Relationship between screen time and myopia in children aged 11-14 years in China
-
摘要:
目的 探讨中国11~14岁儿童视屏时间与近视的关系, 为儿童近视防控工作提供科学依据。 方法 利用科技基础资源调查专项"中国0~18岁儿童营养与健康系统调查与应用"数据, 采用多阶段分层随机抽样方法, 在中国七大区域14个省、28个区/县调查点, 对12 397名11~14岁儿童进行问卷调查并收集每日视屏时间和视力信息。 结果 中国11~14岁儿童自我报告近视率为45.0%, 其中女童高于男童、城市高于农村, 且随年龄增加而增长(χ2值分别为178.82, 79.25, 495.96, P值均<0.01);12 397名儿童的平均每日视屏时间为40.0(30.0, 60.0)min, 男童长于女童, 城市儿童长于农村儿童(χ2值分别为20.86, 102.68, P值均<0.01)。每日视屏时间≥60 min男童自我报告近视率(42.5%)高于视屏时间<60 min的男童(36.4%), 每日视屏时间≥60 min女童自我报告近视率(55.6%)高于视屏时间<60 min的女童(48.0%)(χ2值分别为23.62, 34.15, P值均<0.01)。经调整年龄、性别、地区、中高强度身体活动时间、含糖食品、含糖饮料摄入量和平均每日睡眠时长后, 多因素Logistic回归模型分析显示, 与每日视屏时间<60 min比, ≥60 min(OR=1.14, 95%CI=1.03~1.27)的女童近视风险较高(P=0.01)。调整混杂因素后, 每日视屏时间和男童或女童的近视程度均无相关性(P值均>0.05)。 结论 每天≥60 min视屏时间可能是11~14岁青春期女童近视的正性相关因素之一。鉴于影响视力的因素复杂, 需要进一步研究验证两者之间的关系。 Abstract:Objective To explore relationship between screen time and myopia in children aged 11-14 years in China. Methods The data were extracted from "National Nutrition and Health Systematic Survey and Application for 0-18 Years Old Children". A total of 12 397 children aged 11-14 years old from 14 provinces and 28 districts/counties in seven regions of China were surveyed by using multi-stage stratified random sampling method. Daily screen time and visual acuity information were collected through a questionnaire. Results The myopia rate of 11-14 years old children in China was 45.0%, among which the rate of girls was higher than that of boys, and the rate of urban was higher than that of rural, and it increased with age (χ2=178.82, 79.25, 495.96, P < 0.01). The daily screen time median of 12 397 children was 40.0 minutes, with boys(40.0 min) longer than girls(35.0 min) and urban children(40 min) longer than rural children(33.0 min) (χ2=20.86, 102.68, P < 0.01). The myopia rate of boys (42.5%) with daily screen time greater than or equal to 60 minutes was higher than that of boys (36.4%) with daily screen time less than 60 minutes, and the myopia rate of girls (55.6%) with daily screen time greater than or equal to 60 minutes was higher than that of girls (48.0%)(χ2=23.62, 34.15, P < 0.01). After adjusting for age, gender, region, time of medium and high-intensity physical activity, intake of sugary food and sugary beverages, daily sleep time, multivariable Logistic regression model showed that girls with daily screen time greater than or equal to 60 minutes (OR=1.14, 95%CI=1.03-1.27) had a higher risk of myopia than those with less than 60 minutes. After adjusting for confounding factors, there was no correlation between daily screen time and the degree of myopia in boys or girls(P>0.05). Conclusion Daily screen time greater than or equal to 60 minutes may be a risk factor for myopia in girls aged 11 to 14 years old. Given the complexity of the factors that affect vision, researches are needed to examine the relationship between screen time and myopia. -
Key words:
- Fixation, ocular /
- Time /
- Myopia /
- Regression analysis /
- Child
1) 利益冲突声明 所有作者声明无利益冲突。 -
