1.Mechanism of Wendan Ningxin Granules in Modulating Diastolic Calcium Leakage-related Proteins to Improve Inflammation-associated Atrial Fibrillation Susceptibility
Biyue SHANG ; Tingting ZHU ; Shunxin LYU ; Zhiwei ZHANG ; Yufei WANG ; Xiangning CUI ; Yingdong LU
Chinese Journal of Experimental Traditional Medical Formulae 2026;32(11):133-143
ObjectiveTo investigate the protective effect and mechanism of Wendan Ningxin granules (WNG) on susceptibility to atrial fibrillation (AF) in mice with inflammatory injury. Methods100 C57BL/6 mice were divided into a blank control group, a model group, a low-dose WNG group (2.34 g·kg-1·d-1), a high-dose WNG group (4.68 g·kg-1·d-1), and an amiodarone positive control group (0.091 g·kg-1·d-1), with 20 mice in each group. Except for the blank control group, mice in other groups received intraperitoneal injections of lipopolysaccharide (LPS) to establish an inflammatory injury model. Treatment groups received continuous intragastric administration of their respective interventions for four weeks. During the fourth week, the treatment groups received LPS injections concurrently with their treatments. The blank control and model groups received distilled water (10 mL·kg-1·d-1) by gavage, with a gavage volume of 10 mL·kg-1 for all groups, once daily. Hematoxylin-eosin (HE) staining and Sirius red staining were used to observe atrial tissue morphology and fibrosis degree. Immunohistochemistry was used to assess the expression of α-smooth muscle actin (α-SMA) in mouse atrial tissue. Electrophysiological detection was performed using a multi-channel electrophysiology mapping system to measure AF inducibility, AF duration, and atrial effective refractory period (AERP). High-resolution optical mapping was used to measure action potential duration (APD) dispersion, conduction heterogeneity index, and calcium transient (CaT) dispersion. Real-time quantitative polymerase chain reaction (Real-time PCR) was used to detect mRNA expression of proteins related to diastolic calcium leakage in mouse atria: Ca2+/calmodulin-dependent protein kinase Ⅱ(CaMKⅡ), ryanodine receptor 2(RyR2), sarco/endoplasmic reticulum Ca²⁺-ATPase (SERCA), and sodium-calcium exchanger (NCX). Western blot analysis was performed to detect the expression of CaMKII, RyR2, SERCA, and NCX proteins in myocardial tissue from each group. Enzyme-linked immunosorbent assay (ELISA) was used to measure serum levels of inflammatory factors interleukin-1β (IL-1β) and tumor necrosis factor-α (TNF-α). ResultsPathological staining results showed that compared with the blank control group, the model group exhibited disrupted atrial tissue structure, inflammatory cell infiltration, atrial fibrosis, and diffuse infiltration of numerous brown α-SMA positive cells in the atrial interstitium (P<0.01). AF could be induced by electrical stimulation with a longer duration. AERP was shortened, while APD dispersion, conduction heterogeneity index, and CaT dispersion were increased (P<0.01). The expression of proteins associated with diastolic calcium leakage, including CaMKⅡ, RyR2, and NCX1, showed elevated mRNA and protein levels, whereas SERCA2a mRNA and protein expression decreased (P<0.05). Serum levels of inflammatory factors IL-1β and TNF-α were elevated (P<0.01). Compared with the model group, intervention with WNG alleviated cardiac structural damage, reduced inflammatory cell infiltration, improved atrial fibrosis, and reduced the diffuse infiltration of α-SMA positive cells (P<0.01). AF inducibility and AF duration upon electrical stimulation were significantly reduced (P<0.05), AERP was prolonged (P<0.05), mRNA and protein expression of CaMKⅡ, RyR2, and NCX1-proteins associated with diastolic calcium leakage-were reduced, whilst mRNA and protein expression of SERCA2a increased (P<0.05), and serum levels of IL-1β and TNF-α were decreased (P<0.01). ConclusionBoth low‑ and high‑dose WNG can effectively reduce susceptibility to inflammation-related AF. The mechanism by which WNG reduce AF susceptibility may be related to regulating proteins involved in sarcoplasmic reticulum diastolic calcium leak, thereby improving cardiac electrical remodeling, and alleviating inflammation-induced myocardial fibrosis, thus improving cardiac structural remodeling.
