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Aim: Lifestyle factors may influence cognitive function. Therefore, we compared the risk of cognitive impairment (COI) of all possible combinations of three lifestyle factors—tea consumption, physical activity, and siesta (afternoon nap or rest)—to the absence of any of these lifestyle factors. Methods: This cross‐sectional study consisted of 4579 community‐dwelling Chinese individuals aged 60 years or older living in Suzhou. Among the subjects were 3634 participants with normal cognition and 945 who had been diagnosed with COI according to the Abbreviated Mental Test. Odds ratios (ORs) and 95% confidence intervals (CIs) were estimated with a multivariate‐adjusted model by logistic regression. Results: Individually, tea consumption and physical activity significantly lowered the risk of COI to 0.66 (95%CI: 0.48–0.90) and 0.79 (95%CI: 0.65–0.96), respectively. In combination, physical activity and siesta reduced the risk of COI to the greatest extent (OR = 0.44, 95%CI: 0.31–0.64). Based on multivariate adjustment, almost all combinations of factors had a significant negative association with COI, but the combination of tea consumption and siesta had an irrelevant correlation with COI. All combinations of lifestyle factors had a lower OR than any single lifestyle factor among the correlations that were significant. Conclusion: Based on our findings, engaging in physical activity in combination with either or both of the other lifestyle factors was associated with a lower OR of having COI than adhering on a single factor in elderly Chinese people. [ABSTRACT FROM AUTHOR]

Background: There was a lack of studies focusing on older adults about the longitudinal association between metabolic syndrome (MetS) and hyperuricemia (HUA). We aimed to assess the association of baseline MetS and incident HUA among older Chinese adults, with a special focus on the associations between different combinations of MetS components and HUA. Methods: Data of 3247 Chinese adults aged 60 years or older included in a community-based longitudinal cohort study were analyzed. Anthropometric examinations and collection of blood sample were conducted both at baseline and follow-up. HUA was defined as 7 mg/dl or above for men and 6 mg/dl or greater for women. MetS was assessed based on the National Cholesterol Education Program-Adult Treatment Panel III, and older adults with the presence of at least three of MetS components were considered as having MetS. Results: MetS and its components, including high blood pressure (BP), high body mass index, diabetes mellitus and high triglycerides, were significantly related to incident HUA. The association between high BP and incident HUA is strongest among the five MetS components. Among all combinations of MetS components, the group consisting of diabetes mellitus, high BP and high triglycerides had the highest odds for incident HUA (OR = 13.07, 95% CI = 4.95– 34.54). Conclusion: MetS and its components, except for low high-density lipoprotein cholesterol, could increase the risk of HUA among community-dwelling older adults, and high BP may be the most important determinant. [ABSTRACT FROM AUTHOR]

Background: Few studies examined associations between depressive symptoms and metabolic syndrome (MetS) among older Chinese adults. Considering that the prevalence of depressive symptoms is high in older Chinese adults, we aimed to examine associations of depressive symptoms with MetS and its components in older Chinese adults. Methods: Data from a community-based cross-sectional study of 4579 Chinese adults aged 60 years or older were analyzed. Depressive symptoms were assessed using the nine-item Patient Health Questionnaire. The presence of MetS was defined based on the Adult Treatment Panel III criteria, which include obesity, reduced blood high-density lipoprotein, high blood pressure (BP), elevated fasting plasma glucose and hypertriglyceridemia. A participant was considered as having MetS if he or she met at least three of the above-mentioned criteria. Results: In all participants, depressive symptoms were related to elevated fasting plasma glucose (≥ 7.0 mmol/L) (adjusted odds ratio [OR] = 1.50, 95% confidence interval [CI] [1.00–2.20]) and diabetes (adjusted OR = 1.50, 95% CI [1.01–2.20]). The associations of depressive symptoms with MetS and its components were not significant among women. However, there was a negative association between depressive symptoms and elevated systolic BP (≥ 130 mm Hg) (OR = 0.59, 95% CI [0.4–0.9]), and similar findings were observed after adjusting for lifestyle-related variables in men. Conclusions: In older Chinese adults, depressive symptoms were negatively associated with elevated systolic BP in men while these findings were not found in women. [ABSTRACT FROM AUTHOR]

