 1.40, 95% CI (1.02-1.78) for random-effect model. There was no indication of a publication bias either from the result of Egger's test or Begg's test. CONCLUSION: Regardless of the underlying mechanism, our finding indicated that AMA should be considered as an important risk factor for macrosomia. To adequately evaluate the clinical evolution of AMA, the effect of AMA on macrosomia need to be carefully assessed and monitored.

Maternal pre-pregnancy obesity and the risk of macrosomia: a meta-analysis.

PURPOSE: The aim of our meta-analysis was to explore whether pre-pregnancy obesity is regarded as an important risk factor for predicting macrosomia or not. METHODS: Three databases were systematically reviewed and reference lists of relevant articles were checked. Meta-analysis of published cohort studies comparing whether pre-pregnancy obesity was associated with macrosomia and adjusting for potential confounding factors. Calculations of pooled estimates were conducted in random-effect model. Heterogeneity was tested by using Chi-square test and I 2 statistics. Publication bias was estimated from Egger's test (linear regression method) and Begg's test (rank correlation method). RESULTS: Sixteen cohort studies met the inclusion criteria. The meta-analysis showed that pre-pregnancy obesity was associated with macrosomia as an important risk factor. The adjusted odds ratio was 1.93, 95% CI (1.65, 2.27) in random-effect model, stratified analyses showed no differences regarding different quality grade, definition of macrosomia, location of study and number of confounding factors adjusted for. There was no indication of a publication bias either from the result of Egger's test or Begg's test. CONCLUSION: Our findings indicated that pre-pregnancy obesity should be considered as an important risk factor for macrosomia. The effect of pre-pregnancy obesity on macrosomia need to be carefully assessed and monitored.

Effect of Maternal Obesity on Fetal Growth and Expression of Placental Fatty Acid Transporters.

OBJECTIVE: To explore the effects of maternal high-fat (HF) diet-induced obesity on fetal growth and the expression of placental nutrient transporters. METHODS: Maternal obesity was established in rats by 8 weeks of pre-pregnancy fed HF diet, while rats in the control group were fed normal (CON) diet. Diet-induced obesity (DIO) rats and diet-induced obesity-resistant (DIR) rats were selected according to body weight gain over this period. After copulation, the CON rats were divided into two groups: switched to HF diet (CON-HF group) or maintained on the CON diet (CON-CON group). The DIO rats and DIR rats were maintained on the HF diet throughout pregnancy. Pregnant rats were euthanized at day 21 gestation, fetal and placental weights were recorded, and placental tissue was collected. Reverse transcription-polymerase chain reaction was used to determine mRNA expression of placental nutrient transporters. Protein expression was determined by Western blot. RESULTS: Average fetal weight of DIO dams was reduced by 6.9%, and the placentas of CON-HF and DIO dams were significantly heavier than the placentas of CON-CON and DIR dams at day 21 of gestation (p<0.05). The fetal/placental weight ratio of DIO dams was significantly reduced compared with the fetal/placental weight ratio of CON-CON dams (p<0.05). The mRNA expression of GLUT-1 and SNAT-2 were not significantly different between groups. The mRNA and protein expression levels of CD36, FATP-1, and FATP-4 in DIO dams were decreased significantly (p<0.05). CONCLUSION: Maternal obesity induced by a HF diet led to intrauterine growth retardation and down-regulated the expression of placental fatty acid transporters.

Calorie restriction prevents the development of insulin resistance and impaired lipid metabolism in gestational diabetes offspring.

