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目的 分析大学生健康危险行为与抑郁症状间的关联性，探讨血浆白介素-10(interleukin-10,IL-10)水平在二者关联中的中介作用。方法 于2019年4—5月在安徽省合肥市和江西省上饶市各招募1所大学的大一学生，并于6个月后追踪调查，最终纳入702人，运用美国青少年健康危险行为监测系统改编问卷和抑郁-焦虑-压力自评量表评估大学生的健康危险行为状况和抑郁症状，同时基线时检测血浆IL-10水平。采用单变量分析大学生健康危险行为与抑郁症状的关联性，二分类Logistic回归分析健康危险行为和血浆IL-10与抑郁症状的关联性，并使用中介模型探讨血浆IL-10水平在二者关联中的中介作用。结果 基线时，男生报告抑郁症状检出率高于女生(χ2=6.33,P=0.01);自评家庭经济状况较差(χ2=7.31,P=0.03)和健康状况较差(χ2=6.71,P=0.04)的大学生报告抑郁症状的检出率更高。基线报告体力活动水平较低(χ2=19.09,P<0.01)、吸烟(χ2=7.03,P<0.01)和睡眠障碍(χ2=68.78,P<0.01)的大学生抑郁症状的检出率更高；大学生基线健康危险行为聚集与基线抑郁症状和随访抑郁症状呈正相关(P<0.01)。调整性别、家庭经济状况和健康状况后，回归模型显示，基线血浆IL-10与6个月后抑郁症状(OR=0.36,95%CI 0.18～0.72)均呈负相关。结构方程模型显示健康危险行为负向预测IL-10水平(β=-0.13,SE=0.04),IL-10负向预测抑郁症状(β=-0.09,SE=0.04),IL-10在健康危险行为与抑郁症状起中介作用。结论 大学健康危险行为与抑郁症状存在正相关，基线血浆IL-10水平与6个月后抑郁症状呈负相关，基线IL-10水平在基线健康危险行为聚集与随访抑郁症状间存在部分中介效应。
Abstract：OBJECTIVE To examine the relationship between health-risk behaviors and depressive symptoms among college students, and explore the mediating role of plasma IL-10 level in the relationship between the two.METHODS Freshman students in two universities in Hefei City, Anhui Province and Shangrao City, Jiangxi Province were recruited between April and May 2019, and follow-up investigation was conducted 6 months later. Health risk behaviors were measured based on the Young Risk Behavior Surveillance System(YRBSS) questionnaire, and depressive symptoms was evaluated by using the Depression Anxiety Stress Scale(DASS-21) among college students at baseline and 6 months follow-up survey. Plasma interleukin-10(IL-10) level was measured at baseline. Univariate analysis was used to compare the correlation between health risk behaviors and depressive symptoms among college students. Binary Logistic regression analyzed the relationship between health risk behaviors, IL-10 and depressive symptoms. The mediation model was used to explore the mediating role of IL-10 levels in the association between health risk behaviors and depressive symptoms.RESULTS At baseline, boys reported a higher rate of depressive symptoms than that of girls(χ2=6.33,P=0.01); higher rates of depressive symptoms were observed in students who were from a family with a low perceived economic status(χ2=7.31,P=0.03)or in poor health(χ2=6.71,P=0.04). Participants who reported low physical activity(χ2=19.09,P<0.01), smoking(χ2=7.03,P<0.01), and poor sleep quality(χ2=68.78,P<0.01)at baseline were more likely to experience depressive symptoms. Multiple health-risk behaviors at baseline were positively correlated with depressive symptoms among college students. After adjusting gender, self-reported family economy and self-rated health, the regression model showed that plasma IL-10 at baseline was negatively associated with the prevalence of depressive symptoms(OR=0.36, 95% CI 0.18-0.72) and the incidence of depressive symptoms after 6 months(OR=0.20, 95% CI 0.08-0.49). Structural equation model showed that health-risk behaviors was negatively correlated to IL-10 level(β=-0.13, SE=0.04), IL-10 negatively predicted depressive symptoms at follow-up(β=-0.09, SE=0.04), and IL-10 play a mediating role between health risk behavior and depressive symptoms.CONCLUSION Health risk behaviors are positively correlated with depressive symptoms among college students. Plasma IL-10 level at baseline was negatively associated with the incidence of depressive symptoms after 6 months, and IL-10 level at baseline has a partial mediating effect between baseline health risk behavior clustering and depressive symptoms at follow-up.
