Abstract
BACKGROUND: Smartphone addiction significantly impacts the musculoskeletal system, with 79% of younger adults aged 18-44 reporting excessive cell phone use. In addition, rare data exist on the roles of biological markers like 5-HT receptors, oxidative stress markers (TAC, MDA), collagen biomarkers (TIMP-1, TIMP-2), and triglycerides (TG) in the effects of smartphone addiction on the musculoskeletal system, particularly among university students. OBJECTIVE: Thus, the study aimed to investigate the potential link between smartphone addiction levels and certain biological indicators related to musculoskeletal injuries in the hands and necks of young, healthy university students. METHODS: A total of 250 healthy university students aged 17-30 years old were randomly invited to participate in this descriptive cross-sectional analytical study. All participants were categorized into two groups based on their smartphone usage duration: non-addicted (1-3h./day; n = 48) and addicted (≥ 5h./day; n = 12). Smartphone addiction, musculoskeletal discomfort in the neck and hands, adiposity-related outcomes, and musculoskeletal disorder (MSD) biomarkers, like matrixmetalloproteinases (MMPs); TIMP-1,TIMP-2;5-hydroxytryptophans (5-HT), triglyceride (TG), malondialdehyde (MDA), and total antioxidant capacity (TAC) were assessed using validated questionnaires like the Neck Disability Index (NDI), Cornell Hand Discomfort Questionnaire (CHDQ), and Visual Analogue Scale (VAS), respectively, and ELISA immunoassay analysis. RESULTS: A significant link was reported between smartphone addiction and neck pain, hand discomfort, and adiposity markers in 64%of the participant cohort. Moreover, females exhibited higher rates of addiction and susceptibility compared to their male counterparts (62.5% vs. 37.5%). Overall, the outcomes score of prolonged smartphone usage was positively correlated with adiposity, musculoskeletal disorders, and pain measured by the NDI, CHDQ, and VAS, respectively. Smartphone-addicted students demonstrated lower levels of TIMP-1, TIMP-2, and TAC activity, along with elevated 5-HT, TG, and MDA levels, compared to non-addicted controls. CONCLUSION: Smartphone addiction is positively associated with adiposity and musculoskeletal issues, particularly in the neck, shoulders, and hands, among university students. Key biomarkers (TIMP-1, TIMP-2, 5-HT, TG, MDA, TAC) significantly correlate with the severity of neck and hand MSD, as indicated by NDI, CHDQ, and VAS scores. Thus, public health initiatives are essential to raise awareness of the physical and biological risks of excessive smartphone use.