广东省6~9岁小学生屈光与体格发育指标的相关性

曲亚斌; 王爽; 杨贝; 于水明; 林蓉; 黄岸仲; 林思仁; 李梦; 沈少君; 刘荣; 陈秋霞; 王子轩

doi:10.16835/j.cnki.1000-9817.2024213

广东省6~9岁小学生屈光与体格发育指标的相关性

doi: 10.16835/j.cnki.1000-9817.2024213

曲亚斌¹,
王爽²,
杨贝³,
于水明⁴,
林蓉⁵,
黄岸仲⁶,
林思仁⁷,
李梦¹,
沈少君¹,
刘荣¹,
陈秋霞¹,
王子轩⁴

1.
广东省疾病预防控制中心环境与学校卫生所，广州 511430
2.
中山大学公共卫生学院
3.
南方医科大学公共卫生学院
4.
广州中山眼科验光配镜有限责任公司
5.
广州市疾病预防控制中心学校卫生部
6.
东莞市疾病预防控制中心学校卫生所
7.
惠州市疾病预防控制中心办公室

基金项目:

广州市科技计划项目 202002030405

详细信息

作者简介:
曲亚斌(1978-)，男，云南大理人，硕士，副主任医师，主要研究方向为学校卫生与环境卫生

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中图分类号: R179 R778.1⁺¹ R194.3
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- 被引次数: 0
出版历程
- 收稿日期: 2024-02-18
- 修回日期: 2024-06-08
- 网络出版日期: 2024-07-27
- 刊出日期: 2024-07-25

Correlation between refractive development and physical growth indices in primary school students aged 6-9 years in Guangdong Province

1.
Department of Environmental and School Health, Guangdong Provincial Center for Disease Control and Prevention, Guangzhou (511430), Guangdong Province, China

摘要

摘要: 目的分析6~9岁小学生屈光与体格发育指标的相关性，为制定科学有效的防控措施提供参考依据。方法于2020年10月采用分层整群随机抽样方法选取广东省2 833名6~9岁小学生进行视力筛查、眼生物学参数测量和体格检查。采用χ²检验、t检验和方差分析比较不同组别近视率和检测指标，多重线性回归模型分析身高、体重和体质量指数(BMI)与屈光发育指标的相关性。结果 6~9岁小学生的筛查性近视率为16.7%，近视率随年龄增加而上升(χ_趋势²=51.58，P < 0.01)。近视组身高、体重[(126.96±7.41)cm，(26.59±6.45)kg]均高于非近视组[(124.76±7.77)cm，(25.42±5.87)kg](t值分别为5.84，3.65，P值均 < 0.01)。6~9岁小学生等效球镜度数(SE)、眼轴长度(AL)、前房深度(ACD)、眼轴长度与角膜曲率半径比值(AL/CR)均值分别为(-0.17±1.04)D、(22.96±0.78)mm、(3.38±0.24)mm、(2.95±0.08)，在不同年龄、近视程度组间差异均有统计学意义(t值分别为37.08，119.20，41.54，133.60；935.30，184.10，73.95，498.50，P值均 < 0.01)。多重线性回归模型校正性别、年龄、城乡等因素后，身高与AL、CR，体重与ACD，BMI与AL、ACD均呈正相关(β值分别为0.191，0.070，0.035，0.013，0.007，P值均 < 0.05)。将研究对象按是否近视进行分层，非近视组结果与总体相似，近视组身高、BMI与AL相关均无统计学意义(P值均>0.05)。结论在6~9岁小学生中，非近视组身高、BMI和AL呈正相关，近视组未观察到类似关联，提示除体格发育因素外，更应关注环境和行为等因素对屈光发育的影响。
- 屈光, 眼 /
- 体格检查 /
- 近视 /
- 回归分析 /
- 学生
Abstract: Objective To analyze the correlation between refractive errors and physical development indicators among primary school students aged 6 to 9, so as to provide a scientific basis for the development of effective prevention and control measures. Methods A stratified cluster random sampling method was used to recruit 2 833 elementary school students aged 6 to 9 from Guangdong Province for vision screening, ocular biometry, and physical examinations in Octorber, 2020. The Chi-square test, t-test, and ANOVA were employed to compare myopia rates and indicator values across different groups. Multiple linear regression models were used to analyze the correlations between height, weight, and body mass index (BMI) with refractive development indicators. Results The screening myopia rate among primary school students aged 6 to 9 was 16.7%, and the myopia rate increased with age (χ²=51.58, P < 0.01). The height and weight of the myopic group [(126.96±7.41)cm, (26.59±6.45)kg] were higher than those of the non-myopic group [(124.76±7.77)cm, (25.42±5.87)kg] (t=5.84, 3.65, P < 0.01). The mean values of spherical equivalent (SE), axial length (AL), anterior chamber depth (ACD), and AL/corneal curvature radius (CR) ratio for students aged 6 to 9 were (-0.17±1.04)D, (22.96±0.78)mm, (3.38±0.24)mm, and (2.95±0.08), respectively, with statistically significant differences across different age and myopia severity groups (t=37.08, 119.20, 41.54, 133.60; 935.30, 184.10, 73.95, 498.50, P < 0.01). After adjusting for gender, age, and residence, the multiple linear regression model showed that height was positively correlated with AL and CR, weight was positively correlated with ACD, and BMI was positively correlated with AL and ACD (β=0.191, 0.070, 0.035, 0.013, 0.007, P < 0.05). When stratified by myopia status, results for the non-myopic group were similar to the overall results, whereas in the myopic group, the correlations between height, BMI, and AL were not statistically significant (P>0.05). Conclusions Among primary school students aged 6 to 9, height and BMI are positively correlated with AL in the non-myopic group but no similar correlation is observed in the myopic group, indicating that factors other than physical development, such as environmental and behavioral factors, should be considered for their impact on refractive development.
- Refraction, ocular /
- Physical examination /
- Myopia /
- Regression analysis /
- Students
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表 1 不同组别小学生屈光参数指标比较(x ± s)

