Objective: To understand and analyze the current situation and secular trends for prevalence of malnutrition among Chinese children and adolescents aged 7-18 years from 2005 to 2014, and to provide important scientific basis for students' nutrition improvement.Methods: All the subjects aged 7-18 years in both sexes were sampled from 2005, 2010 and 2014 Chinese National Surveys on Students Constitution and Health.According to the new students' health standard of Screening Standard for Malnutrition of school-age children and adolescents(WS/T456-2014) in 2014 of China, the nutritional status of children in 31 provinces (autonomous regions and municipalities, excluding Hong Kong, Macao and Taiwan province) were analyzed and compared in different ages, genders, regions and provinces from 2005 to 2014.The Tibetan students was used with the data of Tibetan minority and all the other students from 30 provinces (autonomous regions, municipalities) were Han minority.Results: The prevalence of malnutrition of children and adolescents of Han minority aged 7-18 years in 2014 was 10.0%.The prevalence of malnutrition components, including stunting, mild wasting and moderate severe wasting, were 0.8%, 3.7%, and 5.5%.Compared with 2005 and 2010, the prevalence of malnutrition of Han children and adolescents in 2014 had declined with 5.0 and 2.6 percentage points, respectively, and its components had declined with 1.0, 1.8, 2.2 and 0.4, 1.1, 1.2 percentage points, respectively.The prevalence of malnutrition of 2014 in boys was higher than in girls (11.1% vs.8.9%), the rural was higher than the urban (11.0% vs.9.1%) and the west (11.7%) was higher than the east (9.0%) and the middle (9.2%).Mild wasting of Chinese children and adolescents aged 7-18 years was the main component in malnutrition and the stunting in the Han and Tibetan children and adolescents only accounted for 8.0% and 7.5%, respectively.Compared with 2005 and 2010, the prevalence of malnutrition for Chinese children and adolescents aged 7-18 years in 2014 had declined with various extents constantly, and there was a statistically significant difference among three surveys (P<0.05).Provinces (autonomous regions, municipalities) with high prevalence of malnutrition mainly concentrated in the southwest of China from 2005 to 2014.Compared with 2005 and 2010, the prevalence of malnutrition declined in 31 provinces (autonomous regions, municipalities) of China in 2014.The number of provinces (autonomous regions, municipalities) with high prevalence of malnutrition decreased constantly and increased for the number of province (autonomous regions, municipalities) with low prevalence.Conclusion: The prevalence of malnutrition among Chinese children and adolescents aged 7-18 years had declined from 2005 to 2014, but the total prevalence of malnutrition was still high.Mild wasting was the main component in malnutrition and the prevalence of stunting was low.Provinces (autonomous regions, municipalities) with high prevalence of malnutrition mainly concentrated in the southwest of China.

Objective To investigate several related problems possibly affecting the measurement results in the experiment of 125I-FSH in vitro cells uptake by domestic GC-1200 gamma RIA counter.Methods Before entering the measuring room,the sample was performed the background measurement.CPM measured in the different locations of same measurement frame and the different locations in unmeasured area were performed the statistical comparison.Results In high count,the influence of single sample reaching 1.9 ×106CPM on the adjacent low counting tube count was 7%;its influence on low counting tube count in adjacent detector was 7.33%;all samples were arranged from high to low order and the high count sample holder was placed on the measured location close to the detector,its influence on low counting tube count was 5.33%.Conclusion The domestic GC-1200 γ RIA counter is suitable for the measurement of the in vitro cell uptake experiment of 125I nuclear labeling.

Objective: The American Heart Association released the Life s Essential 8 (LE 8) for the overall evaluation of cardiovascular health (CVH) on individual level. The present study aimed to describe the overall CVH in Chinese school aged children using LE 8 metrics. Methods: Data of the present analysis came from a national representative multicentered cross sectional study conducted in 7 provinces of China in 2013. The original study used a multistage cluster sampling method. A total of 10 326 children aged 5 to 19 years with complete data of health behaviors and health outcomes were included in the study. Children s health behavior indicators included diet, physical activity, nicotine exposure and sleep health. Health outcome factors included body mass index, fast blood glucose, lipid profile and blood pressure. Results: The median CVH score was 73.3 ( IQR =14.4) in boys and 73.4 ( IQR = 13.5) in girls. Compared to children aged ≤9 years, the health behavior scores were lowest in the 13-15 age group, with boys scoring 7.73 lower (95% CI =-8.35--7.12, P <0.01) and girls scoring 9.15 (95% CI =-9.83--8.48, P <0.01) lower. The ≥16 age group had the lowest health outcome scores, with boys scoring 7.85 (95% CI =-9.07--6.63, P <0.01) lower and girls scoring 6.11 (95% CI =-7.12--5.09, P <0.01) lower. Conclusions Chinese school aged children are generally at a moderate level of cardiovascular health. Specific LE 8 components vary substantially between groups and therefore require targeted intervention strategies.