Purpose: Parental rural-to-urban migration has a wide range of health effects on children's but its impact on children's refractive status remains unclear. We aim to examine whether parental rural-to-urban migration could influence the refractive status of their children in rural areas of China. Methods: Among the 2346 grade 7 students in the Mojiang Myopia Progression Study, information regarding parental migration was collected by questionnaires and was successfully obtained in 2105 participants. Refractive error was measured in diopters (D) with cycloplegia using an autorefractor and axial length (AL) was measured using an IOL Master. One-to-one nearest-neighbor matching techniques with a 0.01 caliper level were used to estimate the propensity score matching (PSM) models. Results: Among all the participants, 472 pairs (1 student with vs. 1 student without migrant parents) were successfully matched based on propensity scores. Students with migrant parents had a lower proportion of myopia (29.2% vs. 40.7%; P <.001) and more hyperopic refractions (−0.25D vs. −0.31D; P =.04) compared with those without. They also had shorter ALs (23.4 mm vs. 23.6 mm) but the difference was not significance (P =.18). In addition, students with migrant parents spent less time reading after school per day (0.87 vs. 1.01 hours; P =.01). Conclusions: Myopia is less prevalent among children with migrant parents compared with those without. This study indicated that living without parents might be a protect factor for myopia in Chinese school student via giving them less pressure on study. [ABSTRACT FROM AUTHOR]

Purpose: To examine the distribution and determinants of central corneal thickness (CCT) including birth weight and gestational age in a school-based samples of Grade 7 students in rural China. Methods: 2346 (93.5%) grade 7 students with a mean age of 13.8 years participated in the study. CCT was measured for both eyes using the LenStar LS900. Information regarding birth weight and gestational age was retrieved from the participants' delivery records. A linear regression model was established to examine the relationship of birth weight, gestational age and other factors with CCT. Results: The mean CCT in this population was 534.7 µm and boys had a greater CCT compared with girls (P =.06). CCT was positively related to axial length (r = 0.056) while negatively related to anterior chamber depth (r = −0.076) and corneal power (r = −0.105). In multivariate analyses, the cornea was 19.35µm thinner in individuals with low birth weight compared with those with normal. In addition, the cornea was 25.25µm thinner in prematurely born adolescents compared with full-term ones. The combined effect of birth weight and gestational age on CCT was not statistically significant (P for interaction = 0.12) Conclusions: Low birth weight and small gestational age are associated with thinner corneas in adolescence. This disparity across groups with different levels of birth parameters should be taken into account by future studies investigating CCT as risk factors or diagnostic tests for glaucoma. [ABSTRACT FROM AUTHOR]

Background: The aim of this study was to determine the prevalence of refractive errors and their association with glycaemic control among adults with type 2 diabetes mellitus (T2DM) in eastern China.Methods: A community-based survey, including 913 adults with T2DM aged 30 to 89 years, was conducted. Refractive error was assessed by autorefraction, after which subjective refraction was performed. Ocular biometric parameters were measured by non-contact partial coherence laser interferometry. Myopia was defined as spherical equivalent (SE) less than -0.50 dioptres (D), high myopia as SE less than -5.00 D, hyperopia as SE greater than 0.50 D and astigmatism as cylinder less than -0.50 D.Results: After excluding participants who had undergone cataract surgery, 839 were included in the data analyses and 96.1 per cent were found to have refractive errors. The overall prevalences of myopia, high myopia, hyperopia and astigmatism were 28.2 per cent (95 per cent confidence interval [CI] 25.2-31.3), 6.3 per cent (95 per cent CI 4.7-8.0), 46.4 per cent (95 per cent CI 43.0-49.7) and 81.0 per cent (95 per cent CI 78.4-83.7) with no gender differences observed (all p > 0.10). In multivariate analysis, myopia was associated with decreasing age (odds ratio [OR] = 0.86, p = 0.01; per year increase), higher blood levels of haemoglobin A1c (HbA1c ) (OR = 1.12, p = 0.05; per unit increase), higher education levels (OR = 5.10, p < 0.001; university or college versus illiterate or primary school) and the presence of nuclear cataract (OR = 2.36, p < 0.001).Conclusions: Refractive errors may be associated with glycaemic control among T2DM patients. Longitudinal analyses are warranted to examine the relationship between changes in HbA1c and the development of refractive errors. [ABSTRACT FROM AUTHOR]