BACKGROUND: Gestational diabetes mellitus (GDM) has long-lasting influence on offspring, which is associated with increased risks of insulin resistance, obesity, and type II diabetes mellitus. Calorie restriction (CR) is one of the most common and available nutritional interventions to prevent obesity and diabetes. We are trying to explore the effect of CR on GDM offspring. METHODS: The streptozotocin was used to stimulate C57BL/6J mice to develop GDM, a number of metabolic characteristics and related protein expressions were determined in GDM offspring that were fed ad-libitum or treated with calorie restriction. RESULTS: CR reduced body weight and glucose levels in GDM offspring. CR modulated the lipid metabolism by decreasing triglyceride and cholesterol levels in plasma. We also found that the effect of CR on insulin sensitivity may involve in signaling pathway through the regulations of phosphatase and tensin homologue deleted on chromosome 10 (PTEN) and protein kinase B (Akt). CONCLUSION: GDM is a high risk factor for GDM offspring to develop insulin resistance, while CR could ameliorate this adverse outcome. Moreover, the specific decrease in PTEN activation and increase in Akt phosphorylation in livers of GDM offspring with CR improved insulin sensitivity and lipid metabolism.

Weight gain in pregnancy, maternal age and gestational age in relation to fetal macrosomia.

To investigate the possible risk factors related to macrosomia. Pregnant women and their newborns (n = 1041) were recruited from a cohort study in Maternal and Child Care Center of Hefei from January 2011 to July 2012. Questionnaires were applied to collect the demographic data besides the medical records. Detailed health records of the entire pregnancy were obtained using retrospective study. Meanwhile the data of neonatal outcomes was prospectively tracked. Associations between exposure risk factors and macrosomia were analyzed using Pearson's chi squared test. Logistic regression models were used to assess the independent association between these potential predictors and macrosomia. The incidence of macrosomia of this cohort was 11.24% of which male: female = 2.55:1. Male incidence (8.07%) of macrosomia was higher than female (3.17%), p < 0.001. Body mass index (BMI) before pregnancy (pre-BMI), maternal height, parity were not independently associated with macrosomia; multiple logistic regression analysis indicated that macrosomia was mainly independently associated with weight gain in pregnancy (OR=1.14, 95% CI [1.10-1.19]), maternal age (OR = 1.09, 95% CI [1.03-1.15]) and gestational age (OR = 1.62, 95% CI [1.31-1.99]), respectively. Our findings indicate that weight gain in pregnancy, maternal age and gestational age should be considered as independent risk factors for macrosomia.

Maternal serum lipid levels during late pregnancy and neonatal body size.

OBJECTIVE: The aim of this study was to determine the predictive value of maternal serum lipid levels during late pregnancy for neonatal body size. METHODS: This study was conducted from January 1, 2011 to July 31, 2012 at a Maternal and Child Health Hospital. Fasting blood glucose, serum triglyceride, total cholesterol, HDL and LDL were estimated in maternal collected before delivery. Detailed anthropometry of the neonates was performed. RESULTS: Women who delivered a large for gestational age baby were older, taller, had a higher pre-pregnancy weight, higher pre-pregnancy BMI, and higher weight gain during pregnancy than women who delivered an appropriate for gestational age infant. After adjusting for maternal age, pre-pregnancy BMI, weight gain during pregnancy, parity, neonatal sex and gestational age at delivery, we found that only maternal HDL level was inverse associated with birth weight, length and head circumference (p<0.05). On logistic regression analysis, the significant metabolic predictors of large for gestational age was HDL (OR 0.57, 95%CI: 0.38-0.84, per 1 mmol/L increase) after adjusting for the confounders. CONCLUSIONS: Maternal serum HDL level determined in maternal blood taken close to delivery was independently associated with neonatal size and was the independent predictor for large for gestational age.

Is gestational diabetes mellitus an independent risk factor for macrosomia: a meta-analysis?