Table 1. Comparison of refractive parameters among different groups of elementary school students(x ± s)

组别	选项	人数	统计值	SE/D	AL/mm	ACD/mm	CR/mm	AL/CR
性别	男	1 548		-0.15±1.06	23.21±0.74	3.42±0.24	7.84±0.25	2.96±0.08
	女	1 285		-0.18±1.02	22.65±0.72	3.32±0.23	7.70±0.23	2.94±0.08
			t值	0.67	20.58^{* *}	10.74^{* *}	15.57^{* *}	6.22^{* *}
年龄/岁	6	734		0.07±0.91	22.65±0.72	3.33±0.24	7.76±0.25	2.92±0.07
	7	948		-0.13±1.04	22.91±0.72	3.35±0.23	7.77±0.26	2.95±0.08
	8~9	1 151		-0.35±1.09	23.19±0.79	3.42±0.23	7.79±0.25	2.98±0.09
			F值	37.08^{* *}	119.20^{* *}	41.59^{* *}	2.46	133.60^{* *}
城乡	城区	1 341		-0.16±1.03	22.99±0.81	3.40±0.25	7.78±0.26	2.95±0.09
	郊县	1 492		-0.17±1.05	22.92±0.75	3.35±0.23	7.77±0.25	2.95±0.08
			t值	0.49	2.39^*	5.39^{* *}	1.85	0.73
身高	下等	103		-0.18±0.94	22.73±0.73	3.31±0.23	7.76±0.25	2.93±0.07
	中下等	348		-0.11±0.93	22.80±0.74	3.36±0.23	7.72±0.25	2.95±0.08
	中等	1 967		-0.18±1.06	22.96±0.79	3.37±0.24	7.77±0.26	2.95±0.08
	中上等	333		-0.14±0.99	23.13±0.77	3.42±0.25	7.82±0.23	2.96±0.08
	上等	82		-0.23±1.20	23.20±0.78	3.46±0.21	7.86±0.24	2.95±0.08
			F值	0.48	11.84^{* *}	7.97^{* *}	9.13^{* *}	2.22
BMI	消瘦	293		-0.20±1.04	22.97±0.77	3.38±0.24	7.74±0.25	2.97±0.08
	正常	1 822		-0.15±1.05	22.94±0.77	3.37±0.24	7.78±0.25	2.95±0.08
	超重	341		-0.21±0.99	22.97±0.84	3.37±0.23	7.78±0.27	2.95±0.09
	肥胖	377		-0.16±1.06	23.01±0.81	3.42±0.25	7.79±0.26	2.96±0.08
			F值	0.37	0.83	4.21^{* *}	2.27	4.13^{* *}
近视状况	非近视	2 360		0.09±0.80	22.85±0.71	3.35±0.23	7.78±0.25	2.94±0.07
	低度近视	427		-1.19±0.73	23.41±0.83	3.48±0.24	7.73±0.25	3.03±0.08
	中高度近视	46		-3.82±1.66	24.33±0.96	3.59±0.37	7.73±0.24	3.15±0.13
			F值	935.30^{* *}	184.10^{* *}	73.95^{* *}	10.46^{* *}	498.50^{* *}
合计		2 833		-0.17±1.04	22.96±0.78	3.38±0.24	7.77±0.25	2.95±0.08
注： P < 0.05， *P < 0.01。

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表 2 同性别同年龄近视和非近视小学生屈光参数指标比较(x ± s)

Table 2. Comparison of refractive parameters between myopic and non-myopic elementary school students of the same gender and age(x ± s)