2.Co-occurrence of screening myopia and anxiety symptoms and associated factors among junior and senior high school students in Beijing
WANG Lu, ZHAO Hai, SUN Bingjie, LIU Xiuying, XIA Zhiwei
Chinese Journal of School Health 2026;47(5):747-750
Objective:
To investigate the current status of screening myopia and anxiety symptoms and associated factors among junior and senior high school students in Beijing, so as to provide evidence for myopia prevention and control and the improvement of mental health among adolescents.
Methods:
From September to November 2024, a total of 17 245 junior high schools, general senior high schools and vocational high schools from 16 districts in Beijing were enrolled by stratified cluster sampling method. Questionnaire surveys and vision screening were conducted to collect data on anxiety symptom and screening diagnosed myopia. The Chi square test was used to analyze the co-occurrence of myopia and anxiety symptoms, and binary Logistic regression analysis was adopted to explore the related factors of the co-occurrence.
Results:
The overall detection rate of cooccurrence screening myopia and anxiety symptoms among Beijing junior and senior high school students was 6.00%. The detection rate was higher in females ( 7.15 %) than in males (4.90%), higher in urban areas (6.65%) than in suburban areas (5.41%), and higher in general senior high school students (7.61%) than in vocational high school students (6.46%) and junior high school students (4.65%). All differences were statistically significant ( χ 2=38.49, 11.66, 54.88, all P <0.01). Binary Logistic regression analysis showed that female gender ( OR =1.43), general senior high school ( OR =1.60), vocational high school ( OR =1.59), daily sugar sweetened beverage intake ( OR =1.66), participation in academic extracurricular classes in preschool ( OR =1.30), electronic screen use for more than 2 hours per day ( OR =1.21), and insufficient sleep ( OR =2.41) were associated with an increased risk of co-occurring screening diagnosed myopia and anxiety symptoms (all P <0.05).
Conclusions
The co-occurrence of screening diagnosed of myopia and anxiety symptoms among junior and senior high school students in Beijing is common. Female gender, senior high school students, and unhealthy lifestyle behaviors are all risk factors for the co-occurrence of myopia and anxiety symptom. Comprehensive intervention measures can be adopted to simultaneously promote vision protection and mental health among junior and senior high school students.
3.Effect of Modified Baoyuantang Combined with Linggui Zhugantang on Myocardial Mitochondrial Damage and NLRP3/GSDMD-mediated Pyroptosis in Rat Model of Post-myocardial Infarction Heart Failure
Tingting ZHU ; Lifei LYU ; Biyue SHANG ; Zhiwei ZHANG ; Shunxin LYU ; Yufei WANG ; Xiangning CUI ; Yingdong LU
Chinese Journal of Experimental Traditional Medical Formulae 2026;32(17):1-12
ObjectiveTo investigate the therapeutic effects of modified Baoyuantang combined with Linggui Zhugantang on post-myocardial infarction heart failure in rats and its influence on NOD-like receptor pyrin domain-containing protein 3 (NLRP3)/gasdermin D (GSDMD)-mediated pyroptosis. MethodsSixty male SD rats were randomized into sham, model, low-, medium-, and high-dose (2.52, 5.04, 10.08 g·kg-1, respectively) modified Baoyuantang combined with Linggui Zhugantang, and sacubitril/valsartan sodium (0.021 g·kg-1) groups, with 10 rats in each group. Except the sham group, the other groups underwent left anterior descending coronary artery ligation for the modeling of myocardial infarction. The treatment groups were administrated with corresponding drugs by gavage, and the sham and model groups received an equal volume of normal saline. Administration began on the first day after successful modeling, once daily, for 4 weeks. Echocardiography was used to measure left ventricular ejection fraction (LVEF), left ventricular fractional shortening (LVFS), left ventricular end-diastolic and end-systolic diameters (LVIDd and LVIDs), left ventricular posterior wall thicknesses at end-diastole and end-systole (LVPWd, LVPWs), and left ventricular volumes at end-diastole and end-systole (LV Vold and LV Vols). Cardiac mass index and heart weight-to-tibia length ratio were calculated. Hematoxylin-eosin (HE) staining and Sirius Red staining were performed to observe myocardial morphology and collagen deposition. Immunohistochemistry