表 1 不同人口学特征儿童自我报告近视率和近视程度比较
Table 1. Comparison of self-reported myopia rates and degree among children with different demographic characteristics
人口学指标 选项 人数 自我报告近视 近视程度 报告人数 χ2值 P值 <300度 ≥300度 χ2值 P值 性别 男 6 157 2 399(39.0) 178.82 <0.01 1 717(27.9) 682(11.1) 182.03 <0.01 女 6 240 3 177(50.9) 2 343(37.6) 834(13.4) 地区 城市 5 743 2 829(49.3) 79.25 <0.01 2 039(35.5) 790(13.8) 80.83 <0.01 农村 6 654 2 747(41.3) 2 021(30.4) 726(10.9) 年龄/岁 11 3 319 1 025(30.9) 495.96 <0.01 835(25.2) 190(5.7) 561.26 <0.01 12 3 130 1 340(42.8) 1 012(32.3) 328(10.5) 13 3 100 1 571(50.7) 1 103(35.6) 468(15.1) 14 2 848 1 640(57.6) 1 110(39.0) 530(18.6) 总计 12 397 5 576(45.0) 4 060(32.7) 1 516(12.2) 注: ()内数字为报告率/%。 表 2 不同人口学特征儿童视屏时间分布比较
Table 2. Comparison of children's screen time distribution with different demographic characteristics
人口学指标 选项 人数 0 min/d >0~ < 60 min/d ≥60 min/d χ2值 P值 性别 男 6 157 13(0.2) 3 531(57.4) 2 613(42.4) 20.98 <0.01 女 6 240 16(0.3) 3 827(61.3) 2 397(38.4) 地区 城市 5 743 14(0.2) 3 132(54.5) 2 597(45.2) 103.06 <0.01 农村 6 654 15(0.2) 4 226(63.5) 2 413(36.3) 年龄/岁 11 3 319 7(0.2) 2 291(69.0) 1 021(30.8) 217.02 <0.01 12 3 130 6(0.2) 1 888(60.3) 1 236(39.5) 13 3 100 9(0.3) 1 671(53.9) 1 420(45.8) 14 2 848 7(0.2) 1 508(52.9) 1 333(46.8) 每周中高强度身体活动时间/d 0 3 852 18(0.5) 2 446(63.5) 1 388(36.0) 108.78 <0.01 1 2 211 2(0.1) 1 339(60.6) 870(39.3) 2 3 197 4(0.1) 1 929(60.3) 1 264(39.5) ≥3 3 137 5(0.2) 1 644(52.4) 1 488(47.4) 含糖食品摄入量/(g·d-1) <2 4 112 9(0.2) 2 555(62.1) 1 548(37.6) 29.11 <0.01 2~ < 22 4 067 9(0.2) 2 426(59.7) 1 632(40.1) ≥22 4 218 11(0.3) 2 377(56.4) 1 830(43.4) 含糖饮料摄入量/(g·d-1) 0 4 520 13(0.3) 2 758(61.0) 1 749(38.7) 28.86 <0.01 >0~ < 150 4 713 8(0.2) 2 846(60.4) 1 859(39.4) ≥150 3 164 8(0.3) 1 754(55.4) 1 402(44.3) 睡眠时长/(h·d-1) <9 7 785 20(0.3) 4 471(57.4) 3 294(42.3) 32.17 <0.01 ≥9 4 612 9(0.2) 2 887(62.6) 1 716(37.2) 注: ()内数字为构成比/%。 -
[1] 国家卫生健康委. 国家卫生健康委员会2021年7月13日新闻发布会文字实[EB/OL]. (2021-07-13)[2021-12-30]. http://www.nhc.gov.cn/xcs/s3574/202107/2fef24a3b77246fc9fb36dc8943af700.shtml.Health Commission of the PRC. National Health Commission's press conference on July 13, 2021[EB/OL]. (2021-07-13)[2021-12-30]. http://www.nhc.gov.cn/xcs/s3574/202107/2fef24a3b77246fc9fb36dc8943af700.shtml. [2] 马军. 中国儿童青少年主要健康问题及应对策略[J]. 中国学校生, 2015, 36(6): 801-804. https://www.cnki.com.cn/Article/CJFDTOTAL-XIWS201506003.htmMA J. Children's health problems and the their coping strategies in China[J]. Chin J Sch Health, 2015, 36(6): 801-804. https://www.cnki.com.cn/Article/CJFDTOTAL-XIWS201506003.htm [3] 宋逸, 胡佩瑾, 董彦会, 等. 2014年全国各省、自治区、直辖市汉族学生视力不良现况分析[J]. 北京大学学报(医学版), 2017, 49(3): 433-438. doi: 10.3969/j.issn.1671-167X.2017.03.010SONG Y, HU P J, DONG Y H, et al. Prevalence of reduced visual acuity among Chinese Han students in 2014[J]. J Peking Univ(Health Sci), 2017, 49(3): 433-438. doi: 10.3969/j.issn.1671-167X.2017.03.010 [4] 季成叶. 我国中小学生视力不良和疑似近视流行现状[J]. 