[1] 袁兆康，文小桐.中国青少年健康危险行为研究设计与流行现状[J].中国学校卫生，2019,40(4):638-640.
[2] LAZZERI G,PANATTO D,DOMNICH A,et al.Clustering of health-related behaviors among early and mid-adolescents in Tuscany:results from a representative cross-sectional study[J].J Public Health,2018,40(1):e25-e33.
[3] BEUREL E,TOUPS M,NEMEROFF C B.The bidirectional relationship of depression and inflammation:double trouble[J].Neuron,2020,107(2):234-256.
[4] OUYANG W,O′GARRA A.IL-10 family cytokines IL-10 and IL-22:from basic science to clinical translation[J].Immunity,2019,50(4):871-891.
[5] FLOURI E,FRANCESCONI M,PAPACHRISTOU E,et al.Stressful life events,inflammation and emotional and behavioural problems in children:a population-based study[J].Brain Behav Immun,2019,80:66-72.
[6] HAMER M,MOLLOY G J,DE OLIVEIRA C,et al.Leisure time physical activity,risk of depressive symptoms,and inflammatory mediators:the English longitudinal study of ageing[J].Psychoneuroendocrinology,2009,34(7):1050-1055.
[7] PERNA L,TRARES K,PERNECZKY R,et al.Risk of late-onset depression and cognitive decline:results from inflammatory proteome analyses in a prospective population-based cohort study[J].Am J Geriatr Psychiatry,2021.
[8] 朱铮，蒋燕升，魏黎刚.焦虑症患者血清IL-1β、IL-6、IL-10水平分析[J].国际精神病学杂志，2019,46(3):425-427,434.
[9] GU J Y,XU Y W,FENG L P,et al.Enriched environment mitigates depressive behavior by changing the inflammatory activation phenotype of microglia in the hippocampus of depression model rats[J].Brain Res Bull,2021,177:252-262.
[10] SHARIF K,WATAD A,BRAGAZZI N L,et al.Physical activity and autoimmune diseases:get moving and manage the disease[J].Autoimmun Rev,2018,17(1):53-72.
[11] ESPOSITO K,PONTILLO A,GIUGLIANO F,et al.Association of low interleukin-10 levels with the metabolic syndrome in obese women[J].J Clin Endocrinol Metab,2003,88(3):1055-1058.
[12] PUCIATO D,BORYSIUK Z,ROZPARA M.Quality of life and physical activity in an older working-age population[J].Clin Interv Aging,2017,12:1627-1634.
[13] KANN L,MCMANUS T,HARRIS W A,et al.Youth risk behavior surveillance-United States,2015[J].MMWR Surveill Summ,2016,65(6):171-174.
[14] CURCIO G,TEMPESTA D,SCARLATA S,et al.Validity of the Italian version of the Pittsburgh Sleep Quality Index (PSQI) [J].Neurol Sci,2013,34(4):511-519.
[15] TROY D,RUSSELL A,KIDGER J,et al.Childhood psychopathology mediates associations between childhood adversities and multiple health risk behaviours in adolescence:analysis using the ALSPAC birth cohort[J].J Child Psychol Psychiatry,2021,62(9):1100-1109.
[16] GALL S L,SANDERSON K,SMITH K J,et al.Bi-directional associations between healthy lifestyles and mood disorders in young adults:the childhood determinants of adult health study[J].Psychol Med,2016,46(12):2535-2548.
[17] OSMAN A,WONG J L,BAGGE C L,et al.The Depression Anxiety Stress Scales-21 (DASS-21):further examination of dimensions,scale reliability,and correlates[J].J Clin Psychol,2012,68(12):1322-1338.