Purpose: Observational studies have suggested a possible relationship between disordered sleep and myopia, but the association may be subject to selection biases. We aimed to minimize selection biases and assess the association by applying a propensity score matching (PSM) approach. Methods: The study was designed as a school-based cross-sectional study on a Chinese cohort aged 13–14 years in rural areas of China. The Chinese version of the Children's Sleep Habits Questionnaire was used for the measurement of sleep quality and a score of 41 or more was used to define the presence of disordered sleep. Each participant's refractive status was measured after cycloplegia using an autorefractor and myopia was defined as spherical equivalent <−0.50 D. The propensity scores for disordered sleep were formulated using nine potential confounders. We matched the propensity scores for subjects with and without disordered sleep within a caliper of 0.01 of logit function of propensity scores. Results: In this study, 474 pairs (1 subject with vs. 1 subject without disordered sleep) were successfully matched based on propensity scores. The odds ratio (OR) of myopia for disordered sleep before PSM reached conventional levels of statistical significance (OR: 1.43 95% confidence interval [CI] 1.05, 2.58, p = 0.01). After matching, the magnitude of association was reduced and the OR of myopia was not significant (OR: 1.54 95% CI 0.90, 2.57, p = 0.46). Conclusions: At current stage, there are insufficient evidence indicating that disordered sleep could affect the development of myopia in adolescents. [ABSTRACT FROM AUTHOR]

Purpose: We aim to determine the association of the types of lamp for homework including incandescent lamp, fluorescent lamp, and light-emitting diode (LED) lamp with the prevalence of myopia in Chinese children. Methods: 2346 grade 7 students from ten middle schools (93.5% response rate) aged 13 to 14 years in Mojiang, a small county located in Southwestern China, participated in the study. Refractive error was measured with cycloplegia using an autorefractor by optometrists or trained technicians. An IOL Master was used to measure ocular biometric parameters including axial length (AL). Information regarding the types of lamp for homework af``ter schools was collected by questionnaires. Results: Of all the study participants, 693 (29.5%) were affected by myopia, with the prevalence estimates being higher in girls (36.8%; 95% confidence interval [CI]: 34.0, 39.6) than in boys (22.8%; 95% CI: 20.4, 25.1) (P < 0.001). After adjusting for potential confounders such as gender, height, parental history of myopia, time on computer use, time on watching TV, time outdoors, and time on reading and writing, participants using LED lamps for homework had a more myopic refractive error and a longer AL compared with those using incandescent or fluorescent lamps. There were no significant differences in myopia prevalence between children using incandescent and fluorescent lamps for homework. The population attributable risk percentage for myopia associated with using LED lamps for homework after schools was 11.2%. Conclusions: Using LED lamps for homework after schools might contribute to the development of myopia among school-aged children. [ABSTRACT FROM AUTHOR]

Purpose Understanding the association of iris colour and myopia may provide further insights into the role of the wavelength of lights in the pathophysiology of myopia. We aim to assess the association of iris colour and myopia in a school-based sample of Chinese students. Methods Two thousand three hundred and forty-six Year 7 students from 10 middle schools (93.5% response rate) aged 13-14 years in Mojiang, a small county located in Southwestern China, participated in the study. We obtained standardised slit lamp photographs and developed a grading system assessing iris colour (higher grade denoting a darker iris). Refractive error was measured after cycloplegia using an autorefractor by optometrists or trained technicians. An IOLMaster () was used to measure ocular biometric parameters including axial length ( AL). Results Of all the study participants, 693 (29.5%) were affected by myopia with the prevalence estimates being higher in girls (36.8%; 95% confidence interval [ CI]: 34.0, 39.6) than in boys (22.8%; 95% CI: 20.4, 25.1) ( p < 0.001). After adjusting for gender, height, parental history of myopia, time spent on computer, time spent watching TV, time spent outdoors, and time spent reading and writing, participants with a darker iris colour tended to have a higher prevalence of myopia, a more myopic refraction and a longer AL. Dose-response relationships were observed in all regression models ( p for trend <0.05). Conclusions Darker iris colour was associated with more myopic refractive errors and longer ALs among Chinese school-aged children and this association was independent of other known myopia-related risk factors. [ABSTRACT FROM AUTHOR]

