To evaluate the prospective association between the hemoglobin-to-red blood cell distribution width ratio (HRR) and the incidence of fragility fractures in a general Chinese population. A prospective cohort of 80,515 Chinese adults (mean age: 52.1 years, 79.6 % men) was followed from 2006 to 2023. HRR was calculated as hemoglobin divided by red cell distribution width and categorized into quartiles. The incident fragility fractures were identified via medical records. Cox-proportional hazards models were employed to assess the association between HRR and fracture risk, adjusting for demographics, lifestyle factors, clinical measurements, and medication use. Multiple sensitivity analyses were used to verify the robustness of the results. Over a mean follow-up of 15.6 years, 1730 participants sustained fragility fractures. Higher HRR was associated with a lower fracture risk. In fully adjusted models, the highest HRR quartile had a 19 % lower risk than the lowest (HR 0.81, 95 % CI 0.70-0.94; P-trend <0.05). Each one SD increase in HRR corresponded to a 7 % reduction in fracture risk (HR 0.93, 95 % CI 0.88-0.97). The inverse association was significant in men and those aged 60 years. The findings remained robust in sensitivity analyses and competing-risk models. This large-scale study is the first to demonstrate a significant inverse association between HRR and fragility fracture risk. HRR remained an independent protective factor after multivariable adjustment, and, as a simple, low-cost inflammatory biomarker, it demonstrates potential for early identification and risk stratification of high-risk individuals.

Background/Objectives: Previous multi-ethnic genome-wide association studies (GWAS) have identified the GALNT13 rs10196189 polymorphism as a potential genetic marker linked to sprint–power performance. However, its relevance in East Asian populations, particularly the Han Chinese, remains untested. This study aimed to replicate the association of rs10196189 with elite sprint–power athlete status in Han Chinese males and examine its potential influence on physical performance traits and tissue-specific gene regulation. Methods: A total of 188 healthy Han Chinese males (49 elite sprint–power athletes and 139 non-athletic controls) were genotyped using the TaqMan assay. Assessments included strength, sprint, jump, anaerobic power, DXA-derived body composition, and muscle ultrasound. Logistic regression and ROC analyses evaluated the predictive value of rs10196189. Linear regression models adjusted for age and BMI tested genotype–phenotype associations. Tissue expression and functional networks were analyzed using GTEx and HumanBase databases. Results: The G allele frequency was significantly higher in athletes (12.2%) than in controls (5.4%, p = 0.042). Dominant and additive models effectively predicted athlete status (OR = 2.53–2.58, p < 0.05). Although most traits showed no significant associations post-correction, medial gastrocnemius thickness showed a nominal association (β = 0.371, p = 0.011). Functional analyses revealed high GALNT13 expression in brain tissue and co-expression networks enriched in synaptic signaling and glycosylation pathways. Conclusions: This is the first study to validate the association of GALNT13 rs10196189 with elite athletic status in Han Chinese males. Findings provide novel population-specific evidence and propose tissue-specific glycosylation and neural mechanisms as pathways linking this variant to sprint–power phenotypes.

Mental health and sleep problems are among the most significant burdens of illnesses for adolescents in China. This study aimed to investigate the characteristics of depression and sleep quality among high school students and compare sleep quality across students with varying levels of depression. A cross-sectional study was performed to collect data on depression and sleep quality using a paper questionnaire including a self-rating depression scale (SDS) and Pittsburgh Sleep Quality Index (PSQI). Among all the 537 high school students, 57.0% (306 participants) experienced depression and 47.5% (255 participants) suffered from poor sleep quality. Males showed significantly greater SDS scores than females (55.2 ± 7.2 vs 53.8 ± 6.8, P = .027). Significantly greater PSQI score in high school students with moderate-to-severe depression than those with mild depression and nondepression (5.2 ± 2.7 vs 5.3 ± 2.4 vs 6.2 ± 2.3, F = 3.5, P = .032). In contrast, an adjusted logistic regression model indicated that depression severity was not an independent significant predictor of poor sleep quality after adjusting for age, sex, and BMI (all P > .05). Overall, high school students exhibited a high prevalence of depression and poor sleep quality, with those experiencing moderate-to-severe depression showing the poorest sleep quality in unadjusted comparisons. However, depression severity did not remain an independent significant predictor of poor sleep quality after adjustment. Depression and sleep problems among high school students should receive greater attention, particularly for high school students with moderate-to-severe depression.