PURPOSE: The aim of our meta-analysis was to explore whether gestational diabetes mellitus (GDM) is an independent risk factor for macrosomia or not. METHODS: Three databases were systematically reviewed and reference lists of relevant articles were checked. Meta-analysis of published epidemiological studies (cohort and case-control studies) comparing whether GDM was associated with macrosomia. Calculations of pooled estimates were conducted in random-effect models. Heterogeneity was tested by using Chi square test and I (2) statistics. Publication bias was estimated from Egger's test (linear regression method) and Begg's test (rank correlation method). RESULTS: Twelve studies met the inclusion criteria, including five cohort studies and seven case-control studies. The meta-analysis showed that GDM was associated with macrosomia independent of other risk factors. The adjusted odds ratio was 1.71, 95% CI (1.52, 1.94) in random-effect model, stratified analyses showed no differences regarding different study design, quality grade, definition of macrosomia, location of study and number of confounding factors adjusted for. There was no indication of a publication bias either from the result of Egger's test or Begg's test. CONCLUSION: Our findings indicate that GDM should be considered as an independent risk factor for newborn macrosomia. To adequately evaluate the clinical evolution of GDM need to be carefully assessed and monitored.

Longitudinal effects of psychological symptoms on non-suicidal self-injury: a difference between adolescents and young adults in China.

PURPOSE: Few longitudinal studies have examined the psychological symptoms that may lead to non-suicidal self-injury (NSSI) among Chinese adolescents and young adults. This study determined the predictive effects of psychological symptoms for NSSI during a 9-month follow-up period. METHODS: Data from 17,622 students, 12-24 years of age, were analyzed in a cross-sectional fashion with respect to associations between psychological symptoms and NSSI. Follow-up surveys were performed 3, 6, and 9 months later. Incident cases of NSSI during follow-up were correlated with the psychological symptoms at baseline. RESULTS: A total of 3,001 (17.0%) students reported that they had NSSI in the 12 months before the initial assessment. The total rate of NSSI revealed no statistically significant differences by gender, but marked differences between grades. The response rate 3, 6, and 9 months later was 91.8, 81.8, and 79.1%, respectively. Our cross-sectional study demonstrated statistically significant associations between emotional problems, conduct problems, social adaptation problems, psychological problems, and NSSI (P < 0.01). In the longitudinal study, emotional problems, conduct problems, social adaptation problems, and psychological problems at baseline had statistically significant associations with incident NSSI in follow-up involving the adolescents, while the association in young adults was attenuated after adjustment for confounding variables. Moreover, psychological symptoms at baseline showed a monotonic dose-response relationship with NSSI in follow-up involving adolescents. CONCLUSIONS: The findings suggest that adolescents with psychological symptoms are a group with elevated risks for later NSSI. The prevention programs of NSSI should target attenuating the severity of psychological symptoms.

Dietary patterns are associated with body mass index and bone mineral density in Chinese freshmen.

OBJECTIVE: Our objective was to examine associations between dietary patterns and body mass index (BMI) and bone mineral density (BMD) in Chinese freshmen. METHODS: A cross-sectional study was done in 1319 college freshmen (aged 18.1 ± 1.2 years old). Diet was assessed by using a validated self-administrated food-frequency questionnaire. Blood pressure, weight, height, waist circumference, and hip circumference were measured and bone measurements were done using Quantitative Ultrasound System. RESULTS: Four dietary patterns were identified by factor analysis: Western food, animal protein, calcium food, and Chinese traditional patterns. The prevalence of overweight/obesity and osteopenia/osteoporosis were 8.2% (108/1319) and 28.1% (371/1319). The highest tertile of Western food pattern scores had greater odds of overweight/obesity (highest vs. lowest tertile, odds ratio [OR] = 2.00, 95% confidence interval [CI], 1.24-3.22), and the highest tertile of Chinese traditional pattern scores had lower risk of overweight/obesity (highest vs. lowest tertile, OR = 0.65, 95% CI, 0.53-0.80) in an adjusted model. The calcium food pattern and Chinese traditional pattern were negatively associated with the risk of osteopenia/osteoporosis (highest vs. lowest tertile, OR = 0.59, 95% CI, 0.41-0.87; OR = 0.78, 95% CI, 0.55-0.89) after adjusting for confounders. CONCLUSION: These findings suggested that there was a positive correlation between Chinese traditional dietary pattern and healthy BMI and BMD and that this same association existed between calcium food pattern and BMD in Chinese freshmen. In contrast, the Western-style diet was negatively correlated with healthy BMI in Chinese freshmen.