Objective: To investigate the associations between the appendicular skeletal muscle mass index and main anthropometric parameters, and to provide clues for preventing the reduction of skeletal muscle mass among overweight and obese adults in China. Methods: 1 488 volunteered participants who resided in Beijing longer than one year, between 22 and 55 years old, with self-report BMI ≥24 kg/m² were recruited from April to May 2014. 171 participants whose BMI ≤24 kg/m² or with organic diseases at the first physical examination were excluded, finally 1 317 overweight/obese participants (male and female were 507, and 810, respectively) were enrolled into the present study. After measuring the anthropometric parameters and body composition by the DXA, Pearson correlation analysis and multiple linear regression models were used to analyze the associations between the appendicular skeletal muscle mass index and main anthropometric parameters. Results: The average age of males and females was (35.6±8.4) and (38.2±9.4) years old, respectively. The females' mean levels of body fat percentage, BMI, waist circumference, hip circumference, and bone mineral density were (41.59±4.14)%, (29.00±3.75) kg/m², (92.56±9.00) cm, (101.74±6.75) cm, and (1.20±0.10) g/cm², respectively; and the males' mean levels were (34.22±4.61)%, (30.07±4.12) kg/m², (99.63±9.49) cm, (102.93±7.28) cm, and (1.28±0.11) g/cm², respectively. The mean level of appendicular skeletal muscle mass and skeletal muscle mass index in males were (26.98±3.88), and (8.96±1.02) kg, respectively, which were significantly higher than it in females ((18.57±2.61), and (7.26±0.83) kg, respectively) (P<0.001). For male, the correlation coefficients of skeletal muscle mass index with BMI, waist circumference, hip circumference, body fat percentage and bone mineral density were 0.814, 0.601, 0.637, 0.558, and 0.434, respectively; for female, the correlation coefficients of skeletal muscle mass index with BMI, waist circumference, hip circumference, body fat rate and bone mineral density were 0.761, 0.534, 0.585, 0.610, and 0.304, respectively. The correlations were statistically significant (P<0.001). Multiple linear regression analysis showed that the skeletal muscle mass index of male decreased with the increase of age (β=-0.01, 95%CI:-0.01-0.00) and body fat percentage (β=-0.13, 95%CI:-0.15--0.12) (P<0.05), while increased with the increase of BMI (β=0.31, 95%CI: 0.29-0.32) and bone mineral density (β=0.54, 95%CI: 0.10-1.01) (P<0.05). The skeletal muscle mass index of female decreased with the increase of age (β=-0.01, 95%CI:-0.01-0.00) and body fat percentage (β=-0.12, 95%CI:-0.14--0.12) (P<0.05), while increased with the increase of BMI (β=0.26, 95%CI: 0.25-0.28) and hip circumference (β=0.01, 95%CI: 0.00-0.02) (P<0.05). Conclusion The skeletal muscle mass index of male was higher than it of female. For male, the skeletal muscle mass index might be associated with age, BMI, body fat percentage and bone mineral density. While for female, the skeletal muscle mass index might be associated with age, BMI, body fat percentage and hip circumference.