年龄/岁	分组	统计值	男生						女生
年龄/岁	分组	统计值	人数	SE/D	AL/mm	ACD/mm	CR/mm	AL/CR	人数	SE/D	AL/mm	ACD/mm	CR/mm	AL/CR
6	非近视		350	0.20±0.66	22.90±0.63	3.37±0.22	7.84±0.24	2.92±0.06	307	0.24±0.78	22.30±0.65	3.27±0.22	7.69±0.23	2.90±0.06
	近视		46	-1.35±1.34	23.19±0.90	3.45±0.38	7.72±0.22	3.00±0.10	31	-1.09±1.14	22.49±0.45	3.34±0.21	7.58±0.24	2.97±0.08
		t值		7.76^{* *}	-2.12^*	-1.42	3.61^{* *}	-5.59^{* *}		6.39^{* *}	-2.14^*	-1.73	2.40^*	-4.42^{* *}
7	非近视		456	0.10±0.76	23.07±0.61	3.38±0.22	7.84±0.26	2.94±0.06	357	0.03±1.00	22.53±0.60	3.28±0.22	7.71±0.24	2.92±0.06
	近视		74	-1.36±1.40	23.71±0.83	3.52±0.25	7.79±0.25	3.04±0.10	61	-1.25±0.74	22.87±0.75	3.41±0.24	7.63±0.24	3.00±0.08
		t值		8.76^{* *}	-6.35^{* *}	-4.51^{* *}	1.52	-8.50^{* *}		11.77^{* *}	-3.41^{* *}	-3.67^{* *}	2.54^*	-7.32^{* *}
8~9	非近视		491	0.06±0.80	23.29±0.66	3.44±0.22	7.87±0.25	2.96±0.07	399	-0.04±0.71	22.72±0.65	3.34±0.22	7.71±0.23	2.95±0.06
	近视		131	-1.67±1.27	24.00±0.82	3.57±0.24	7.79±0.27	3.08±0.09	130	-1.48±0.94	23.50±0.69	3.49±0.22	7.70±0.22	3.05±0.09
		t值		14.79^{* *}	-9.25^{* *}	-5.87^{* *}	2.70^{* *}	-13.76^{* *}		16.02^{* *}	-11.41^{* *}	-6.67^{* *}	0.34	-12.78^{* *}
注： P < 0.05， *P < 0.01。

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表 3 小学生身高、体重、BMI对屈光发育指标的多重线性回归分析[β值(95%CI)，n=2 833]

Table 3. Multiple linear regression analysis of refractive development indices based on height, weight and BMI of elementary school students[β(95%CI), n=2 833]

模型	组别	自变量	SE	AL	ACD	CR	AL/CR
1		身高	-0.160(-0.209~-0.111)^*	0.338(0.303~0.373)^*	0.062(0.051~0.073)^*	0.053(0.041~0.065)^*	0.023(0.019~0.027)^*
		体重	-0.144(-0.208~-0.080)^*	0.339(0.293~0.386)^*	0.078(0.063~0.092)^*	0.057(0.042~0.073)^*	0.022(0.017~0.027)^*
		BMI	-0.011(-0.026~0.004)	0.034(0.023~0.046)^*	0.011(0.008~0.015)^*	0.007(0.003~0.010)^*	0.002(0.001~0.003)^*
2	非近视组	身高	0.003(-0.071~0.077)	0.204(0.146~0.262)^*	0.016(-0.004~0.037)	0.073(0.051~0.095)^*	-0.001(-0.007~0.005)
		体重	-0.057(-0.137~0.023)	0.008(-0.054~0.071)	0.031(0.009~0.053)^*	-0.011(-0.035~0.014)	0.005(-0.001~0.011)
		BMI	-0.011(-0.024~0.002)	0.013(0.003~0.024)^*	0.006(0.003~0.010)^*	0.002(-0.002~0.006)	0.001(-0.000~0.002)
	近视组	身高	-0.044(-0.293~0.205)	0.101(-0.065~0.267)	-0.036(-0.089~0.018)	0.056(0.005~0.108)^*	-0.010(-0.029~0.010)
		体重	0.147(-0.092~0.385)	0.027(-0.132~0.187)	0.057(0.005~0.108)^*	0.020(-0.030~0.070)	-0.004(-0.023~0.015)
		BMI	0.028(-0.010~0.067)	0.009(-0.017~0.035)	0.009(0.000~0.017)^*	0.007(-0.001~0.015)	-0.002(-0.005~0.001)
	总体	身高	-0.015(-0.103~0.073)	0.191(0.133~0.250)^*	0.009(-0.010~0.029)	0.070(0.049~0.091)^*	-0.002(-0.009~0.005)
		体重	-0.028(-0.121~0.065)	0.012(-0.050~0.074)	0.035(0.015~0.056)^*	-0.006(-0.027~0.016)	0.004(-0.003~0.011)
		BMI	-0.006(-0.021~0.009)	0.013(0.003~0.023)^*	0.007(0.004~0.010)^*	0.003(-0.001~0.007)	0.001(-0.001~0.002)
注：模型1未校正任何混杂因素；模型2校正了年龄、性别、城乡、身高/体重因素。*P < 0.05。

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