[18] PENGPID S,PELTZER K.Sedentary behaviour,physical activity and life satisfaction,happiness and perceived health status in university students from 24 countries[J].Int J Environ Res Public Health,2019,16(12):2084.
[19] 谯燕群.珠海市大学生健康危险行为现状及影响因素分析[D].遵义：遵义医学院，2017.
[20] 陈江媛，吴冉.大学生的睡眠质量与抑郁、焦虑的关系[J].中国健康心理学杂志，2021,29(4):608-614.
[21] 张翠翠，崔瑞兰.济南市大学生体力活动抑郁症状与进食障碍的关联[J].中国学校卫生，2021,42(1):69-72.
[22] 蔡杰.生活方式对大学生心理健康影响的纵向研究[D].南京：南京大学，2017.
[23] RUIZ-ESTIGARRIBIA L,MARTíNEZ-GONZáLEZ M á,DíAZ-GUTIéRREZ J,et al.Lifestyles and the risk of depression in the “Seguimiento Universidad de Navarra” cohort[J].Eur Psychiatry,2019,61:33-40.
[24] KANDOLA A,ASHDOWN-FRANKS G,HENDRIKSE J,et al.Physical activity and depression:towards understanding the antidepressant mechanisms of physical activity[J].Neurosci Biobehav Rev,2019,107:525-539.
[25] LECHNER W V,SIDHU N K,CIOE P A,et al.Effects of time-varying changes in tobacco and alcohol use on depressive symptoms following pharmaco-behavioral treatment for smoking and heavy drinking[J].Drug Alcohol Depend,2019,194:173-177.
[26] KASEVA K,DOBEWALL H,YANG X,et al.Physical activity,sleep,and symptoms of depression in adults-testing for mediation[J].Med Sci Sports Exerc,2019,51(6):1162-1168.
[27] ROBERTS R E,DUONG H T.The prospective association between sleep deprivation and depression among adolescents[J].Sleep,2014,37(2):239-244.
[28] SARRIS J,THOMSON R,HARGRAVES F,et al.Multiple lifestyle factors and depressed mood:a cross-sectional and longitudinal analysis of the UK Biobank (N=84,860)[J].BMC Med,2020,18(1):354.
[29] SWANN O G,BRESLIN M,KILPATRICK M,et al.Dietary fibre intake and its associations with depressive symptoms in a prospective adolescent cohort[J].Br J Nutr,2020,3:1-11.
[30] LAMERS F,MILANESCHI Y,SMIT J H,et al.Longitudinal association between depression and inflammatory markers:results from the Netherlands study of depression and anxiety[J].Biol Psychiatry,2019,85(10):829-837.
[31] JIA Y,LIU L,SHENG C,CHENG Z,et al.Increased serum levels of cortisol and inflammatory cytokines in people with depression[J].J Nerv Ment Dis,2019,207(4):271-276.
[32] HILES S A,BAKER A L,DE MALMANCHE T,et al.Unhealthy lifestyle may increase later depression via inflammation in older women but not men[J].J Psychiatr Res,2015,63:65-74.
[33] GIALLUISI A,BONACCIO M,DI CASTELNUOVO A,et al.Lifestyle and biological factors influence the relationship between mental health and low-grade inflammation[J].Brain Behav Immun,2020,85:4-13.
[34] EUTENEUER F,DANNEHL K,DEL REY A,et al.Immunological effects of behavioral activation with exercise in major depression:an exploratory randomized controlled trial[J].Transl Psychiatry,2017,7(5):e1132.
基本信息:
DOI：10.19813/j.cnki.weishengyanjiu.2022.03.002
中图分类号:R749.4
引用信息:
[1]翟爽,陶舒曼,伍晓艳,等.白介素-10在大学生健康危险行为与抑郁症状关联中的中介作用[J].卫生研究,2022,51(03):353-360.DOI:10.19813/j.cnki.weishengyanjiu.2022.03.002.
基金信息:
国家自然科学基金(No.81803257,81773455); 出生人口健康教育部重点实验室开放课题(No.JK20205)
2022-05-30
2022-05-30