was employed to detect the expression of type I collagen (Collagen Ⅰ), NLRP3, GSDMD, and interleukin-1β (IL-1β). Transmission electron microscopy was used to observe the mitochondrial ultrastructure. Tetramethylrhodamine methyl ester (TMRM) staining was conducted to assess mitochondrial membrane potential (MMP) in cardiomyocytes. Real-time PCR was used to quantify the mRNA levels of NLRP3, cysteinyl aspartate-specific proteinase-1 (Caspase-1), IL-1β, GSDMD, and interleukin-18 (IL-18) in the myocardial tissue. Western blotting was employed to determine the protein levels of NLRP3, Caspase-1, GSDMD, IL-1β, IL-18, nuclear factor kappa-B (NF-κB) p50, and NF-κB p65 in the myocardial tissue. Enzyme-linked immunosorbent assay (ELISA) was adopted to measure the serum levels of tumor necrosis factor-α (TNF-α), IL-1β, and IL-6. ResultsCompared with the sham group, the model group showed increased LVIDd, LVIDs, LV Vold, LV Vols, cardiac mass index, and heart weight-to-tibia length ratio (P<0.05), decreased LVPWs, LVEF, LVFS, and MMP (P<0.05), evident myocardial inflammation, fibrosis, and mitochondrial damage, upregulated expression of NLRP3, Caspase-1, GSDMD, IL-1β, IL-18, NF-κB p50, and NF-κB p65, and elevated serum levels of TNF-α, IL-1β, and IL-6 (P<0.05). Compared with the model group, modified Baoyuantang combined with Linggui Zhugantang reduced the LVIDd, LVIDs, LV Vols, cardiac mass index, and heart weight-to-tibia length ratio (P<0.05), increased the LVPWs, LVEF, LVFS, and MMP (P<0.05), alleviated myocardial inflammation and fibrosis, improved the mitochondrial structure and function, downregulated the expression of NLRP3, Caspase-1, GSDMD, IL-1β, IL-18, NF-κB p50, and NF-κB p65 (P<0.05), and reduced the serum levels of TNF-α, IL-1β, and IL-6 (P<0.05). ConclusionModified Baoyuantang combined with Linggui Zhugantang can ameliorate post-myocardial infarction ventricular remodeling and improve the cardiac function by reducing mitochondrial damage and inhibiting NLRP3/GSDMD-mediated pyroptosis.
4.Factors influencing willingness to participate in health science popularization among medical workers in Guangdong Province
Bingjun SONG ; Ying ZHAO ; Mengxiong WU ; Zhiwei LU ; Fan YANG ; Ping CHEN ; Caiwen LI ; Xibo WANG ; Kun HUANG ; Ziqian ZHENG
China Occupational Medicine 2026;53(2):162-167
Objective To analyze the status of willingness to participate in health science popularization (HSP) and its influencing factors among medical workers in Guangdong Province. Methods A total of 462 medical workers in Guangdong Province were recruited as the study subjects using a stratified convenience sampling method. The Questionnaire on Influencing Factors of Willingness to Participate in Health Science Popularization, developed by the research team, was used to investigate their willingness to participate in HSP and related variables, including previous communication experience, attitude, moral belief, descriptive norm, injunctive norm, self-efficacy, and social support. Hierarchical regression analysis was used to identify the influencing factors of willingness to participate in HSP. Results The median and 25th and 75th percentiles score of willingness to participate in HSP was 4.0 (3.8, 4.5), indicating a moderately high level of willingness. The HSP participation willingness score was positively correlated with scores for previous communication experience, attitude, moral belief, descriptive norm, injunctive norm, self-efficacy, and social support (Spearman correlation coefficients were 0.513, 0.384, 0.507, 0.533, 0.463, 0.556, and 0.435, respectively; all P<0.01). Hierarchical regression analysis showed that previous communication experience, moral belief, descriptive norm and self-efficacy positively predicted willingness to participate in HSP (all P<0.05). Medical workers in the non-Pearl River Delta region had lower willingness than those in the Pearl River Delta region for HSP participation (P<0.05). Conclusion There is still room for improving willingness for HSP participation among healthcare professionals in Guangdong Province. It is recommended to enhance self-efficacy through communication skills training, strengthen professional ethics education, foster a positive peer engagement atmosphere, and intensify resource support and capacity building for HSP in the non-Pearl River Delta region, to improve HSP participation willingness among medical workers in Guangdong Province.
