上海市小学高年级学生近视与营养状况的相关性

齐文娟; 杨东玲; 周月芳; 曲爽笑; 冯晓刚; 何鲜桂; 王菁菁; 罗春燕

doi:10.16835/j.cnki.1000-9817.2022.01.025

上海市小学高年级学生近视与营养状况的相关性

doi: 10.16835/j.cnki.1000-9817.2022.01.025

1.
上海市疾病预防控制中心儿童青少年健康所，200336
2.
上海市眼病防治中心

基金项目:

上海市第五轮公共卫生三年行动计划重点学科项目 GWV-10.1-XK08

上海市疾病预防控制中心青耕计划青耕2020-15

详细信息

作者简介:
齐文娟(1990-)，女，河南开封人，硕士，医师，主要研究方向为儿童青少年健康

通讯作者:
罗春燕，E-mail：luochunyan@scdc.sh.cn

利益冲突声明 所有作者声明无利益冲突。
中图分类号: R778.11 R179 G478 R153.2
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- 被引次数: 0
出版历程
- 收稿日期: 2021-04-16
- 修回日期: 2021-10-19
- 刊出日期: 2022-01-25

Relationship between myopia and nutritional status among upper elementary students in Shanghai

1.
Department of Adolescent Health, Shanghai Municipal Center for Disease Control & Prevention, Shanghai (200336), China

摘要

摘要: 目的探索上海市小学高年级学生近视与营养状况的关联，为开展儿童青少年近视防控提供依据。方法采用多层整群抽样的方法选取上海市16个区四至五年级5 576名学生进行视力检查、体格测量和问卷调查。分别采用两水平多因素Logistic回归和混合线性模型分析近视和等效球镜度数与营养状况的关联。结果高年级学生超重、肥胖检出率分别为17.0%(949名)和18.7%(1 042名)，男、女生营养状况构成差异有统计学意义(χ²=210.94，P < 0.01)，男生超重、肥胖占比高于女生。超重男生更倾向于发生近视(单因素：OR=1.23，P=0.04;多因素：OR=1.21，P=0.06);超重学生屈光度低于体重正常学生(多因素，男生：β=-0.19，女生：β=-0.24，P值均 < 0.05)。肥胖学生近视风险和屈光度与体重正常学生差异无统计学意义(P值均>0.05)。结论上海小学高年级超重学生屈光度低于体重正常学生，需更多的研究验证儿童青少年近视和营养状况间的关联，为近视防控提供理论依据。
- 近视 /
- 营养状况 /
- 回归分析 /
- 学生
Abstract: Objective To explore the relationship between myopia and nutritional status among upper elementary students in Shanghai. Methods A stratified cluster sampling method was used to select 5 576 fourth- and fifth-grade students from 16 districts in Shanghai, vision test, physical examination and questionnaire survey were administered. Two-level multivariate Logistic regression and mixed linear models were used to analyze the relationship between myopia, spherical equivalent (SE) and nutritional status. Results The detection rates of overweight and obesity were 17.0%(949) and 18.7%(1 042), respectively. There was a statistical difference in the proportion of the nutritional status in boys and girls(χ²=210.94, P < 0.01), with overweight and obesity in boys higher than those of girls. The overweight boys were more likely to have myopia (univariate analysis: OR=1.23, P=0.04; multivariate analysis: OR=1.21, P=0.06) than the normal-weight boy. Overweight students tended to had more negative refractive than those with normal-weight in both boys and girls(multivariate analysis, boys: β=-0.19, girls: β=-0.24, P < 0.05). Myopia risk and refractive power in obese students showed no statistical difference with normal-weight students(P>0.05). Conclusion Overweight students have lower SE than the normal-weight among upper elementary students of Shanghai, more researches are needed to confirm this finding and to provide theoretical bases for myopia prevention and control.
- Myopia /
- Nutritional status /
- Regression analysis /
- Students
注释:

1) 利益冲突声明 所有作者声明无利益冲突。

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表 1 不同性别与年级学生营养状况分布比较

Table 1. Comparison of nutritional status of students between genders and grades

性别和年级		人数	营养不良	正常	超重	肥胖	χ²值	P值
性别	男	2 940	191(6.5)	1 446(49.2)	586(19.9)	717(24.4)	210.94	< 0.01
	女	2 636	231(8.8)	1 717(65.1)	363(13.8)	325(12.3)
年级	四	2 826	223(7.9)	1 617(57.2)	455(16.1)	531(18.8)	3.91	0.27
	五	2 750	199(7.2)	1 546(56.2)	494(18.0)	511(18.6)
合计		5 576	422(7.6)	3 163(56.7)	949(17.0)	1 042(18.7)
注： ()内数字为构成比/%。

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表 2 上海市高年级小学生近视与营养状况关联的两水平Logistic回归分析

Table 2. Two-level Logistic regression analysis between myopia and nutritional status among upper elementary students in Shanghai

性别	自变量	单因素		多因素
性别	自变量	β值	OR值(OR值95%CI)	β值	OR值(OR值95%CI)
男	营养不良	-0.12	0.89(0.65~1.28)	-0.18	0.83(0.60~1.16)
(n=2 940)	超重	0.20	1.23(1.01~1.49)^*	0.19	1.21(0.99~1.49)
	肥胖	-0.10	0.90(0.75~1.08)	-0.06	0.94(0.78~1.14)
女	营养不良	-0.11	0.90(0.68~1.91)	-0.06	0.94(0.70~1.27)
(n=2 636)	超重	0.10	1.10(0.88~1.39)	0.10	1.11(0.87~1.42)
	肥胖	0.18	1.20(0.94~1.54)	0.26	1.29(1.00~1.68)
注：多因素分析调整变量为年级、父母近视人数、所在经济片区、白天户外活动时间、读写姿势、近距离用眼休息频次、睡眠时间、课后读写时间、补习开始年龄，自变量以正常为参照组，*P < 0.05。

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表 3 上海市小学高年级学生屈光度与营养状况关联的混合线性模型分析[β值(β值95%CI)]

Table 3. Analysis of the mixed linear model between SE and nutritional status[β(β 95%CI)]

性别	自变量	单因素	多因素
男	营养不良	0.05(-0.19~0.29)	0.08(-0.16~0.32)
(n=2 940)	超重	-0.20(-0.35~-0.04)^*	-0.19(-0.35~-0.04)^*
	肥胖	0.02(-0.13~0.16)	0.01(-0.13~0.15)
女	营养不良	-0.09(-0.35~0.14)	-0.07(-0.29~0.16)
(n=2 636)	超重	-0.25(-0.44~-0.06)^*	-0.24(-0.43~-0.05)^*
	肥胖	-0.12(-0.32~0.08)	-0.14(-0.34~0.06)
注：多因素分析调整变量为年级、父母近视人数、所在经济片区、白天户外活动时间、读写姿势、近距离用眼休息频次、睡眠时间、课后读写时间、补习开始年龄; 自变量以正常为参照组。*P < 0.05。

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