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.