[Impact of maternal weight gain during pregnancy on the risk of infant obesity].

OBJECTIVE: To study the impact of maternal weight gain during pregnancy on the risk of infant obesity within 1 year old. METHODS: A total of 785 infants who were born in Hefei and participated children medical care in one district health center and their mothers were chosen as the research subjects from September 2010 to September 2011. Three groups were classified by weight gain during pregnancy according to the percentiles: excessive pregnancy weight gain group of 126 pairs, adequate pregnancy weight gain group of 542 pairs and inadequate pregnancy weight gain group of 117 pairs. Mother's general demographic information was collected. The height and weight were measured when the infant was 42 days, 3, 6, 9, and 12 months of physical examination. Z score was calculated. The differences of Z score in different groups were compared and the RR values of different weight gain during pregnancy on infant obesity were computed. RESULTS: The weight-for-age Z score (WAZ) of infant at 42 days 3, 6, 9 and 12 months in excessive pregnancy weight gain group were 0.23 ± 0.93, 0.25 ± 1.03, 0.23 ± 0.99, 0.28 ± 1.09, 0.26 ± 1.14, respectively, all higher than that of the corresponding age in adequate pregnancy weight gain group (-0.04 ± 1.02, -0.07 ± 0.99, -0.05 ± 0.98, -0.06 ± 0.97, -0.07 ± 0.95, respectively). The differences were statistically significant (all P values < 0.05). In excessive pregnancy weight gain group, infant body mass index (BMI) at 9 months ((18.01 ± 0.15) kg/m(2)) and 12 months ((17.66 ± 0.15) kg/m(2)) were higher than that of adequate pregnancy weight gain group ((17.63 ± 0.13) and (17.22 ± 0.15) kg/m(2), respectively). The differences were statistically significant (all P values < 0.05). Differences of infant Height-for-age Z score (HAZ) among three groups were not statistically significant (all P values > 0.05). Compared to adequate pregnancy weight gain group, RR (95%CI) value of infant obesity in excessive pregnancy weight gain group was 1.86 (1.14 - 3.03). CONCLUSION: Excessive maternal weight gain during pregnancy increased the risk of infant obesity within 1 year old.

[Influence of physical activity on postpartum weight retention among women, one year after childbirth].

OBJECTIVE: To explore the risk factors affecting the postpartum weight retention among women. METHODS: Six hundred eight postpartum women were involved to establish a baseline at 42 days of postpartum in Hefei Maternal and Child Health Center of Anhui province. Information regarding pre-pregnancy weight and weight gain during pregnancy and childbirth were obtained from the Maternal Information Management System. RESULTS: Women that under study were followed up at 3, 6, 9, and 12 months after childbirth, with 502, 476, 469 and 434 available copies of valid data, respectively. Indicators of physical activity were observed. Relationship between postpartum weight retention and physical activities were analyzed by mixed-effect model, together with repeated measure-analysis on related variances. The pre-pregnancy average weight of the study objects was(54.26±8.11)kg, with postpartum average weight retention as(7.83±5.12), (6.58±5.21), (5.10±5.19), (4.07±4.96) and (3.43±4.98) kg in 42 days, 3, 6, 9, 12 months, respectively. Rates of weight retention was significantly different at different times of repeated measures analysis on variance (P < 0.001). Physical activities were also significantly different at different time spans (P < 0.001). Results from the mixed-effects model showed that physical activity and postpartum weight retention were statistically associated when adjustments were made on factors as:pre-pregnancy BMI, ways of feeding, mode of delivery and other confounders (P < 0.001) while results from the mixed-effects model showed that these data were stable from step adjustment on confounding factors. CONCLUSION: It seemed that the strength of physical activity play an important role on postpartum weight retention.