5.Correlation of short sleep duration and screening myopia among primary and middle school students in Beijing
WANG Lu, ZHAO Hai, SUN Bingjie, XIA Zhiwei, GUO Xin
Chinese Journal of School Health 2025;46(1):14-17
Objective:
To study the correlation between short sleep duration and screening myopia among primary and middle school students in Beijing, so as to provide a scientific basis for the comprehensive prevention and control of myopia among students.
Methods:
Using a stratified cluster random sampling, 25 593 primary and middle school students from 16 districts of Beijing were selected from September to November 2023. The National Common Diseases and Health Influencing Factors Monitoring Survey Questionnaire was used to conduct a questionnaire survey, and visual acuity was tested according to the Specification for the Screening of Refractive Error in Primary and Middle School Students. The reporting rates of short sleep duration and detection rates of screening myopia among primary and middle school students were compared using the Chi square test. Binary Logistic regression was used to analyze the correlation between short sleep duration and screening myopia.
Results:
About 68.63% of students reported short sleep duration. There was a statistically significant difference in the reporting rate of short sleep duration among students in different school stages ( χ 2=981.18, P <0.01), with the lowest reporting rate of vocational high school students (47.07%) and the highest reporting rate of ordinary high school students (76.17%). The detection rates of screening myopia among primary school students ( 57.09% ) and middle school students (76.53%) who reported short sleep duration were higher than those who reported enough sleep duration (52.65%, 71.94%), with satistically significant differences ( χ 2=14.83, 17.96, P <0.01). The results of binary Logistic regression analysis showed that primary and middle school students with short sleep duration had a higher risk of developing screening myopia, compared to students with enough sleep duration ( OR =1.25); after adjusting for confounding factors such as educational stage, gender, region, boarding situation, primary and secondary school students with short sleep duration still had a higher risk of screening myopia ( OR =1.26) ( P <0.01). The analysis results stratified by educational stage showed that primary school students from grades 4-6 and middle school students with short sleep duration had a higher risk of screening myopia ( OR=1.18, 1.20, P <0.01).
Conclusions
Primary and secondary school students in Beijing with short sleep duration sleep have a higher risk of developing screening myopia. Families, schools, and society should ensure enough sleep duration to reduce the occurrence of myopia among students.
