Context Although the role of iron in the development of type 2 diabetes (T2D) has long been a concern, prospective studies directly linking body iron stores to T2D risk in a sex-dependent context have been inconsistent. Objective A systematic meta-analysis was conducted to explore the sex-specific association of circulating ferritin with T2D risk. Data Sources We searched PubMed, Web of Science, and EMBASE databases to identify available prospective studies through 1 August 2018. Results Fifteen prospective studies comprising 77,352 participants and 18,404 patients with T2D, aged 20 to 80 years, and with ∼3 to 17 years of follow-up were identified. For each 100-μg/L increment in ferritin levels of overall participants, T2D risk increased by 22% (RR, 1.22; 95% CI, 1.14 to 1.31). Of note, major heterogeneities by sex were identified, with increased ferritin level having an apparently greater effect on T2D risk in women (RR, 1.53; 95% CI, 1.29 to 1.82) than in men (RR, 1.21; 95% CI, 1.15 to 1.27) after exclusion of a study with high heterogeneity (41,512 men and 6974 women for sex-specific analyses; P = 0.020 for sex difference). Further nonlinear analysis between circulating ferritin and T2D risk also showed sex-dimorphic association in that the T2D risk of women was twice as strong in magnitude as that of men at the same ferritin level. Conclusions Greater circulating ferritin levels were independently associated with increased T2D risk, which appeared stronger among women than men. Our findings provide prospective evidence for further testing of the utility of ferritin levels in predicting T2D risk in a sex-specific manner.
BackgroundTo date, numerous studies have examined the health status of Chinese left-behind children and migrant children. However, the impact of children's diverse migration/left-behind experiences on their health is still unclear.MethodsA cross-sectional survey was conducted in 2020 in Nanling country (Anhui province) and Kaihua country (Zhejiang province) in China. School children from grade 5 to 8 reported their socio-demographic, interpersonal relationships, self-rated health, suicidal ideation, and depression. Participants were divided into four groups based on their migrant patterns, namely rural left-behind children with previous migration experience (ME-LBC), rural children with previous migration experience (ME-NLBC), rural left-behind children without migration experience (LBC), and rural children without migration experience (NLBC).ResultsAmong 2,323 participants included in the present study, there were 336 ME-LBC (14.5%), 283 ME-NLBC (12.2%), 561 LBC (24.1%) and 1,143 NLBC (49.2%). Compared with NLBC, ME-LBC reported significantly poorer self-rated health (OR = 0.72, 95% CI [0.53–0.97], p < 0.05), higher risk of depression (β = 0.90, 95% CI [0.02–1.77], p < 0.05) with adjustment of socio-demographic and interpersonal relationships. There was no significant difference in suicidal ideation among different groups of children. The better interpersonal relationship was associated with a better self-rated health, and lower prevalence of depression and suicidal intention.ConclusionsCompared to ordinary rural children, ME-LBC tended to experience higher levels of depression and poorer self-rated health. These research findings imply developing intervention programs about psychological adjustment tailored to different migrant patterns of Chinese rural children. The keys might be to strengthen the relationships with peer and teacher in school and improve the quality of parent-child communication in family for LBC.
BackgroundIn China, the figure for left-behind children (LBC) of migrants stood at 68. 77 million in 2015. Despite being seen as a whole in the last few decades, LBC today differ broadly in parental migrating status. This study focused on LBC with both parents migrating (BLBC), LBC with only mothers migrating (MLBC), LBC with only fathers migrating (FLBC), and previous LBC with one or both parents migrating (PLBC), separately. We aimed at exploring the extent to which LBC were being affected by each migrant parent on both mental health and risk behaviors.MethodsData from 4,832 children were collected by a school-based survey in both rural and urban areas of China's Anhui province. Each participant anonymously completed a self-administered questionnaire containing the sociodemographics, the Strength and Difficulties Questionnaire (SDQ), the items from the Youth Risk Behavior Surveillance System (YRBSS), and Young's Internet Addiction Test for Chinese (YIAT-C). Data were analyzed using one-way ANOVA and the Chi-squared test. Associations were estimated by multiple linear regression and logistic regression analyses adjusted for several confounders.ResultsThe results suggested that BLBC (p < 0.001), MLBC (p < 0.05), FLBC (p < 0.01), and PLBC (p < 0.001) significantly scored higher for total difficulties along with emotional symptoms and conduct problems than never left-behind children (NLBC). Besides, BLBC, FLBC, and PLBC further reported a significantly higher rate of smoking (p < 0.001, p < 0.01, and p < 0.001, respectively) and drinking (p < 0.01, p < 0.05, and p < 0.01, respectively) than did NLBC. Also, MLBC appeared higher risks of smoking problems [OR = 2.31, 95% CI (1.45–3.69), p < 0.001] and the internet addiction [OR = 2.15, 95% CI (1.24–3.72), p < 0.01], when compared to NLBC.ConclusionsThe findings provided insight into LBC within the different contexts of parental migrations and contributed to a better understanding of their specific and potentially persistent health risks. Correspondingly, the study highlighted the implications for differentiating LBC to capture the more vulnerable group and tailored interventions to prioritize.
Background Adolescent mental health is a global public health concern and parental migration has been identified as a risk factor. However, the effect mechanism remained unclear. Methods A total of 2,737 participants (mean = 11.93, SD = 1.23) were recruited from twelve schools in migrant-sending areas in Zhejiang and Anhui provinces. The participants responded to items in Child Depression Inventory, Parent–Adolescent Communication Scale, Olweus Bully or Victim Questionnaire and socio-demographic questions. Serial multiple mediation models were analysed using the bootstrapping method. Results Current and previous left-behind (LB) experience were significantly associated with higher risks of depression, non-suicidal self-injury and suicidal ideation (p < 0.05). Mother–adolescent communication and school bullying victimisation, in serial order, mediated the effect of current LB status on mental health (p < 0.05). In terms of previously LB adolescents, parent–adolescent communication was a standalone mediator (p < 0.01) and the serial mediation effect of parent–adolescent communication and school bullying victimisation was significant. Conclusions Lack of parent–adolescent communication and school bullying victimisation acted as risk factors for the negative effect of LB status or experience on adolescent mental health. The importance of these two interpersonal factors motivates future intervention initiatives to support the mental health of LB adolescents from an integrated perspective.
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