Objective: This study conducts a Meta analysis on the epidemiological studies of obesity and autism spectrum disorder (ASD) in order to explore the relationship between autism spectrum disorder and obesity in children and adolescents, and to provide some guidance for improving the quality of daily life of children and adolescents with ASD. Methods: PubMed and CNKI (January,2010-January,2022) were systematically searched for literature related to autism spectrum disorders reported the or value by Meta analysis, and compared the weight, BMI acquisition method. Results: A total of 11 literatures were selected for analysis. The total sample included 336 830 participants, including 58 187 patients with ASD and 278 643 patients with normal development. Through Meta analysis, children and adolescents with ASD had a higher risk of obesity than normal people ( OR=1.80, 95%CI = 1.74 -1.86). when stratified by BMI acquisition, autistic patients with BMI obtained from objective measurement, medical records and parents reports had a higher risk of obesity than normal people, and the OR value (95% CI ) was 1.43(1.04-1.96),5.23( 4.44- 6.16),2.57(1.79-3.69). When stratified by age, children and adolescents with ASD aged 14 to 20 years had a higher risk of obesity than normal people. The OR value (95% CI ) was 2.19(1.21-3.94). Conclusion Compared with healthy peers, children and adolescents with ASD have a higher risk of obesity. ASD patients need guidance in diet and physical activity, especially in adolescence, to prevent obesity or diseases caused by obesity.

Objective: To summarize recent progress in the inflammation and immunity research on autism spectrum disorder (ASD) in children during 2002 to 2021, and to provide future directions. Methods: Literature review was conducted in May 2022, with the literature source of core collection of the Web of Science database. CiteSpace software was used for bibliometric analysis. A total of 4 458 literature was included. Results: In the past decade, the number of published articles increased rapidly, from 52 to 528. American has produced the highest number of articles ( n =2 016), followed by China with 407 papers published. The high frequency words included autism spectrum disorder, children, brain, autism, spectrum disorder. The high centrality keywords included schizophrenia, central nervous system, mental regression, multiple sclerosis, autoantibody. Recent researches in ASD primarily focused on the following three aspects:core symptoms and brain mechanism, gene environment interaction, and epidemiological research. Maternal immune activation and gut brain axis were gradually becoming research hotspots. Conclusion Research on inflammation and immunity of ASD in children increased rapidly in the past 20 years. Recent research hotspots included maternal immune activation and gut brain axis mechanisms, which could be integreted in future efforts to develop prevention and intervention programming on ASD in children.

Objective: To apply eye-tracking technology to measure the fixation duration of children and adolescents with autism spectrum disorder (ASD) towards emotional faces, so as to provide potential objective indicators for the diagnosis and intervention of ASD. Methods: Case-control studies related to emotional faces in ASD children and adolescents aged 3-18 years were searched in PubMed, Web of Science, CNKI and Wanfang, with a search period spanning from the inception of the databases to April 1, 2024. The Newcastle-Ottawa Scale (NOS) was employed to assess the quality of the retrieved articles, and a Meta analysis was conducted by Stata 17.0 software. Results: A total of 18 articles were included, encompassing 361 participants in the ASD group and 413 in the control group. All studies scored ≥6 on the NOS, indicating high research quality. Compared to the control group, the ASD group demonstrated significantly shorter fixation duration ( P <0.01) towards specific emotional faces, including happy faces under the paradigm of self-made and same ethnicity emotional faces ( SMD =-1.05, -1.16), neutral faces in domestic literature ( SMD = -1.00), angry and sad faces under clinical diagnosis criteria ( SMD =-1.73, -1.29), and fearful faces under Chinese Classification and Diagnostic Criteria of Mental Disorders, Version 3 (CCMD-Ⅲ) ( SMD =-1.51). Conclusion Children and adolescents with ASD exhibit abnormal eye tracking indicators towards certain emotional faces, which may serve as early warning indicators for the diagnosis of ASD.