6.Pollution characteristics and ecological risk assessment of typical pharmaceutical and personal care products in Zhengzhou rivers
Xie WANG ; Qingqing MA ; Suge LU ; Hongli LIU ; Yongheng SU ; Zhiwei HAN ; Congke ZHANG
Journal of Environmental and Occupational Medicine 2025;42(11):1330-1335
Background The residues of pharmaceutical and personal care products (PPCPs) in aquatic environments have become an increasingly prominent urban pollution issue, attracting widespread attention. The analysis of PPCPs pollution in water environments holds profound implications in Zhengzhou, a strategically important city in central China. Objective To analyze the pollution characteristics of PPCPs, such as antidepressants and antibiotics, in rivers of Zhengzhou and assess associated ecological risk. Methods Water samples were collected from three rivers of Zhengzhou, and 13 PPCPs (5 antibiotics and 8 antidepressants) were analyzed quantitatively by high performance liquid chromatography-triple quadrupole mass spectrometry (HPLC-MS/MS) after automatic solid phase extraction. Risk quotient (RQ) was applied to assess ecological risk of PPCPs with high concentration. Results The primary antibiotics pollutants were norfloxacin and ofloxacin, both with a detection rate of 100%. Among antidepressants, venlafaxine and citalopram showed the highest detection rates at 92.3% and 88.5%, respectively. The detected antibiotics with the highest average concentrations included ofloxacin and sulfamethoxazole with concentrations of 99.8 ng·L−1and 96.2 ng·L−1, respectively, while antidepressants venlafaxine and citalopram were detected with the highest average concentrations of 15.2 ng·L−1and 1.35 ng·L−1, respectively. The inter-river comparisons revealed statistically significant differences in contaminant loads (P<0.05). The sums of average PPCP concentrations at sampling points in the Jialu River and Suoxu River were 83.4 ng·L−1 and 100.4 ng·L−1, respectively. The Xiaoqing River exhibited higher pollution levels than both the Jialu and Suoxu Rivers, with a total average concentration of 478.4 ng·L−1, where ofloxacin and sulfamethoxazole were identified as the predominant pollutants. The results of ecological risk assessment indicated the RQ contributed by sulfamethoxazole ranged between 0.50−0.95 in the Xiaoqing River, suggesting a controllable risk but requiring prioritized mitigation strategies. The RQ values of norfloxacin were distributed within the range of 0.10-0.30, indicating a moderate ecological risk. The RQ values for ofloxacin and venlafaxine remained below 0.10, indicating a lower risk level. Conclusion PPCPs contamination is positive in the rivers of Zhengzhou, and sulfamethoxazole and ofloxacin are the primary cantaminants. The Xiaoqing River exhibits the highest pollution levels. The initial risk assessment show that sulfamethoxazole and norfloxacin pose potential ecological risks, requiring prioritized contamination management.
7.Effects of high intensity interval training on glucose metabolism, cortisol and sleep quality among college students with comorbid depressive symptoms and obesity
Chinese Journal of School Health 2025;46(12):1721-1726
Objective:
To explore the intervention effects of high intensity interval training (HIIT) on glucose metabolism, cortisol (Cor), and sleep quality among college students with comorbid depressive symptoms and obesity, so as to provide a reference for improving sleep quality among college students with comorbid depressive symptoms and obesity.
Methods:
In March 2023, 45 college students with comorbid depressive symptoms and obesity were recruited and randomly assigned to an exercise group ( n =23) and a control group ( n =22) by random number table method. The exercise group received HIIT intervention for 12 weeks, three times a week, while the control group received no intervention. Blood samples were collected from participants to measure fasting insulin (FINS), fasting blood glucose (FBG), homeostatic model assessment of insulin resistance (HOMA-IR), Cor, and Pittsburgh Sleep Quality Index (PSQI) before and after intervention. Statistical analysis was performed using t-test, repeated measures analysis of variance (ANOVA), simple effect analysis.
Results:
The repeated measures ANOVA revealed statistically significant time×group interaction effects for body composition (weight, body mass index, percentage of body fat, fat mass, waist to hip ratio), depressive symptoms, PSQI scores and its subdimensions (subjective sleep quality, sleep onset time, sleep efficiency, sleep disorders, daytime dysfunction), as well as FBG, FINS, and HOMA-IR between the exercise group and control group before and after intervention ( F =7.10-53.38, all P <0.05). Simple effect analysis showed that compared to the control group, the exercise group demonstrated significant improvements in body composition (body mass index, fat mass, waist to hip ratio), depressive symptoms, PSQI scores and its sub dimensions (subjective sleep quality, sleep onset time, sleep efficiency, sleep disorders, daytime dysfunction), FBG, FINS, HOMA-IR, and Cor (all P <0.05).
