内蒙古地区2021年中小学生近视与肥胖共患现状及生活方式的调节作用

张依航; 袁雯; 党佳佳; 刘云飞; 蔡珊; 师嫡; 陈子玥; 杨田; 马鑫悦; 马彩霞; 蒋家诺; 董彦会; 张秀红; 马军; 宋逸

doi:10.16835/j.cnki.1000-9817.2023.09.005

文章导航 > 中国学校卫生 > 2023 > 44(9): 1299-1303

张依航, 袁雯, 党佳佳, 刘云飞, 蔡珊, 师嫡, 陈子玥, 杨田, 马鑫悦, 马彩霞, 蒋家诺, 董彦会, 张秀红, 马军, 宋逸. 内蒙古地区2021年中小学生近视与肥胖共患现状及生活方式的调节作用[J]. 中国学校卫生, 2023, 44(9): 1299-1303. doi: 10.16835/j.cnki.1000-9817.2023.09.005

引用本文:

ZHANG Yihang, YUAN Wen, DANG Jiajia, LIU Yunfei, CAI Shan, SHI Di, CHEN Ziyue, YANG Tian, MA Xinyue, MA Caixia, JIANG Jianuo, DONG Yanhui, ZHANG Xiuhong, MA Jun, SONG Yi. Co-morbidity of myopia and obesity and the moderating role of lifestyle among primary and secondary school students in Inner Mongolia Autonomous Region in 2021[J]. CHINESE JOURNAL OF SCHOOL HEALTH, 2023, 44(9): 1299-1303. doi: 10.16835/j.cnki.1000-9817.2023.09.005

Citation:

ZHANG Yihang, YUAN Wen, DANG Jiajia, LIU Yunfei, CAI Shan, SHI Di, CHEN Ziyue, YANG Tian, MA Xinyue, MA Caixia, JIANG Jianuo, DONG Yanhui, ZHANG Xiuhong, MA Jun, SONG Yi. Co-morbidity of myopia and obesity and the moderating role of lifestyle among primary and secondary school students in Inner Mongolia Autonomous Region in 2021[J]. CHINESE JOURNAL OF SCHOOL HEALTH, 2023, 44(9): 1299-1303. doi: 10.16835/j.cnki.1000-9817.2023.09.005

引用本文:

Citation:

ZHANG Yihang, YUAN Wen, DANG Jiajia, LIU Yunfei, CAI Shan, SHI Di, CHEN Ziyue, YANG Tian, MA Xinyue, MA Caixia, JIANG Jianuo, DONG Yanhui, ZHANG Xiuhong, MA Jun, SONG Yi. Co-morbidity of myopia and obesity and the moderating role of lifestyle among primary and secondary school students in Inner Mongolia Autonomous Region in 2021[J]. CHINESE JOURNAL OF SCHOOL HEALTH, 2023, 44(9): 1299-1303. doi: 10.16835/j.cnki.1000-9817.2023.09.005

内蒙古地区2021年中小学生近视与肥胖共患现状及生活方式的调节作用

doi: 10.16835/j.cnki.1000-9817.2023.09.005

1.
北京大学公共卫生学院/北京大学儿童青少年卫生研究所，北京 100191
2.
内蒙古自治区综合疾病预防控制中心学校卫生科

基金项目:

首都卫生发展科研专项重点攻关项目 20221G4251

详细信息

作者简介:
张依航(1998-)，女，内蒙古赤峰人，在读硕士，主要研究方向为儿童青少年健康与发展

通讯作者:
宋逸，E-mail：songyi@bjmu.edu.cn

利益冲突声明 所有作者声明无利益冲突。
中图分类号: R778.1⁺1 R723.14 R179
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出版历程
- 收稿日期: 2023-08-16
- 修回日期: 2023-08-31
- 网络出版日期: 2023-09-28
- 刊出日期: 2023-09-25