Objective: To understand the latent categories of sleep disturbances among children and adolescents with neurodevelopmental disorders (NDDs) in Tianjin and their relationship with behavioral and social issues, so as to provide a basis for preventing and improving sleep disturbances in the population. Methods: From September 2021 to June 2024, 272 children and adolescents aged 2-23 years with neurodevelopmental disorders were recruited from special education schools and designated rehabilitation institutions in Tianjin. Sleep disturbances were assessed using the Children s Sleep Habits Questionnaire (CSHQ). Behavioral and social issues and severity were evaluated using the Autism Behavior Checklist (ABC) and Childhood Autism Rating Scale (CARS). Latent class analysis (LCA) was employed to categorize the subjects into different sleep disturbances categories. Cochran- Armitage test was used to analyze the trend of detection rate of sleep disturbances in different age groups. Spearman rank correlation was used to analyze the correlation between the scores of each scale. The generalized linear model was used to analyze the influence of CARS and ABC scale scores. Covariance analysis was used to examine differences in behavioral and social issues among the different categories. Results: Among 272 survey respondents, a total of 197(72.4%) children and adolescents with NDDs were identified with sleep disturbances. The detection rates of sleep disturbances were 88.9% for those aged 2-6 years, 70.6% for aged 7-12, 66.7% for aged 13-18 and 50.0% for 19-23 years old, which was decreased across age group ( Z =3.58, P <0.01). There was a positive correlation between the total CSHQ score and the total ABC score ( r=0.16, P =0.01). The generalized linear model analysis showed that after adjusting age, gender, parents education level and family monthly income, bedtime habit ( β =3.60) and sleeping latency disorder ( β =3.36) were positively correlated with CARS scores, while the bedtime habit ( β =16.73) and waking up at night ( β =17.46) were positively correlated with ABC scores ( P <0.05). LCA revealed that sleep disturbances in children and adolescents with NDDs could be classified into four categories. The covariance analysis results showed that there were statistically significant differences in the average scores of CSHQ (70.84±9.05, 50.96±6.64, 50.33±5.82, 43.84±5.44) and ABC (49.44± 39.34 , 53.04±39.75, 63.51±40.31, 38.14±34.23) among different categories of all partipants ( F=92.09, 3.95, P <0.05). Conclusion Sleep disturbances in children and adolescents with NDDs are severe and exhibit distinct categorical characteristics.

Objective:To explore the relationship between environmental factors and refractive parameters of children and adolescents aged 6 to 14 years old.Methods:A total of 566 students aged 6 to 14 years old were selected by using random cluster sampling method in Nankai District and Hongqiao District of Tianjin from September to December 2016. Questionnaires were conducted and refractive parameters were measured including axial length (AL), central corneal thickness (CCT), anterior chamber depth (ACD) and lens thickness (LT). Vitreous chamber depth (VCD), corneal radius (CR), the ratio of axial length to corneal radius (AL/CR) and equivalent spherical diopter (SER) were calculated. Multivariate generalized linear model was used to analyze the related factors of refractive parameters.Results:The average age of the subjects was (9.8±2.5) years old, including 302 male students (53.4%). The overall SER, AL, CCT, ACD, LT, VCD, CR and AL/CR ratios were (-1.31±1.85) D, (23.67±1.16) mm, (23.67±1.16) mm, (546.60±31.98) μm, (3.06±0.27) mm, (3.48±0.21) mm, (17.12±1.13) mm, (7.78±0.25) mm and 3.04±0.14, respectively. Multivariate generalized linear model analysis showed that after adjusting for age, gender, height, weight, education level of parents, occupation of parents and family income, compared with those whose daily reading and writing time>6 hours, the AL and VCD of students with daily reading and writing time ≤ 2 hours, 3-4 hours or 5-6 hours were smaller, and the AL/CR ratio of students with daily reading and writing time ≤ 2 hours or 3-4 hours were also smaller (all P<0.05). Compared with those having daily sleep time>9 hours, the students with daily sleep time of 8 hours or 9 hours had higher AL, while the students with daily sleep time of 8 hours had higher CCT, and the students with daily sleep time ≤ 7 hours had higher CR (all P<0.05). Compared with those whose daily electronic screen usage time>1.5 hours, the AL, VCD and CR of students who used electronic screen ≤1.5 hours per day were lower (all P<0.05). Conclusions:Daily reading and writing time, daily electronic screen use time and daily sleep time are the main environmental factors related to eye refractive parameters.