中国学校卫生, 2008, 29(2): 97-99. doi: 10.3969/j.issn.1000-9817.2008.02.027JI C Y. Status of impaired-vision and suspect-myopia in Chinese primary and secondary school students in 2005[J]. Chin J Sch Health, 2008, 29(2): 97-99. doi: 10.3969/j.issn.1000-9817.2008.02.027 [5] STRAKER L, ZABATIERO J, DANBY S, et al. Conflicting guidelines on young children's screen time and use of digital technology create policy and practice dilemmas[J]. J Pediat, 2018, 202: 300-303. doi: 10.1016/j.jpeds.2018.07.019 [6] STRASBURGER V C, HOGAN M J, MULLIGAN D A, et al. Children, adolescents, and the media[J]. Pediatrics, 2013, 132(5): 958-961. doi: 10.1542/peds.2013-2656 [7] SAXENA R, VASHIST P, TANDON R, et al. Prevalence of myopia and its risk factors in urban school children in Delhi: the North India Myopia study (NIM Study)[J]. PLoS One, 2015, 10: e0117349. doi: 10.1371/journal.pone.0117349 [8] QIAN D J, ZHONG H, LI J, et al. Myopia among school students in rural China (Yunnan)[J]. Ophthal Physiol Opt, 2016, 36: 381-387. doi: 10.1111/opo.12287 [9] 胡佳, 丁子尧, 韩迪, 等. 苏州市中小学生近视的影响因素分析[J]. 预防医学, 2021, 33(3): 241-245. https://www.cnki.com.cn/Article/CJFDTOTAL-ZYFX202103007.htmHU J, DING Z R, HAN D, et al. Influencing factors for myopia among primary and secondary school students in Suzhou[J]. Prev Med, 2021, 33(3): 241-245. https://www.cnki.com.cn/Article/CJFDTOTAL-ZYFX202103007.htm [10] LIU D, JU L H, YANG Z Y, et al. Food frequency questionnaire for Chinese children aged 12-17 years: validity and reliability[J]. Biomed Environ Sci, 2019, 32(7): 486-495. [11] YANG X, JAGO R, ZHANG Q, et al. Validity and reliability of the wristband activity monitor in free-living children aged 10-17 years[J]. Biomed Environ Sci, 2019, 32(11): 812-822. [12] 中国医学装备协会眼科专业委员会. 儿童青少年近视眼检测与防控的应用标准[J]. 中华眼科医学杂志(电子版), 2018, 8(6): 276-288. doi: 10.3877/cma.j.issn.2095-2007.2018.06.006Ophthalmology Professional Committee of Chinese Medical Equipment Association. Application standards for detection, prevention and control of myopia in children and adolescents[J]. Chin J Ophthal (Electr Edit), 2018, 8(6): 276-288. doi: 10.3877/cma.j.issn.2095-2007.2018.06.006 [13] 董彦会, 刘慧彬, 王政和, 等. 中国2005—2014年7~18岁汉族儿童青少年近视现状和增长速度趋势分析[J]. 中华流行病学杂志, 2017, 38(5): 583-587. doi: 10.3760/cma.j.issn.0254-6450.2017.05.005DONG Y H, LIU H B, WANG Z H, et al. Prevalence of myopia and increase trend in children and adolescents aged 7-18 years in Han ethnic group in China, 2005-2014[J]. Chin J Epidemiol, 2017, 38(5): 583-587. doi: 10.3760/cma.j.issn.0254-6450.2017.05.005 [14] WANG J Y, YING G S, FU X J, et al. Prevalence of myopia and vision impairment in school students in Eastern China[J]. BMC Ophthal, 2020, 20(1): 2. doi: 10.1186/s12886-019-1281-0 [15] American Aademy of Pediatrics. Children, adolescents and television[J]. Pediatrics, 2001, 107(2): 423-426. doi: 10.1542/peds.107.2.423 [16] American Aademy of Pediatrics. Children, adolescents, and television-1990[J]. Am Acad Pediatr, 1990, 85(6): 1119-1120. [17] American Aademy of Pediatrics. Committee on public education: children, adolescents, and television[J]. Pediatrics, 2001, 107(2): 423-426. doi: 10.1542/peds.107.2.423 [18] STRASBURGER V C. Policy statement-children, adolescents, obesity, and