Objective: To investigate the prevalence of metabolic syndrome (MS) among children and adolescents aged 10-16 years old in 7 provinces in China. Methods: Using the method of stratified cluster random sampling, 93 primary and secondary schools were selected from Guangdong, Hunan, Liaoning, Shanghai, Chongqing, Tianjin, and Ningxia provinces in China. A total of 9 296 students aged 10-16 years old with complete physical and biochemical parameters were selected as the subjects of the present study from above 93 primary and secondary schools. MS was determined using the definition of 'guideline of 2010 Chinese children and adolescents MS definition and treatment’. The standardized age-sex composition of the 2010 census was used to standardize the MS detection rate of every province. Chi-square test was used to compare the difference of MS prevalence among participants with different characteristics. Results: The prevalence of MS was 4.1% (384/9 296) among children and adolescents aged 10-16 years old in 7 provinces in China. The prevalence of MS among males was 5.0% (237/4 754), which was significantly higher than females (3.2%) (147/4 542) (P<0.05). Stratified by nutrition conditions, the prevalence of MS was 0, 0.6% (39/6 733), 8.9% (104/1 170), 30.0% (241/803) for thin, normal weight, overweight, and obese population, respectively. The MS prevalence increased with the increase of body mass index (BMI) (P<0.001). Stratified by provinces, the prevalence of MS was the highest in Tianjin (9.2%) and the lowest in Hunan province (0.8%). Conclusion The prevalence of MS was high among children and adolescents aged 10-16 years old in 7 provinces in China. MS prevalence among males was higher than females; MS prevalence among overweight/obese population was higher than normal weight population. The detection rate of metabolic syndrome was different in different provinces.

Objective: To investigate the association between the combined effect of height growth and overweight/obesity with elevated blood pressure in Chinese children. Methods: Based on a cohort study of puberty development in Xiamen, a cluster sampling method was used to select 1 313 children whose complete height, weight and blood pressure levels at baseline were obtained in 2017 and during a follow up in 2019. The incidence of elevated blood pressure was compared between four different subgroups, and multivariate Logistic regression was performed to analyze the combined effect in boys and girls. Results: Among 1 313 children, the prevalence of elevated blood pressure at baseline was 25.2%. After 2 years of follow up, the incidence of elevated blood pressure was 19.7% and 23.4% in boys, and 16.6% in girls. After adjusting for factors including age, sex, family history of hypertension, sleep time, intake of fruits, vegetables, sugar sweetened beverages, and meat products, multivariate Logistic regression analyses showed that children in the high height growth and overweight/obesity group were more likely to exhibit a higher incidence of elevated blood pressure (overall:RR=2.41，95%CI=1.44-4.04；boys：RR=2.69，95%CI=1.45-5.02). Among girls, the risk of elevated blood pressure in the low height growth and overweight/obesity group also increased significantly (RR=4.47, 95%CI=1.45-13.75). Conclusion A large magnitude of height growth and being overweight/obesity were associated with elevated blood pressure in children, especially boys. Therefore, interventions that are targeted toward obesity prevention in children before pubertal growth spurts in height may be beneficial to reduce childhood high blood pressure.

Objective: To explore the relationship between nutritional status and puberty onset in boys, and to provide a reference for promoting the development of physical and mental health of boys. Methods: A total of 2 724 boys aged 7 to 12 years from grade 2 to 6 were recruited from Xiamen city by cluster sampling method in 2017. The nutritional status was assessed by physical examination, pubertal developmental status was evaluated by rating scales of Tanner and Prader orchidometer, and puberty timing was determined by the P25 age of puberty onset. The association between nutritional status and puberty onset was estimated by logistic regression model. Results: Pubertal onset was found in 29.0% of the boys and the incidence of early pubertal timing was 2.9%. The prevalence of puberty onset in wasting, normal weight, overweight and obesity boys was 19.6%, 28.7%, 34.4% and 31.5%, respectively. The age of puberty onset was significantly earlier in obese boys (F=3.23, P<0.05). The results of Logistic regression analysis showed that with the increase of BMI, the possibility of puberty onset and risk of early pubertal timing increased. After adjusting for confounding factors, the odds of puberty onset in boys with wasting decreased by 64.0% (OR=0.36, 95%CI=0.22-0.60), the possibility of puberty onset and risk of early pubertal timing in boys with obesity increased by 78.3% (OR=1.78, 95%CI=1.14-2.79) and 192.9% (OR=2.93, 95%CI=1.46-5.86), respectively. These relationships were more pronounced in boys of households with lower economic level (P<0.05). Conclusion BMI was positively correlated with puberty onset in boys, the odds of puberty onset and risk of early pubertal timing were significantly increased in obese boys, especially in those with low household economic level.