Purpose: To understand the prevalence, awareness, and risk factors for diabetic retinopathy (DR) among Chinese with known type-2 diabetes mellitus (T2DM) in eastern China communities. Methods: A community-based survey including 913 patients with known T2DM was conducted in Suzhou, China. Diabetes was defined as hemoglobin A1c (hbA1c) ≥6.5%, use of diabetic medication or a physician diagnosis of diabetes. Retinal photographs were graded for the presence of DR using the Airlie House classification system. Binary logistic regression models were established to examine the associations of risk factors with DR and vision-threatening diabetic retinopathy (VTDR). Results: The overall prevalence of any DR was 18.0% (95% confidence interval [CI]: 15.5–20.6%) in this population. VTDR affected 4.4% (95% CI: 3.1–5.8%) of the study participants. In multivariate analysis, the presence of DR among T2DM patients was associated with decreased age (odds ratio [OR] = 0.97;p= 0.01; per year increase), longer durations of diabetes (OR = 1.02; per year increase;p= 0.03), higher blood levels of hbA1c (OR = 1.15; per unit increase;p= 0.03). Of the 158 participants with DR, only 12 (8%) had been aware of their condition or had been diagnosed previously as having DR. Conclusions: The prevalence of DR among diabetes patients in eastern China was lower than those in northern China. The awareness of DR was poor, which emphasizes the pressing need for increasing the public awareness of this vision-threatening eye disorder and routine eye screening should be performed among T2DM patients in the communities. [ABSTRACT FROM AUTHOR]

Purpose: To determine the difference between cycloplegic and non-cycloplegic refractive error and its associated factors in Chinese children and adolescents with a high prevalence of myopia. Methods: A school-based study including 1565 students aged 6 to 21 years was conducted in 2013 in Ejina, Inner Mongolia, China. Comprehensive eye examinations were performed. Pre-and postcycloplegic refractive error were measured using an auto-refractor. For cycloplegic refraction, one drop of topical 1.0% cyclopentolate was administered to each eye twice with a 5-minute interval and a third drop was administered 15 minutes after the second drop if the pupil size was less than 6 mm or if the pupillary light reflex was still present. Results: Two drops of cyclopentolate were found to be sufficient in 59% of the study participants while the other 41% need an additional drop. The prevalence of myopia was 89.5% in participants aged over 12 years and 68.6% in those aged 12 years or younger (P<0.001). When myopia was defined as spherical equivalent (SE) of less than -0.5 diopter (D), the prevalence estimates were 76.7% (95% confidence interval [CI] 74.6–78.8) and 54.1% (95%CI 51.6–56.6) before and after cycloplegic refraction, respectively. When hyperopia was defined as SE of more than 0.5D, the prevalence was only 2.8% (95%CI 1.9–3.6) before cycloplegic refraction while it was 15.5% (95%CI 13.7–17.3) after cycloplegic refraction. Increased difference between cycloplegic and non-cycloplegic refractive error was associated with decreased intraocular pressures (P = 0.01). Conclusions: Lack of cycloplegia in refractive error measurement was associated with significant misclassifications in both myopia and hyperopia among Chinese children and adolescents. Decreased intraocular pressure was related to a greater difference between cycloplegic and non-cycloplegic refractive error. [ABSTRACT FROM AUTHOR]

Purpose To determine the prevalence, types and awareness of glaucoma in a rural community in China and to examine possible ethnic variations. Methods The Yunnan Minority Eye Study was a multi-ethnic community-based eye survey using random cluster sampling strategies. 2133 Bai, 2205 Han and 2208 Yi Chinese aged 50 years or older participated in this study. Glaucoma including primary open-angle glaucoma ( POAG), primary angle-closure glaucoma ( PACG) and secondary glaucoma was defined based on the International Society of Geographical and Epidemiological Ophthalmology criteria. Results The overall age-standardized prevalence of all glaucoma was 2.6% (95% confidence interval [ CI]: 2.2-3.1%) in this population. It was 1.8% (95% CI: 1.1-1.9%) for POAG and 0.5% (95% CI: 0.9-1.6%) for PACG, respectively. Among 29 people with secondary glaucoma, 27 (93%) were blind in at least one eye. The presence of primary open-angle glaucoma was associated with male gender (odds ratio [ OR] = 2.94; comparing men with women), Yi ethnicity ( OR = 2.27; comparing Yi with Han people), higher IOP ( OR = 1.09 per mmHg increase), and the presence of myopia ( OR = 1.84). Of the 212 participants with glaucoma, only 38 (18%) were aware of the disease and had been diagnosed previously as having glaucoma or suspected glaucoma. Patients who were better educated tended to be aware of the disease. Conclusions Significant ethnic difference in the prevalence of POAG was observed in this study. The low awareness of glaucoma highlights the pressing need to increase public awareness of this potentially blinding condition in rural China. [ABSTRACT FROM AUTHOR]