the media[J]. Pediatrics, 2011, 128(1): 201-208. doi: 10.1542/peds.2011-1066 [19] American Aademy of Pediatrics. Policy statement-children, adolescents, and the media[J]. Am Acad Pediatr, 2013, 132(5): 958-961. [20] WHO. WHO guidelines on physical activity and sedentary behaviour[EB/OL]. (2020-02-09)[2021-12-30]. https://apps.who.int/iris/handle/10665/336656. [21] Australian Bureau of Statistics. Australian health survey: physical activity, 2011-12[EB/OL]. (2020-02-09)[2021-12-30]. https://www.abs.gov.au/ausstats/abs@.nsf/Lookup/4364.0.55.004Chapter1002011-12. [22] OFCOM. Children and parents: media use and attitudes report. In children's media literacy[R/OL]. (2017-11-29)[2021-12-30]. https://www.ofcom.org.uk/_data/assets/pdf_file/0020/108182/children-parents-media-use-attitudes-2017. [23] CAI Y, ZHU X, WU X. Overweight, obesity, and screen-time viewing among Chinese school-aged children: national prevalence estimates from the 2016 physical activity and fitness in China: the youth study[J]. J Sport Health Sci, 2017, 6(4): 404-409. doi: 10.1016/j.jshs.2017.09.002 [24] 教育部. 综合防控儿童青少年近视实施方案[EB/OL]. (2020-12-20)[2021-12-30]. http://www.moe.gov.cn/srcsite/A17/moe_943/s3285/201808/t20180830_346672.html.Ministry of Education of the PRC. Implementation plan for comprehensive prevention and control of myopia in children and adolescents[EB/OL]. (2020-12-20)[2021-12-30]. http://www.moe.gov.cn/srcsite/A17/moe_943/s3285/201808/t20180830_346672.html. [25] SAXENA R, VASHIST P, TANDON R, et al. Incidence and progression of myopia and associated factors in urban school children in Delhi: the North India Myopia Study (NIM Study)[J]. PLoS One, 2017, 12: e0189774. doi: 10.1371/journal.pone.0189774 [26] 周佳, 马迎华, 马军, 等. 中国6省市中小学生近视流行现状及其影响因素分析[J]. 中华流行病学杂志, 2016, 37(1): 29-34. doi: 10.3760/cma.j.issn.0254-6450.2016.01.006ZHOU J, MA Y H, MA J, et al. Prevalence of myopia and influencing factors among primary and middle school students in 6 provinces of China[J]. Chin J Epidemiol, 2016, 37(1): 29-34. doi: 10.3760/cma.j.issn.0254-6450.2016.01.006 [27] 王晓婕, 李静. 义务教育中小学生近视眼患病率调查和影响因素分析[J]. 中国医药导报, 2021, 18(12): 86-89. https://www.cnki.com.cn/Article/CJFDTOTAL-YYCY202112022.htmWANG X J, LI J. Investigation on the prevalence of myopia and analysis of influencing factors among primary and middle school students in compulsory education[J]. Chin Med Herald, 2021, 18(12): 86-89. https://www.cnki.com.cn/Article/CJFDTOTAL-YYCY202112022.htm [28] 高青, 刘懿卿, 叶茜雯, 等. 辽宁省学生近视情况及其影响因素[J]. 中华疾病控制杂志, 2021, 25(2): 222-226. https://www.cnki.com.cn/Article/CJFDTOTAL-JBKZ202102020.htmGAO Q, LIU Y Q, YE Q W, et al. Analysis of myopia and its influencing factors among students in Liaoning Province[J]. Chin J Dis Control Prev, 2021, 25(2): 222-226. https://www.cnki.com.cn/Article/CJFDTOTAL-JBKZ202102020.htm [29] CARLA L, SAW S M. The association between digital screen time and myopia: a systematic review[J]. Ophthalm Physiol Opt, 2020, 40(1): 216-229. -

计量
- 文章访问数: 806
- HTML全文浏览量: 430
- PDF下载量: 135
- 被引次数: 0