U-shaped association between outdoor artificial light at night exposure and metabolic syndrome in Chinese youth: Findings from a nationally representative study

Dec 20, 2025Environmental pollution (Barking, Essex : 1987)

Both low and high outdoor artificial light at night link to metabolic syndrome in Chinese youth

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Abstract

The overall prevalence of metabolic syndrome (MetS) among 14,804 children aged 7-17 years was 4.03%.

Higher exposure to artificial light at night (ALAN) is significantly associated with increased prevalence of MetS, with an odds ratio of 1.104.
Increased ALAN exposure correlates with higher odds of high blood pressure (odds ratio = 1.120) and abdominal obesity (odds ratio = 1.075).
U-shaped associations between ALAN and MetS, as well as high blood pressure, were identified, with specific thresholds for concern.
No significant associations were found between ALAN and elevated fasting blood glucose or high triglycerides.
Stronger associations with MetS were observed among boys, urban residents, and participants with low physical activity.

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Artificial light at night (ALAN) has emerged as a potential environmental risk factor, yet evidence on its association with metabolic syndrome (MetS) in pediatric populations remains unclear. We conducted a nationally representative study in 2013, recruiting 14,804 children aged 7-17 years from 94 schools in seven Chinese provinces/municipalities. Outdoor ALAN exposure was quantified using 3-year average calibrated satellite-derived nighttime light data around each school. MetS was defined by the Chinese pediatric criteria. Mixed-effects logistic regression and restricted cubic spline (RCS) models were used to examine the linear and non-linear associations between ALAN and MetS, as well as its components. Two-piecewise models estimated associations across thresholds. The mean age of the participants was 11.89 years, and 51.24 % were boys. The overall prevalence of MetS was 4.03 %. Higher ALAN exposure was significantly associated with an increased prevalence of MetS (odds ratio [OR] = 1.104, 95 % confidence interval [CI] = 1.019-1.195), high blood pressure (OR = 1.120, 95 % CI = 1.066-1.178), and abdominal obesity (OR = 1.075, 95 % CI = 1.033-1.119). RCS revealed U-shaped associations between ALAN and MetS, as well as high blood pressure, with thresholds at 15.933 and 26.868 nW/cm/sr, respectively. In contrast, no significant association was found with elevated fasting blood glucose or high triglycerides (all P for non-linear >0.05). Stratified analyses revealed stronger associations among boys, urban residents, and participants who were physically inactive. These findings underscore that both insufficient and excessive ALAN may be detrimental, highlighting the importance of maintaining an optimal level of nighttime light exposure and promoting physical activity to protect youth metabolic health. 2

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U-shaped association between outdoor artificial light at night exposure and metabolic syndrome in Chinese youth: Findings from a nationally representative study

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