Table 1_Insomnia and anxiety: exploring their hidden effect on natural killer cells among young female adults.docx

IntroductionGeneralized anxiety disorder (GAD) is one of the most prevalent mental conditions globally, and it is frequently associated with sleep disturbances such as insomnia. Recently, these mental health conditions have been increasing in prevalence among younger generations, particularly among young women. Therefore, this study aimed to explore the relationship between anxiety, insomnia, and immune function, with a specific focus on natural killer (NK) cells.
MethodsA cross-sectional study was conducted recruiting young female students under 25 years of age. Self-reported GAD-7 and insomnia symptoms were assessed using validated, previously published questionnaires, while immune cell profiles were measured by complete blood count (CBC) and flow cytometry.
ResultsThe results revealed that 75% of participants experienced GAD-7 symptoms at varying severity levels, and over 50% reported insomnia. Interestingly, students with symptoms of GAD-7 had a lower percentage and number of circulatory NK cells and their subpopulation—CD16+CD56dim and CD16+CD56high—compared to normal students. Moreover, among students who were suffering from insomnia, higher GAD-7 scores were negatively associated with the proportion of total peripheral NK cells.
DiscussionThese findings suggest that anxiety and sleep disturbances may compromise immune function and contribute to immune dysregulation. Raising awareness of these physiological effects may help in the prevention of inflammation-related diseases and cancers in young female populations.

引言
通用焦虑障碍（Generalized anxiety disorder, GAD）是全球最普遍的精神疾病之一，常与失眠等睡眠障碍相关联。近年来，这类精神健康问题在年轻群体中的患病率不断攀升，尤以青年女性群体最为显著。因此，本研究旨在探讨焦虑、失眠与免疫功能之间的关联，重点关注自然杀伤（natural killer, NK）细胞。

方法
本研究开展了一项横断面研究，招募25岁以下的青年女性学生。研究采用经过验证的已发表问卷评估受试者自我报告的GAD-7评分与失眠症状，并通过全血细胞计数（complete blood count, CBC）与流式细胞术检测免疫细胞谱。

结果
研究结果显示，75%的参与者存在不同严重程度的GAD-7症状，超过50%的受试者报告存在失眠症状。值得注意的是，存在GAD-7症状的学生，其循环NK细胞及其亚群CD16+CD56dim与CD16+CD56high的占比与绝对计数均低于正常学生。此外，在存在失眠症状的学生中，更高的GAD-7评分与外周总NK细胞占比呈负相关。

讨论
本研究结果表明，焦虑与睡眠障碍可能损害免疫功能并导致免疫失调。提升对这类生理效应的认知，或有助于青年女性群体中炎症相关疾病与癌症的预防。