[Relationship between deliberate self-harm and suicidal behaviors in college students].

OBJECTIVE: To describe the prevalence of deliberate self-harm (DSH) and suicidal behaviors (SIB) as well as the relationship between them in a college student population. METHODS: A total of 4063 medical students were selected under the cluster sampling method in Anhui province. Data were analyzed by Pearson Chi-square and logistic regression. RESULTS: A total of 4063 (13.4%) students reported that they had deliberately harmed themselves during the past 12 months. The acts of DSH with 1 and more than or equal to 2 times occurrence accounted for 3.7% and 9.6% among all the respondents. The act of DSH was significantly higher among boys than that among girls. Rates of suicide ideation, suicide plan, attempted suicide and SIB in the last year were 4.5%, 1.4%, 0.6% and 4.9%, respectively. However no statistically significant difference was found in different sex. Students in the DSH group that with SIB were found to have lower positive coping levels (OR=0.5, 95%CI: 0.3-0.8), getting less support from friends (3-5 vs. less than or equal to 2: OR=0.6, 95%CI: 0.3-0.9; more than or equal to 6 vs. less than or equal to 2: OR=0.4, 95%CI: 0.2-0.8), with higher negative coping levels (OR=2.1, 95%CI: 1.2-3.7), having more serious depressive symptoms (OR=2.9, 95%CI: 1.6-5.2) and anxiety symptoms (OR=2.2, 95%CI: 1.2-3.8), having more serious sleeping problems (OR=1.7, 95%CI: 1.1-2.8) and perceived fat (fat vs. moderate: OR=2.0, 95%CI: 1.1-3.6) than the DSH group without SIB. The rates of SIB in students with DSH behavior were significantly higher than those in students without those behaviors (OR=4.7, 95%CI: 3.5-6.4). Psychosocial variables could attenuate the relationship between the DSH status and suicidal events (OR=3.3, 95%CI: 2.4-4.5). The DSH frequency exhibited a curvilinear relationship to SIB (OR=3.1-10.0) and psychosocial variables also attenuated this relationship (OR=2.4-5.9). CONCLUSION: It was well known that SIB was not a suicidal gesture but our findings suggested that the presence of DSH might trigger the suicidal attempts.

Birth weight and subsequent blood pressure: a meta-analysis.

Hypertension is becoming an important health problem in many countries. The 'small baby syndrome hypothesis' suggests that an inverse linear relationship exists between birth weight and later risk of hypertension; however, this relationship is under debate. We conducted a meta-analysis to examine the association between birth weight and subsequent blood pressure. Among 78 studies reporting on the association between birth weight and subsequent blood pressure, 20 articles (reporting 27 original studies) were eligible for inclusion. Low birth weight (< 2500 g) compared with birth weight greater than 2500 g was associated with an increased risk of hypertension (odds ratio [OR] 1.21; 95% confidence interval [CI] 1.13, 1.30); high birth weight (> 4000 g) compared with birth weight less than 4000 g was associated with a decreased risk of hypertension (OR 0.78; 95% CI 0.71, 0.86). When low birth weight (< 2500 g) was compared with birth weight greater than 2500 g, mean systolic blood pressure (SBP) increased by 2.28 mmHg (95% CI 1.24, 3.33); when high birth weight (> 4000 g) was compared with birth weight less than 4000 g, mean SBP decreased by 2.08 mmHg (95% CI -2.98, -1.17). These findings indicate that there is an inverse linear association between birth weight and later risk of hypertension, and that this association primarily exists between birth weight and SBP.

Higher waist-to-height ratio and waist circumference are predictive of metabolic syndrome and elevated serum alanine aminotransferase in adolescents and young adults in mainland China.