Conclusion
HIIT can improve the sleep quality of college students with comorbid depressive symptoms and obesity by enhancing glucose metabolism and regulating Cor levels.
8.Study on the ADC value of deep gray matter nuclei in patients with Parkinson's disease by RESOLVE DWI
Lishu ZHU ; Xinyou LI ; Bin YU ; Yunfeng LU ; Zhiwei ZHANG ; Yongmei LI ; Fajin LYU ; Silin DU
Chongqing Medicine 2025;54(4):915-920
Objective Readout segmentation of long variable echo-trains diffusion weighted imaging(RESOLVE DWI)was used to analyze the difference of apparent diffusion coefficient(ADC)value in deep cerebral nucleus and its correlation with clinical characteristics in patients with Parkinson's disease(PD).Methods Clinical data of 60 patients with PD were retrospectively analyzed as PD group,and were divided in-to the tremor group(n=30)and the bradykinesia group(n=30)according to symptom type,middle-aged(≤65 years old)group(n=23)and elderly(>65 years old)group(n=37)according to age,and 60 healthy vol-unteers were selected as the control group during the same period.ADC values were measured on the ADC map of RESOLVE DWI sequence,and the ADC values of bilateral putamen,pallidus,substantia nigra,rubra,and dentate nucleus were analyzed and their correlation with UPDRS-Ⅲ score and H&Y grading.Results Compared with the control group,the ADC values of both putamen,globus pallidus,globus pallidus,red nucleus,right substantia nigra and right dentate nucleus were increased in the PD group,the ADC values of both putamen,globus pallidus,red nucleus and right substantia nigra in the tremor group were increased,and the ADC values of right putamen,globus pallidus and bilateral red nucleus in the bradykinesia group were increased(P<0.05).Compared with the bradykinesia group,the values of ADC in the tremor group were similar.Compared with the middle-aged group,the ADC values of right putamen,bilateral globus pallidus,left substantia nigra and left red nucleus were higher in the elderly group(P<0.05).In the PD group,the ADC values of the right putamen,globus pallidus,and dentate nucleus were positively correlated with H&Y grade and UPDRS-Ⅲscore,and the ADC value of the left putamen was positively correlated with H&Y grade.Conclusion RE-SOLVE DWI can be used to evaluate the differences in deep gray matter nuclei in PD patients,and its ADC value may be used to evaluate and predict the severity of nuclear mass damage and motor symptoms in PD pa-tients.
9.Clinical study on acupuncture combined with hemoperfusion for the treatment of hemodialysis patients with intractable pruritus
Zhiwei WANG ; Anming LU ; Chunyu LIU ; Jijun WU
International Journal of Traditional Chinese Medicine 2025;47(6):778-783
Objective:To explore the clinical efficacy of acupuncture combined with hemoperfusion in hemodialysis patients with intractable pruritus.Methods:A retrospective clinical study was conducted. A total of 126 hemodialysis patients with intractable pruritus were enrolled from June 2023 to June 2024 and divided into two groups (63 cases each) based on treatment modalities. The control group received hemoperfusion alone, while the observation group received acupuncture combined with hemoperfusion. Both groups were treated for 3 months. The Modified Pruritus Duo's Score was used to evaluate pruritus severity, the Pittsburgh Sleep Quality Index (PSQI) for sleep quality, and the 36-Item Short Form Health Survey (SF-36) for quality of life before and after treatment. Serum β 2-microglobulin (β 2-MG) and parathyroid hormone (PTH) levels were measured using immunoturbidimetry and chemiluminescence, respectively. Clinical efficacy was assessed. Results:The total effective rate was 98.42% (62/63) in the observation group and 78.77% (49/63) in the control group, with a statistically significant difference ( χ2=16.90, P<0.001). Post-treatment scores for pruritus severity, affected areas, frequency, sleep interference, and total pruritus score in the observation group were significantly lower than those in the control group ( t values were 16.94, 12.23, 12.67, 12.71, 23.91, respectively, P<0.001). The observation group also exhibited lower post-treatment serum β 2-MG [(13.24±3.11) mg/L vs. (17.61±4.58) mg/L, t=10.46] and PTH [(198.11±96.12) ng/L vs. (249.27±88.45) ng/L, t=6.72] levels were lower than those in the control group ( P<0.001). Additionally, the observation group demonstrated significantly lower scores in subjective sleep quality, sleep latency, sleep duration, habitual sleep efficiency, sleep disturbances, daytime dysfunction, and total PSQI score ( t values were 14.97, 6.98, 2.06, 23.63, 2.68, 3.56, 14.89, respectively, P<0.001), as well as higher scores in physical health, role-physical, bodily pain, general health, vitality, social functioning, role-emotional, and mental health domains of SF-36 ( t values were -3.13, -4.35, -6.34, -7.90, -4.49, -5.30, -5.00, -3.95, respectively, P<0.05). Conclusion:Acupuncture combined with hemoperfusion effectively alleviates pruritus, reduces serum β 2-MG and PTH levels, improves sleep quality, and enhances overall quality of life in hemodialysis patients with intractable pruritus, demonstrating superior efficacy compared to hemoperfusion alone.