The national health industry standard (WS/T 610-2018), 'the reference of screening for elevated blood pressure among children and adolescents aged 7-to 18-years-old’, plays a significant role in the standardization of the blood pressure evaluation, the early detection of high blood pressure, and the early intervention of hypertension and other chronic non-communicable diseases among Chinese children and adolescents. This standard gives screening thresholds for blood pressure assessment of children and adolescents in different genders, ages, and heights. Given the complexity of applying this standard, it is error-prone and less efficient to evaluate blood pressure one by one or program this procedure. Therefore, this study provides a SPSS package based on the standard for researchers to download and use, combined with specific cases to guide the use of this package to evaluate the blood pressure of children and adolescents step by step, which could empower researchers to accurately and efficiently conduct blood pressure screening for children and adolescents in China.

Objective: To discuss the main causes and risk factors of disability and death among current Chinese adolescents. Methods: Subnational data of China from Global Burden of Disease Study 2015 (GBD 2015) was used to rank the causes and risk factors leading to death and disability adjusted life years (DALY) in Chinese adolescents aged between 10 and 19 years old, and thereby to analyze the main cauese and risk factors of death and DALY among Chinese adolescents in different genders. Results: In 2015, among Chinese adolescents aged 10-19 years old, the total DALY was 13 million 490 thousand years, and the total number of deaths was 63 258 cases. The top 3 causes of DALY were skin and subcutaneous diseases, iron-deficiency anemia and road injuries, resulting in DALY (constituent ratio) of 1 411 (10.5%), 1 094 (8.1%) and 1 029 (7.6%) thousand years respectively. The top 3 causes of death were road injuries, drowning and leukemia, causing 13 881 (21.9%), 9 895 (15.6%) and 4 620 (7.3%) deaths (constituent ratio) respectively. The top 3 risk factors of DALY were iron deficiency, alcohol use and drug use, causing 1 094 (8.1%), 487 (3.6%) and 220 thousand years (1.6%) DALY (constituent ratio) respectively. The top 3 risk factors of death were alcohol use, occupational injuries and drug use, causing 5 957 (9.4%), 1 523 (2.4%) and 810 (1.3%) deaths respectively. Conclusion Unintentional injury was the top cause of DALY and death in Chinese adolescents, followed by skin and subcutaneous diseases and iron-deficiency anemia. Iron deficiency and alcohol use were the top two risk factors of DALY and death.

Objective: This study aimed to explore the association between malnutrition and the level of blood pressure (BP) as well as elevated BP (EBP) in Han students aged 7 to 18 years in China. Methods: 170 037 subjects with normal nutritional status and malnutrition were enrolled in this study from 2014 Chinese National Surveys on Students' Constitution and Health with a multi-stage stratified cluster random sampling framework covering 31 provinces, autonomous regions and municipalities after the exclusion of 44 317 overweight and obese students. According to the standard of "Screening Standard for Malnutrition of School-age Children and Adolescents" (WS/T456-2014), the nutritional status of children were classified into two categories, normal nutritional status and malnutrition containing stunting, mild wasting and moderate severe wasting. The level of BP and prevalence of EBP were compared between students with normal nutritional status and malnutrition. The multivariate logistic regression model was used to analyze the association between malnutrition and EBP. Results: The levels of systolic BP (SBP) and diastolic BP (DBP) in Chinese Han students aged 7-18 years who were non-overweight and non-obesity status were (103.4±12.3) and (64.7±9.5) mmHg (1 mmHg=0.133 kPa), respectively. The prevalence of EBP, systolic EBP and diastolic EBP in Chinese Han malnourished students (N=21 012) were 3.1% (n=649), 1.5% (n=324) and 2.1% (n=445), respectively, which was significantly lower than those (N=148 320) with normal nutritional status (4.5% (n=6 707), 2.6% (n=3 872) and 2.7% (n=3 959)), and the corresponding differences were statistically significant (P<0.05). The OR (95%CI) between malnutrition and EBP was 0.68 (0.62-0.73), which were 0.65 (0.58-0.72) and 0.68 (0.60-0.77) for boys and girls. The OR (95%CI) between EBP and stunting as well as mild wasting and moderate severe wasting were 0.69 (0.62-0.77), 0.63 (0.55-0.72) and 0.79 (0.60-1.05), respectively. Conclusion The level of BP and prevalence of EBP in Chinese Han students with malnutrition were lower than those with normal nutritional status. The negative correlation existed between malnutrition and EBP in Chinese Han students aged 7 to 18 years.