Purpose: To determine the prevalence and associations of pterygium in a multiethnic adult population in rural China and to examine potential ethnic differences Methods: A total of 6418 adults (2133 ethnic Bai, 2130 ethnic Yi, and 2155 ethnic Han) aged 50 years or older participated in the study. Anterior segment examination was performed without pupil dilation using a slit lamp. Pterygium was defined as a raised fleshy triangular fibrovascular tissue growth of the conjunctiva encroaching onto a clear cornea. Results: Pterygium was least prevalent among adults of Yi ethnicity (29.5%) compared with Bai (39.0%,p< 0.001) or Han (39.5%,p< 0.001) ethnicities. Those of Bai ethnicity were most likely to be affected by severe pterygium (7.5%), while Yi were least likely to be affected (3.8%). Multivariate analysis revealed that increasing age (odds ratio, OR, 1.017), female sex (OR 1.53), lower educational level (OR 1.25), higher blood pressure levels (OR 1.002), and greater time spent outdoors per day (OR 1.09) were significantly associated with a higher prevalence of pterygium, while Yi ethnicity (OR 0.65, comparing Yi with Han) and wearing brimmed hats outdoors (OR 0.82) were protective factors. Conclusion: Ethnicity was significantly associated with prevalence of pterygium. Our findings may be applicable to many other countries located within the “pterygium belt” for health resource allocation among different ethnic groups. [ABSTRACT FROM PUBLISHER]

Purpose To determine the prevalence and possible causes for reduced visual acuity ( VA) in preschool children in a metropolis in China. Methods A school-based paediatric eye survey including 5862 preschool children aged three to 6 years was conducted from 2011 to 2012 in Yuhuatai District, Nanjing, China, using an age-stratified random sampling procedure. Clinical examinations including ocular alignment, ocular motility, visual acuity, prism cover test, cycloplegic refraction, stereopsis screening, slit lamp examination and fundus examination were performed by trained study ophthalmologists and optometrists. Reduced VA was defined as presenting VA of worse than 0.30 log MAR (Snellen 6/12 or 20/40), for both better and worse eyes. Results 5667 (94.8%) children with complete VA data were included in the data analyses. Among them, 208 and 93 had reduced VA in the worse and better eye, respectively. Reduced VA was detected in 3.7% (95% confidence interval [ CI] 3.2%-4.2%) in the worse eye and 1.6% (95% CI 1.3%-2.0%) in the better eye. No significant age and gender differences in reduced VA were observed ( p > 0.05). Refractive errors and amblyopia were the principal causes for reduced VA in the worse eye which accounted for 66.8% and 32.7% of the total cases with reduced VA, respectively. Astigmatism and hyperopia were the major types of refractive errors causing reduced VA. Conclusions The burden of reduced VA in preschool children in China was similar to that of Asian children of similar ages in the United States. Uncorrected refractive error and amblyopia were the principal causes for reduced VA among preschoolers (aged three to 6 years) in China. [ABSTRACT FROM AUTHOR]

