6岁儿童线性生长及BMI轨迹与屈光不正关联队列研究

刘佳; 谢阳; 黄锟; 伍晓艳; 陶舒曼; 许韶君; 汪兴; 袁敏; 陶芳标

doi:10.16835/j.cnki.1000-9817.2022.10.026

6岁儿童线性生长及BMI轨迹与屈光不正关联队列研究

doi: 10.16835/j.cnki.1000-9817.2022.10.026

刘佳¹,
谢阳¹,
黄锟^{1, 2},
伍晓艳^{1, 2},
陶舒曼^{2, 3},
许韶君^{1, 2},
汪兴¹,
袁敏^{2, 4},
陶芳标^{1, 2, ,}

1.
安徽医科大学公共卫生学院儿少卫生与妇幼保健学系，合肥 230032
2.
出生人口健康教育部重点实验室/人口健康与优生安徽省重点实验室
3.
安徽医科大学第二附属医院眼科
4.
安徽医科大学卫生管理学院健康数据科学系

基金项目:

国家重点研发计划资助项目 2021YFC2702105

详细信息

作者简介:
刘佳(1996-)，女，安徽池州人，在读硕士，主要研究方向为儿童青少年健康

通讯作者:
陶芳标，E-mail: fbtao@ahmu.edu.cn

利益冲突声明 所有作者声明无利益冲突。
中图分类号: R179 G478 R778.1
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出版历程
- 收稿日期: 2022-05-07
- 修回日期: 2022-06-24
- 网络出版日期: 2022-10-28
- 刊出日期: 2022-10-25

A cohort study of the association between linear growth and BMI trajectories with ametropia among 6-year-old children

LIU Jia¹,
XIE Yang¹,
HUANG Kun^{1, 2},
WU Xiaoyan^{1, 2},
TAO Shuman^{2, 3},
XU Shaojun^{1, 2},
WANG Xing¹,
YUAN Min^{2, 4},
TAO Biao^{1, 2
, ,}

1.
Department of Maternal, Child & Adolescent Health, School of Public Health, Anhui Medical University, Hefei(230032), China

摘要

摘要: 目的描述0~6岁儿童线性生长及体质量指数(BMI)生长轨迹，探讨不同类型生长轨迹模式与学龄前儿童屈光不正的关联。方法研究对象源自马鞍山优生优育队列(MABC)，MABC建立于2013年5月至2014年9月，2 037名活产儿在出生后42 d至72月龄共随访15次，测量儿童身长、体重，问卷调查喂养情况、代养人等数据信息, 并于儿童(72±6)月龄时由马鞍山市妇幼保健院专业眼科医生测量其裸眼视力，视力不良者行睫状肌麻痹扩瞳验光诊断近视和远视。运用潜变量增长模型拟合0~6岁儿童身高及BMI生长轨迹。采用多项式Logistic回归模型分析不同生长轨迹与6岁儿童屈光不正的关联。结果根据潜变量增长模型，线性生长轨迹可将儿童的身高发育轨迹划分为3类：较慢身高生长轨迹(302名)、适宜身高生长轨迹(1 162名)和较快身高生长轨迹(573名)。BMI Z生长轨迹可将儿童的发育轨迹划分为3类：较慢BMI Z生长轨迹(630名)、适宜BMI Z生长轨迹(1 058名)和较快BMI Z生长轨迹(349名)。多因素Logistic回归分析显示，缓慢身高生长模式与6岁儿童远视呈正相关[OR值(95%CI)=1.80(1.09~2.98)，P < 0.05]，而与近视关联无统计学意义；快速和缓慢BMI Z生长轨迹模式与6岁儿童近视、远视关联均无统计学意义(P值均>0.05)。结论线性生长轨迹中较慢身高生长模式与6岁儿童远视相关。应密切关注学龄前儿童身高增长模式，定期检查体格发育指标以及远视力，有助于预防学龄前儿童屈光不正的发生发展。
- 生长和发育 /
- 人体质量指数 /
- 屈光不正 /
- 队列研究 /
- 儿童
Abstract: Objective To describe the linear growth trajectory and BMI growth trajectory of children aged 0-6 years, and to investigate the relationship between different growth trajectory patterns and refractive error of preschool children. Methods The participants were selected from Ma'anshan Birth Cohort Study (MABC), which was established from May 2013 to September 2014. In this study, 15 follow-up interviews were conducted among 2 037 live births between 42 days after birth and 72 months of age to collect the data of body length and body weight. And at the age of (72±6) months, data of the naked eye visual acuity was measured by professional ophthalmologist in Ma'anshan Maternal and Child Health Hospital. The latent class growth model was conducted to identify distinct linear growth trajectory and BMI Z-score trajectories of 0 to 6 year old infants and young children. Multinomial Logistic regression model was used for analyzing the relationship between distinct growth trajectories and ametropia in 6-year-old children. Results According to the latent class growth model, children showed three obvious linear growth trajectories: slow growth trajectory (n=302), normal growth trajectory (n=1 162), and fast growth trajectory (n=573). And BMI growth trajectory were also divided into three patterns: slow growth trajectory (n=630), normal growth trajectory (n=1 058), and fast growth trajectory (n=349). Multinomial Logistic regression analysis showed that linear slow growth trajectory was a risk factor for hyperopia in 6-year-old children (OR=1.80, 95%CI=1.09-2.98, P < 0.05). But it was not significantly associated with myopia. There was no significant correlation between fast growth BMI pattern and slow growth BMI pattern with myopia and hyperopia in 6-year-old children. Conclusion Slower growth patterns in linear growth trajectories were associated with hyperopia in 6-year-old children.It should pay close attention to the height growth pattern of preschool children. Regular examination of physical development indicators and distance vision can help prevent the occurrence and development of ametropia in preschool children.
- Growth and development /
- Body mass index /
- Refractive errors /
- Cohort studies /
- Child
注释:

1) 利益冲突声明 所有作者声明无利益冲突。

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图 1 儿童身高(身长)三分类生长轨迹

Figure 1. Growth trajectory of children body length/height three classification diagram

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图 2 儿童BMI Z三分类生长轨迹

Figure 2. Growth trajectory of children BMI Z three classification diagram

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表 1 儿童不同生长轨迹模型参数(身高轨迹)

Table 1. Different growth trajectory model parameters of children(height trajectory)

类别	占比/%	BIC	AIC	aBIC	LMRT P值	BLRT P值	熵值
1	100.0	127 150.62	127 032.61	127 083.90
2	52.3/47.7	123 602.68	123 456.58	123 520.08	＜0.01	＜0.01	0.78
3	57.0/14.8/28.1	114 110.76	113 919.70	114 002.74	＜0.01	＜0.01	0.80
4	31.7/47.0/5.0/16.3	122 139.27	121 936.98	122 024.90	0.47	＜0.01	0.79
5	15.8/10.2/42.9/4.7/26.4	113 549.03	113 301.78	113 409.24	0.14	＜0.01	0.76

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表 2 儿童不同生长轨迹模型参数(BMI Z轨迹)

Table 2. Different growth trajectory model parameters of children(BMI Z trajectory)

类别	占比/%	BIC	AIC	aBIC	LMRT P值	BLRT P值	熵值
1	100.0	67 932.79	67 814.79	67 866.07
2	59.6/40.4	61 703.73	61 540.78	61 611.60	＜0.01	＜0.01	0.83
3	51.6/17.3/31.1	59 997.91	59 806.86	59 889.89	＜0.01	＜0.01	0.84
4	49.3/17.1/3.2/30.3	59 495.20	59 276.05	59 371.29	0.10	＜0.01	0.86
5	45.0/2.8/23.5/5.3/23.4	60 749.73	60 519.34	60 619.47	0.17	＜0.01	0.85

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表 3 生长轨迹与6岁儿童近视及远视关联性的Logistic回归分析[n=2 037，OR(OR值95%CI)]

Table 3. Logistic regression analysis of correlation between growth trajectory and myopia and hyperopia in 6-year-old children [n=2 037, OR(OR 95%CI)]

生长轨迹	选项	模型1		模型2		模型3
生长轨迹	选项	近视	远视	近视	远视	近视	远视
身高轨迹	适宜	1.00	1.00	1.00	1.00	1.00	1.00
	缓慢	0.79(0.41~1.53)	1.82(1.20~2.74)^**	0.85(0.41~1.76)	1.87(1.20~2.91)^**	0.94(0.41~2.12)	1.80(1.09~2.98)^*
	快速	0.96(0.59~1.55)	0.79(0.52~1.21)	0.83(0.49~1.41)	0.85(0.54~1.33)	1.14(0.63~2.06)	0.70(0.41~1.20)
BMI Z轨迹	适宜	1.00	1.00	1.00	1.00	1.00	1.00
	缓慢	1.19(0.75~1.91)	0.86(0.59~1.25)	1.20(0.73~1.96)	0.81(0.55~1.20)	1.20(0.68~2.12)	0.84(0.54~1.32)
	快速	0.96(0.52~1.78)	0.72(0.44~1.17)	0.82(0.43~1.55)	0.75(0.45~1.24)	0.78(0.37~1.62)	0.84(0.48~1.48)
注：* P < 0.05，** P < 0.01。模型1未调整混杂因素；模型2调整一般人口学资料，包括孕妇纳入年龄、产次、妊娠糖尿病、父亲文化程度、母亲文化程度、家庭人均月收入、居住地、儿童性别、主要带养人、宫内发育情况；模型3调整一般人口学资料以及父母近视情况、儿童视屏时间、户外活动时间、睡眠时间。

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