Co-morbidity of myopia and obesity and the moderating role of lifestyle among primary and secondary school students in Inner Mongolia Autonomous Region in 2021

1.
Institute of Child and Adolescent Health/School of Public Health, Peking University, Beijing (100191), China

摘要

摘要: 目的分析2021年内蒙古7~18岁学生近视与肥胖共患流行现状及生活方式的调节作用，为儿童青少年常见疾病“共病-共因-共防”机制的建立提供科学依据。方法 2021年9月采用分层随机整群抽样方法，抽取内蒙古139 630名7~18岁中小学生为研究对象。使用远视力检查及屈光度检查判断近视情况，依据中国学龄儿童青少年超重与肥胖筛查标准判定肥胖情况。根据美国心脏协会的健康生活方式评分，综合吸烟、饮酒、饮食、运动、视屏时间和睡眠时间6项总分对健康生活方式进行判定。采用χ²检验比较近视与肥胖共患率的组间差异，采用多因素Logistic回归模型探索近视与肥胖共患的影响因素及分层分析不同群组生活方式对共患病的调节作用。结果 2021年内蒙古7~18岁学生近视与肥胖共患率为13.7%，男生高于女生(15.5%，11.8%)，10~12岁高于7~9，13~15，16~18岁(14.7%，13.7%，13.3%，12.0%)，其他少数民族高于汉族及蒙古族(15.3%，14.0%，12.5%)，城市高于郊县(15.3%，13.0%)，经济水平中等片区高于差片区和好片区(14.8%，12.9%，12.6%)(χ²值分别为392.37，115.73，62.80，119.02，121.60，P值均 < 0.05)。多因素Logistic回归模型显示，不健康生活方式(OR=1.24，95%CI=1.19~1.29)和中等水平生活方式(OR=1.15，95%CI=1.10~1.19)学生的共患病率均更高，在男生和女生，10~12，13~15，16~18岁年龄组以及汉族和蒙古族中结果均有统计学意义(P值均 < 0.05)。结论 2021年内蒙古中小学生近视与肥胖共患和不健康生活方式现况不容乐观，不健康生活方式与共患病发生呈正相关。
- 近视 /
- 肥胖症 /
- 生活方式 /
- 回归分析 /
- 学生 /
- 少数民族
Abstract: Objective To describe the current status of the prevalence of co-morbid myopia and obesity among 7-18 years students in the Inner Mongolia Autonomous Region in 2021 and to analyze the moderating effect of lifestyle in this association, so as to provide scientific basis for the establishment of the mechanism of Co-morbidity, Shared Etiology, and Shared Prevention of common diseases in children and adolescents. Methods A total of 139 630 primary and secondary school students aged 7-18 years from Inner Mongolia Autonomous Region were selected by stratified random cluster sampling method in September, 2021. Myopia was determined using distance visual acuity examination and refractive error examination, and obesity was determined according to the BMI classification criteria for overweight, obesity screening of Chinese school-age children and adolescents. Used a questionnaire, healthy lifestyles were determined according to the American Heart Association's Healthy Lifestyle Score by totaling the six scores for smoking, alcohol consumption, diet, exercise, screen time, and sleep duration. The χ² test was used to compare the association between group differences in the co-morbidity rate of myopia and obesity. The multivariable Logistic regression model was used to explore the influencing factors of the co-morbidity of myopia and obesity, and the stratified analysis was used to analyze the moderating effect of lifestyles on the prevalence of the co-morbidity. Results The prevalence of myopia and obesity co-morbidity among students aged 7-18 years old in the Inner Mongolia Autonmous Region in 2021 was 13.7%, higher among boys than girls (15.5% vs. 11.8%), higher among those aged 10-12 years old than 7-9, 13-15, and 16-18 years old (14.7%, 13.7%, 13.3%, 12.0%), higher among other ethnic minorities than Han Chinese and Mongolians (15.3%, 14.0%, 12.5%), higher in urban areas than that in suburban areas(15.3%, 13.0%), and middle economic level tracts were higher than poor and good tracts (14.8%, 12.9%, 12.6%) (χ²=392.37, 115.73, 62.80, 119.02, 121.60, P < 0.05). Multivariable Logistic regression modeling showed that unhealthy lifestyles (OR=1.24, 95%CI=1.19-1.29) and middle level of lifestyle score (OR=1.15, 95%CI=1.10-1.19) students had higher prevalence of co-morbidity, and the results were statistically significant among both boys and girls, the age groups of 10-12, 13-15, and 16-18 years old, as well as the Han and Mongolian ethnic groups (all P < 0.05). Conclusion In 2021, the current situation of myopia and obesity co-morbidity and unhealthy lifestyles among primary and secondary school students in the Inner Mongolia Autonomous Region are not optimistic.
- Myopia /
- Obesity /
- Life style /
- Regression analysis /
- Students /
- Minority groups
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表 1 不同组别内蒙古学生近视肥胖及共患率比较