Objective:To explore the relationship between environmental factors and refractive parameters of children and adolescents aged 6 to 14 years old.Methods:A total of 566 students aged 6 to 14 years old were selected by using random cluster sampling method in Nankai District and Hongqiao District of Tianjin from September to December 2016. Questionnaires were conducted and refractive parameters were measured including axial length (AL), central corneal thickness (CCT), anterior chamber depth (ACD) and lens thickness (LT). Vitreous chamber depth (VCD), corneal radius (CR), the ratio of axial length to corneal radius (AL/CR) and equivalent spherical diopter (SER) were calculated. Multivariate generalized linear model was used to analyze the related factors of refractive parameters.Results:The average age of the subjects was (9.8±2.5) years old, including 302 male students (53.4%). The overall SER, AL, CCT, ACD, LT, VCD, CR and AL/CR ratios were (-1.31±1.85) D, (23.67±1.16) mm, (23.67±1.16) mm, (546.60±31.98) μm, (3.06±0.27) mm, (3.48±0.21) mm, (17.12±1.13) mm, (7.78±0.25) mm and 3.04±0.14, respectively. Multivariate generalized linear model analysis showed that after adjusting for age, gender, height, weight, education level of parents, occupation of parents and family income, compared with those whose daily reading and writing time>6 hours, the AL and VCD of students with daily reading and writing time ≤ 2 hours, 3-4 hours or 5-6 hours were smaller, and the AL/CR ratio of students with daily reading and writing time ≤ 2 hours or 3-4 hours were also smaller (all P<0.05). Compared with those having daily sleep time>9 hours, the students with daily sleep time of 8 hours or 9 hours had higher AL, while the students with daily sleep time of 8 hours had higher CCT, and the students with daily sleep time ≤ 7 hours had higher CR (all P<0.05). Compared with those whose daily electronic screen usage time>1.5 hours, the AL, VCD and CR of students who used electronic screen ≤1.5 hours per day were lower (all P<0.05). Conclusions:Daily reading and writing time, daily electronic screen use time and daily sleep time are the main environmental factors related to eye refractive parameters.

Objective: To investigate the association of physical activity and screen time with overweight and obesity among children and adolescents with special needs in Tianjin, so as to provide scientific evidence for childhood obesity prevention and intervention measures in the population. Methods: From January 2022 to June 2024, 296 children and adolescents with intellectual disabilities and autism spectrum disorders aged 2-18 years were recruited from special education schools and institutions in Tianjin. Height and weight were measured, and a standardized questionnaire was used to assess physical activity and screen time. Binary Logistic regression analysis was carried out to investigate the association of physical activity and screen time with overweight and obesity. Results: The prevalence of overweight and obesity among children and adolescents with special needs in Tianjin were 17.2% and 21.6%, respectively, and the combined prevalence of overweight and obesity was 38.9%. The median of moderatetovigorous physical activity (MVPA) time was 0.20 h/d, and physical activity sufficiency rate was 7.8%. The median of screen time was 1.79 h/d, and the screen time compliance rate was 68.2%. The binary Logistic regression results showed that lower levels of MVPA time and increased screen time were associated with a higher risk of overweight and obesity among children and adolescents with special needs [OR(95%CI)=1.80(1.06-3.07), 2.40(1.42-4.07),P<0.05]. Conclusions Insufficient physical activity and excessive screen time are associated with an increased risk of overweight and obesity among children and adolescents with special needs. Therefore, comprehensive intervention measures should be implemented as early as possible to prevent and reduce the incidence of overweight and obesity in this population.