Purpose The association between myopia and cognitive dysfunction among elderly adults was assessed by applying a Propensity Score Matching ( PSM) approach. This is a statistical method which allows investigators to estimate causal treatment effects using observational or nonrandomised data. Methods The study was designed as a community-based cross-sectional study based on a Chinese cohort aged 60 years or older in China. Objective refraction was measured using an autorefractor and subjective refraction was used to refine vision, using the results of the objective refraction as the starting point. Myopia was defined as a spherical equivalent value of less than −0.50 dioptre (D) in the right eye. The Abbreviated Mental Test ( AMT) was used for cognitive assessment. The propensity scores for myopia were formulated using 13 potential confounders. We matched the propensity scores for subjects with and without myopia within a caliper of 0.01 of logit function of propensity scores. Results About 4123 elderly adults who successfully completed the AMT were included in this analysis. The odds ratio ( OR) of cognitive dysfunction for myopia before matching was 1.98 (95% confidence interval [ CI] 1.61, 2.44; p < 0.001). There were significant covariate imbalances between comparison groups and after propensity score matching, covariate imbalance was significantly reduced. After propensity score matching, the OR of cognitive dysfunction was marginally significant and the magnitude of association was reduced ( OR: 1.31 95% CI 1.00, 1.71; p = 0.05). Traditional multivariate logistic regression modelling found an OR of 1.52 (95% CI 1.23, 2.06; p < 0.001) after adjusting for the 13 potential confounders. Conclusions Myopia was associated with a higher prevalence of cognitive dysfunction among elderly Chinese aged 60 years or older in China. The PSM approach may be a useful method to address selection bias in observational studies when randomised trials cannot ethically be conducted. [ABSTRACT FROM AUTHOR]

Purpose: Changes in lens may reflect the status of systemic health of human beings but the supporting evidences are not well summarized yet. We aimed to determine the relationship of age-related cataract, cataract surgery and long-term mortality by pooling the results of published population-based studies. Methods: We searched PubMed and Embase from their inception till March, 2014 for population-based studies reporting the associations of any subtypes of age-related cataract, cataract surgery with all-cause mortality. We pooled the effect estimates (hazards ratios [HRs]) under a random effects model. Results: Totally, we identified 10 unique population-based studies including 39,659 individuals at baseline reporting the associations of any subtypes of cataract with all-cause mortality from 6 countries. The presence of any cataract including cataract surgery was significantly associated with a higher risk of death (pooled HR: 1.43, 95% CI, 1.21, 2.02; P<0.001; I2 = 64.2%). In the meta-analysis of 9 study findings, adults with nuclear cataract were at higher risks of mortality (pooled HR: 1.55, 95% CI, 1.17, 2.05; P = 0.002; I2 = 89.2%). In the meta-analysis of 8 study findings, cortical cataract was associated with higher risks of mortality (pooled HR: 1.26, 95% CI, 1.12, 1.42; P<0.001, I2 = 29.7%). In the meta-analysis of 6 study findings, PSC cataract was associated with higher risks of mortality (pooled HR: 1.37, 95% CI, 1.04, 1.80; P = 0.03; I2 = 67.3%). The association between cataract surgery and mortality was marginally non-significant by pooling 8 study findings (pooled HR: 1.27, 95% CI, 0.97, 1.66; P = 0.08; I2 = 76.6%). Conclusions: All subtypes of age-related cataract were associated with an increased mortality with nuclear cataract having the strongest association among the 3 cataract subtypes. However, cataract surgery was not significantly related to mortality. These findings indicated that changes in lens may serve as markers for ageing and systemic health in general population. [ABSTRACT FROM AUTHOR]

Objectives: We examined the prevalence of and trends in obesity among children and adolescents in China (1985–2010). Methods: We used data from the 1985, 1991, 1995, 2000, 2005, and 2010 Chinese National Surveys on Students’ Constitution and Health (CNSSCH). The CNSSCH is a national survey of physical fitness and health status in Chinese students that uses multistage stratified sampling of 31 provinces and municipalities. A subject was considered obese or overweight if weight-for-height exceeded the 20% or 10% of standard weight-for-height. The standard weight-for-height was the 80th percentile for sex- and age-specific growth charts. Results: The age-adjusted prevalence of obesity and of overweight and obesity combined was 8.1% (95% CI, 8.0–8.3%) and 19.2% (95% CI, 19.1–19.4%) among children and adolescents 7–18 years in age. Obesity was more likely to be present among children or adolescents who were male (RR, 1.93; 95% CI, 1.90–1.97), urban (RR, 1.99; 95% CI, 1.95–2.02), or 10–12 years (RR, 1.43; 95% CI, 1.40–1.46). Trend analyses of the 25-year period revealed a significant increasing trend in males (RR, 1.59; 95% CI, 1.58–1.60) and in females (RR, 1.49; 95% CI, 1.48–1.50). The rate of increase in obese or overweight prevalence was highest in boys from rural areas (9% annual increase). Conclusions: During 1985–2010, there was a significant and continuous increase in the prevalence of obesity in children and adolescents. Obesity is epidemic in China, but may be reduced with evidence-based interventions (e.g., school intervention programs). [ABSTRACT FROM AUTHOR]