10.Association between polymorphisms in the glucose metabolism and lipid regulation genes with metabolic abnormalities in childhood obesity
Chinese Journal of School Health 2025;46(6):888-893
Objective:
To explore the association between CDKAL1 rs35261542, FAIM2 rs 3205718, and VGLL4 rs 2574704 polymorphisms with childhood obesity and related metabolic phenotypes to provide evidence for personalized prevention and management strategies.
Methods:
Based on the 2023 Long term Nutritional Health Effects of Early Childhood Nutrition Package Intervention project, the study enrolled 1 078 children aged 5-7 years from four counties in Henan (Songxian and Ruyang countries) and Guizhou (Guiding and Fuquan countries) provinces. Using BMI Z scores, 87 overweight and obese(OVOB) children were selected and matched by sex, age, and BMI Z score with 117 normal weight controls. Participants were further stratified into four metabolic phenotype groups: metabolically healthy normal weight (MHNW, n =51), metabolically unhealthy normal weight (MUNW, n =66), metabolically healthy obesity (MHO, n =31) and metabolically unhealthy obesity (MUO, n =56) based on four conventional cardiometabolic risk factor (CR) criteria. Data were collected through questionnaires, anthropometric measurements, serum biochemical tests, and KASP genotyping. The distribution of three genetic polymorphisms ( CDKAL1 rs35261542, FAIM2 rs3205718, VGLL4 rs 2574704) across metabolic subgroups was analyzed. Multivariate Logistic regression models assessed associations between these polymorphisms and obesity/metabolic phenotypes.
Results:
Multivariate Logistic regression analysis showed that Homozygous mutant AA genotype of CDKAL1 rs 35261542 was positively associated with OVOB( OR =3.63), MHO ( OR =11.04), MUO ( OR = 4.88 ) ( P <0.05). Homozygous TT genotype of FAIM2 rs 3205718 increased OVOB risk ( OR =4.44, P <0.05) but showed no association with metabolic phenotypes ( P >0.05). Homozygous mutant TT of VGLL4 rs 2574704 reduced the risks of MHO and MUO ( OR = 0.30, 0.24, P <0.05). Cumulative genetic effects analysis demonstrated carriers of 1 or 2 risk genotypes of rs 35261542 and rs 3205718 had progressively higher OVOB risk ( OR =2.53, 20.79), and the combination of rs 35261542 and rs 2574704 increased risks for both MHO ( OR =8.50) and MUO ( OR =5.00) ( P <0.05).
Conclusions
The AA genotype of rs 35261542 ( CDKAL1 ) positively correlates with childhood obesity and metabolic abnormalities. The TT genotype of rs 3205718 ( FAIM 2) increases obesity risk but not metabolic phenotypes. The TT genotype of rs 2574704 ( VGLL 4) shows protective effects against metabolic dysfunction. Risk genotypes exhibit dosedependent cumulative effects on obesity and metabolic outcomes.


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