OBJECTIVES: The prevalence of overweight and obesity continue to increase among children and adolescents worldwide. This study examined whether waist circumference (WC), waist-to-hip ratio (WHpR) and waist-to-height ratio (WHtR) are predictive of metabolic syndrome and elevated serum alanine aminotransferase (ALT) among adolescents and young adults in mainland China. STUDY DESIGN: Cross-sectional study. METHODS: In total, 6997 students aged 12-24 years from nine Chinese cities participated in this study. Anthropometric and biochemical data were collected. A logistic regression model was performed to determine the association between anthropometric indicators and metabolic syndrome components and abnormal liver function. RESULTS: This study found prevalence rates for the metabolic syndrome and elevated ALT of 1.4% and 3.1%, respectively, among adolescents and young adults in mainland China. A multivariate logistic regression model found that WHtR ≥0.50 was more strongly associated with metabolic syndrome components and elevated ALT than WC values at or above the 90th percentile (P(90)) or WHpR ≥P(90). Odds ratios for elevated ALT were 2.03 [95% confidence interval (CI) 1.46-2.81], 4.56 (95% CI 3.07-6.78) and 13.43 (95% CI 7.67-23.51) in adolescents and young adults with one, two and three or more components of metabolic syndrome, respectively (P < 0.001 for all). CONCLUSIONS: Higher WC and WHtR were found to be predictive of metabolic syndrome components and elevated ALT among adolescents and young adults in mainland China, and the association was stronger for WHtR. Furthermore, adolescents and young adults with more metabolic syndrome components were more likely to suffer from elevated ALT.

Deliberate self-harm behaviors in Chinese adolescents and young adults.

The aim of this paper was to describe the prevalence of deliberate self-harm (DSH) and to determine the socio-demographic, behavioral, and psychological correlates of DSH behaviors in Chinese adolescents and young adults in a representative sample of the general population. The data were obtained from an epidemiologic study involving adolescents and young adults from junior and senior schools and colleges located in eight provinces of China. A total of 17,622 cases were retained for analysis. The relationship between the explanatory variables with self-harm was analyzed using a Pearson χ (2) test and a multinomial logistic regression model. A total of 3,001 (17.0%) students reported that they had harmed themselves deliberately in the past 12 months. The act of DSH occurring 1 and >2 times accounted for 4.2% (742) and 12.8% (2,259) of all respondents, respectively. The most frequently reported form of DSH was self-hitting. If the reference category was No DSH, the findings indicated that family composition, father's education, perceived family economic status, cigarette use, perceived body image, and higher scores in depression scales were important concomitants of repeat-incidents of DSH. The students, in western areas, who were younger, reported that having unhealthy weight control behaviors, and alcohol use had a higher risk for both types of DSH. Regarding students of age 15-18 years perceived body image (too fat), having unhealthy weight control behaviors or a high level of depression symptoms demonstrated an elevated risk for repeat-incident DSH when single-incident DSH was used as the reference category, whereas the students in middle area reported family composition (both parents), education of the father (less than college) or alcohol use had a decreased risk for repeat-incident DSH. The results of this study suggest that both types of DSH are associated with other wide-ranging problems in the students' lives. Despite their common features, these phenomena also differed from each other. It is necessary to investigate the possible neurobiologic underpinnings of DSH within a longitudinal study to enhance the knowledge of this behavior.

[Dietary patterns and its influencing factors among freshmen students in college].