Table 1. Comparison of prevalence of myopia, obesity and co-morbidities among students in Inner Mongolia Autonomous Region

组别	选项	人数	近视	肥胖	近视与肥胖共患	χ²值	P值
性别	男	70 136	45 744(65.2)	16 775(23.9)	10 846(15.5)	392.37	< 0.01
	女	69 494	51 454(74.0)	11 433(16.5)	8 217(11.8)
年龄/岁	7~9	11 465	5 760(50.2)	3 140(27.4)	1 567(13.7)	115.73	< 0.01
	10~12	54 135	33 415(61.7)	13 013(24.0)	7 966(14.7)
	13~15	49 284	38 054(77.2)	8 420(17.1)	6 568(13.3)
	16~18	24 746	19 969(80.7)	3 635(14.7)	2 962(12.0)
民族	汉族	95 763	69 126(72.2)	19 119(20.0)	13 381(14.0)	62.80	< 0.01
	蒙古族	37 250	23 588(63.3)	7 521(20.2)	4 670(12.5)
	其他少数民族	6 617	4 484(67.8)	1 568(23.7)	1 012(15.3)
城乡	城市	38 262	27 908(72.9)	8 218(21.5)	5 848(15.3)	119.02	< 0.01
	郊县	101 368	69 290(68.4)	19 990(19.7)	13 215(13.0)
社会经济水平	好片	37 620	26 610(70.7)	6 835(18.2)	4 749(12.6)	121.60	< 0.01
	中片	60 890	41 808(68.7)	13 520(22.2)	9 011(14.8)
	差片	41 120	28 780(70.0)	7 853(19.1)	5 303(12.9)
家庭结构	核心家庭	95 307	67 863(71.2)	18 715(19.6)	12 911(13.5)	2.85	0.09
	非核心家庭	44 323	29 335(66.2)	9 493(21.4)	6 152(13.9)
住校	是	39 779	28 213(70.9)	5 862(14.7)	4 072(10.2)	550.61	< 0.01
	否	99 851	68 985(69.1)	22 346(22.4)	14 991(15.0)
吸烟	是	2 620	1 823(69.6)	435(16.6)	313(11.9)	6.59	0.01
	否	137 010	95 375(69.6)	27 773(20.3)	18 750(13.7)
饮酒	是	18 789	13 940(74.2)	3 630(19.3)	2 709(14.4)	10.79	< 0.01
	否	120 841	83 258(68.9)	24 578(20.3)	16 354(13.5)
健康饮食	是	18 227	12 264(67.3)	3 873(21.2)	2 516(13.8)	0.41	0.52
	否	121 403	84 934(70.0)	24 335(20.0)	16 547(13.6)
良好体育锻炼	是	23 405	15 555(66.5)	4 178(17.9)	2 715(11.6)	100.48	< 0.01
	否	116 225	81 643(70.2)	24 030(20.7)	16 348(14.1)
视屏时间达标	是	87 329	60 372(69.1)	17 865(20.5)	11 979(13.7)	0.83	0.36
	否	52 301	36 826(70.4)	10 343(19.8)	7 084(13.5)
睡眠时间达标	是	84 495	54 433(64.4)	18 578(22.0)	11 678(13.8)	5.15	0.02
	否	55 135	42 765(77.6)	9 630(17.5)	7 385(13.4)
健康生活方式评分	0~2	42 797	31 150(72.8)	8 542(20.0)	6 078(14.2)	44.89	< 0.01
	3	59 747	41 696(69.8)	12 284(20.6)	8 292(13.9)
	4~6	37 086	24 352(65.7)	7 382(19.9)	4 693(12.7)
注：χ²值和P值为近视与肥胖共患率的组间比较，()内数字为患病率/%。