Purpose: To determine the association of season of birth and refractive error in very young Chinese children in China. Methods: We conducted a population-based study of Chinese children aged 0 to 3 years residing in eastern China. Refraction was determined by non-cyclopegic autorefraction using a hand-held autorefractor. Date of birth was retrieved from birth certificate of the individual subjects. A generalized linear regression model was fitted to estimate the regression coefficient and 95% confidence interval (CI) of refractive error for season of birth, adjusting for confounders. Results: Of the 1385 children eligible to participate, 1222 (88.2%) were examined. Refractive error data were available for 1219 children. The mean spherical equivalent were 1.21 diopters (D) in children born Spring, 1.24 D in those born in Summer, 1.23 D in those born in Autumn, 1.15 D in Winter. After adjusting for age, sex, father's educational level, birth weight and the number of summers between birth and examination date the children have been exposed to, children born in winter had a 0.12 D more myopic refraction compared with those born in summer (regression coefficient: −0.12; 95% CI, −0.27,−0.06; P = 0.006). The association between season of birth and cylinder power was not statistically significant. Conclusions: In China, children born in winter had a more myopic refraction compared with those born in other seasons. The observed association between season of birth and refractive error was independent of parental educational level and birth weight, suggesting that light level may have a small impact on refractive development in early life. [ABSTRACT FROM AUTHOR]

Understanding the iris colour might be a useful biomarker in predicting emotional health status. We aimed to examine the relationship of iris colour with subjective emotional status in a sample of Chinese adolescents aged 13 to 14 years. A total of 2346 students from ten middle schools in Mojiang participated the examination. The emotional health status was measured by the adolescent self-reported PedsQL 4.0. We obtained standardized slit-lamp photographs and developed a grading system assessing iris colour (higher grade denoting darker). Logistic regression models were fitted to assess the relationship between iris colour and emotional status. The trend of decreasing negative emotional status with darker iris colour was significantly. Compared with grades 1 and 2 of iris colour, the students with grades 4 and 5 had less negative emotional status (OR fear = 0.56, 95 % CI : 0.41, 0.76; OR sadness = 0.67, 95 % CI : 0.49, 0.92; OR anger = 0.71, 95 % CI : 0.52, 0.98). In addition, the trend did not change after adjusting for potential confounders, including height, waist circumstance, sleep habits and computer times in logistic regression models. Only negative emotional indexes were selected as evaluative materials, it is unclear whether the pattern found in the present study also exists with regard to positive emotional indexes, such as happiness. Darker iris colour might be associated with less negative emotional status in Chinese adolescents. • The study assessed iris colour based on standardized slit-lamp photographs. • Darker iris was associated with less negative emotion in Chinese adolescents. • The study providing a novel perspective for preventing negative emotion. [ABSTRACT FROM AUTHOR]

Purpose: Our aim was to investigate the association between sleep and the development of metabolic syndrome (MetS) in Chinese older adults and to accumulate evidence for the prevention of MetS through sleep management.Methods: This prospective study followed 3005 participants aged over 60 derived from the Weitang Geriatric Diseases Study who were without MetS at baseline. MetS was defined according to the Adult Treatment Panel III (ATP III) criteria. Logistic regression models were fit to assess the association between sleep and MetS incident and a linear regression model was used to examine the impact of sleep duration on every component of MetS. Data on sleep-related parameters were obtained based on a self-reported questionnaire.Results: After five-year follow-up, 13.51% participants developed MetS, of which 46.86% were women. The incidence of MetS was highest among adults who slept 6 h or less and lowest among those who slept 7 h after adjusted for multiple variables. Subgroup analyses showed no gender specificity. The variation of fasting plasma glucose (FBG) for ≥9 h per night was significantly lower than that for 7.01-7.99 h per night (β = -0.18, P < 0.05). Sleeping for 8-8.99 h also decreased the variation of diastolic blood pressure (DBP) compared to 7.01-7.99 h (β = -0.84, P < 0.05).Conclusion: We conclude that both short and long sleep duration are risk factors for MetS incident in older adults. [ABSTRACT FROM AUTHOR]