OBJECTIVE: To investigate the dietary pattern in college freshmen students and to analyze the influencing factors on their dietary patterns. METHODS: A questionnaire survey on situation of dietary pattern and influencing factors was conducted among 1319 freshmen students. RESULTS: Four major dietary patterns were noticed and they were: I, high consumption in hamburger, fried food, nuts, biscuit, chocolate, cola, coffee, sugars, II, high consumption in pork, mutton, beef, poultry meat, animal liver, III, high consumption in fresh fruits, eggs, fish and shrimps, kelp laver and sea fish, milk and dairy products, beans and bean products, IV, high consumption in rice and grain, fresh fruits, fresh vegetables, pork. Risk factors on dietary pattern were presented as follows: (1) boys:having the food pattern I and II showed a strong positive association with the place where they live (OR = 1.67, 95%CI: 0.87 - 3.19; OR = 1.51, 95%CI: 0.79 - 2.88), eating place (OR = 1.63, 95%CI: 1.03 - 2.59;OR = 1.83, 95%CI: 1.04 - 3.23), level of mother's education (OR = 2.52, 95%CI: 1.07 - 5.95; OR = 3.38, 95%CI: 1.50 - 7.63), family income (OR = 2.24, 95%CI: 1.30 - 3.88; OR = 3.06, 95%CI: 1.77 - 5.29) and the status of passive smoking (OR = 1.80, 95%CI: 0.70 - 4.59; OR = 1.83, 95%CI: 0.75 - 4.45). Inverse correlations was found on the level of mother's education (OR = 0.56, 95%CI: 0.17 - 1.79). The food pattern IV showed a strong positive association with place of eating (OR = 1.83, 95%CI: 1.04 - 3.23) but having an inverse correlation with the level of mother's education (OR = 0.56, 95%CI: 0.17 - 1.79). (2) girls when compared with boys, the food pattern I showed minor association with the places of living and eating; while the food pattern II and III had minor association with the status of passive smoking. CONCLUSION: Socio-demographic factors and lifestyle had influenced on the dietary patterns among college freshmen students who should be guided to have a reasonable, balanced diet in the college.

[Impact of psychosocial factors on suicide attempts in high school and college students, data from eight cities of China].

OBJECTIVE: This paper aimed to report the rate of suicide attempts among adolescent and young students of eight cities in China, and to examine the impact of related psychosocial factors on suicide attempts. METHODS: The investigation was obtained in senior and junior high school and college students in eight cities of China. All of the 17 622 participants were recruited to complete anonymous questionnaires regarding their experiences of suicide attempts and related psychosocial factors. RESULTS: Overall, 2.2 percent of the respondents reported that they had experienced attempted suicide during the previous year. Scores on high anxiety (OR = 2.61, 95%CI: 1.64 - 4.16), high depression (OR = 2.05, 95%CI: 1.35 - 3.10), suicide idea (OR = 14.21, 95%CI: 9.88 - 20.43), suicide plan (OR = 3.50, 95%CI: 2.59 - 4.73) were revealed as common risk factors while the whole time span being accompanied by mothers during juvenile years (OR = 0.38, 95%CI: 0.20 - 0.74) seemed to be protective factor for suicide attempts through multivariate logistic regression analysis. CONCLUSION: Our results showed that emotional symptom, idea and plans for suicide were statistically associated with suicide attempted in high school and college students.

[The relationship between emotional, physical abuse and Internet addiction disorder among middle school students].

OBJECTIVE: To study the relationship between emotional, physical abuse and internet addiction disorder (IAD) among middle school students, in order to lay foundation for the development of prevention and control programs on IAD. METHODS: Students selected from 76 classes in Grade One and Grade Two, filled out the anonymous questionnaire, which including demographic characteristics of students, Young's Internet Addiction Scale, Parent-Child Conflict Tactics Scales, etc. Non-conditional multivariate logistic regression model was employed to explore the relationship between child abuse and IAD. Independent variable was child abuse while dependent variable was IAD. Covariant variables would include demographic characteristics, as sex, age, style of household, et al. RESULTS: Among 3798 students, the overall prevalence of emotional abuse was 81.1%, with 55.1% of them reported having experienced physical abuse. Among 3507 internet users, 5.2% was diagnosed as IAD. Results from the non-conditional multivariate logistic regression model showed that odds ratio of severe physical abuse and moderate physical abuse were 3.02 (1.63-5.58) and 4.00 (2.01-7.93). CONCLUSION: Moderate physical abuse and severe physical abuse were possible risk factors of IAD.