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表 2 内蒙古学生近视肥胖共患与生活方式等的单因素Logistic回归分析(n=139 630)

Table 2. Logistic regression analysis of myopia and obesity co-morbidity and lifestyle etc. among students in Inner Mongolia Autonomous Region(n=139 630)

变量	选项	β值	标准误	P值	OR值(95%CI)
性别	女	-0.30	0.02	< 0.01	0.74(0.72~0.76)
年龄/岁	10~12	0.10	0.03	< 0.01	1.10(1.04~1.17)
	13~15	0.03	0.03	0.36	1.03(0.97~1.09)
	16~18	-0.07	0.04	0.06	0.94(0.87~1.00)
民族	蒙古族	-0.10	0.02	< 0.01	0.91(0.88~0.94)
	其他少数民族	0.04	0.04	0.29	1.04(0.97~1.11)
吸烟	是	-0.22	0.06	< 0.01	0.80(0.71~0.91)
饮酒	是	0.16	0.03	< 0.01	1.17(1.12~1.23)
健康饮食	否	-0.02	0.02	0.43	0.98(0.94~1.03)
良好体育锻炼	否	0.26	0.02	< 0.01	1.29(1.24~1.35)
视屏时间达标	否	0.02	0.02	0.28	1.02(0.99~1.05)
睡眠时间达标	否	0.07	0.02	< 0.01	1.07(1.03~1.11)
健康生活方式评分	3	0.14	0.02	< 0.01	1.15(1.10~1.19)
	0~2	0.21	0.02	< 0.01	1.24(1.19~1.29)

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表 3 内蒙古学生近视肥胖共患与生活方式关联的分层分析

Table 3. Stratified analysis of association between myopia and obesity co-morbidity and lifestyle among students in Inner Mongolia Autonomous Region

自变量	选项	人数	中等水平生活方式		不健康生活方式
自变量	选项	人数	OR值(95%CI)	P值	OR值(95%CI)	P值
性别	男	70 136	1.15(1.09~1.21)	< 0.01	1.20(1.14~1.28)	< 0.01
	女	69 494	1.14(1.08~1.21)	< 0.01	1.27(1.19~1.36)	< 0.01
年龄/岁	7~9	11 465	1.03(0.92~1.16)	0.64	1.13(0.96~1.32)	0.15
	10~12	54 135	1.14(1.08~1.20)	< 0.01	1.25(1.17~1.33)	< 0.01
	13~15	49 284	1.21(1.12~1.30)	< 0.01	1.28(1.19~1.38)	< 0.01
	16~18	24 746	1.14(1.01~1.28)	0.04	1.21(1.08~1.36)	< 0.01
民族	汉族	95 763	1.16(1.11~1.22)	< 0.01	1.23(1.17~1.29)	< 0.01
	蒙古族	37 250	1.11(1.03~1.20)	< 0.01	1.25(1.15~1.36)	< 0.01
	其他少数民族	6 617	1.07(0.90~1.27)	0.43	1.26(1.05~1.51)	0.02
注：自变量以健康生活方式为参照组，因变量以无共患为参照组；控制条件包括城乡、社会经济水平、是否住校。

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