天津市小学生生活方式与近视风险的列线图预测模型构建

刘盛鑫; 杜蓓; 金楠; 唐春玉; 宋德胜; 张欣; 魏瑞华

doi:10.16835/j.cnki.1000-9817.2024008

天津市小学生生活方式与近视风险的列线图预测模型构建

doi: 10.16835/j.cnki.1000-9817.2024008

刘盛鑫¹,
杜蓓²,
金楠²,
唐春玉²,
宋德胜²,
张欣^3, ,,
魏瑞华^2, ,

1.
天津中医药大学管理学院，天津 301617
2.
天津医科大学眼科医院/眼视光学院/眼科研究所/国家眼耳鼻喉疾病临床医学研究中心天津市分中心/天津市视网膜功能与疾病重点实验室
3.
天津医科大学公共卫生学院

基金项目:

天津市教委科研计划项目 2021SK134

详细信息

作者简介:
刘盛鑫(1991-)，女，天津市人，博士，讲师，主要研究方向为儿童青少年近视屈光发育

通讯作者:
张欣，E-mail: zhangxin@tmu.edu.cn

魏瑞华，E-mail: rwei@tmu.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 R179 R174⁺³
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- 被引次数: 0
出版历程
- 收稿日期: 2023-10-12
- 修回日期: 2023-10-26
- 网络出版日期: 2024-02-01
- 刊出日期: 2024-01-25

Construction of Nomogram prediction model of myopia risk and lifestyle among primary school students in Tianjin City

1.
School of Management, Tianjin University of Traditional Chinese Medicine, Tianjin (301617), China

摘要

摘要: 目的探讨天津市小学生生活方式与近视的关联，构建列线图模型预测近视风险，为小学生近视精准防控提供科学依据。方法于2022年4—7月，采用普查的方式对天津市15个区的373 180名小学生进行裸眼远视力检查、屈光检测和生活方式相关问卷调查。采用多因素Logistic回归模型分析小学生生活方式与近视的关联，并构建近视风险的列线图预测模型。结果天津市小学生近视检出率为37.6%。多因素Logistic回归模型分析结果显示，每日户外活动时长1~2 h(OR=0.94)和＞2 h(OR=0.84)、每日近距离电子产品使用时长＞2 h(OR=1.03)、每日近距离纸质材料读写时长1~2 h(OR=1.02)和＞2 h(OR=1.09)、每周新鲜蔬菜摄入2~6次(OR=0.93)和≥7次(OR=0.88)均与近视关联有统计学意义(P值均＜0.01)。近视风险列线图预测模型表明，影响天津市小学生近视患病风险的因素依次是年级、近视家族史、性别、每日户外活动时长、每周新鲜蔬菜摄入频率、每日近距离纸质材料读写时长和每日近距离电子产品使用时长。结论天津市小学生生活方式与近视存在关联，所构建的列线图模型可以为识别近视重点干预人群及采取有针对性的防控措施提供科学依据。
- 生活方式 /
- 近视 /
- 列线图 /
- 回归分析 /
- 学生
Abstract: Objective To explore the relationship between lifestyle and myopia and construct Nomogram model to predict myopia risk among primary school students in Tianjin, so as to provide a scientific basis for precision myopia prevention and control. Methods From April to July of 2022, a census method was used to conduct vision testing and lifestyle-related questionnaires among 373 180 primary school students in 15 districts of Tianjin. The relationship between lifestyle and myopia was analyzed by the multivariate Logistic regression, and a nomogram prediction model was constructed to predict myopia risk. Results The detection rate of myopia among primary school students in Tianjin was 37.6%. The results of the multivariate Logistic regression showed that daily outdoor activity time of 1-2 h (OR=0.94) and >2 h (OR=0.84), time of using daily electronic devices of >2 h (OR=1.03), daily paper materials reading and writing time of 1-2 h (OR=1.02) and >2 h (OR=1.09), weekly fresh vegetable intake of 2-6 times (OR=0.93) and ≥7 times (OR=0.88) were statistically correlated with myopia (P < 0.01). The Nomogram prediction model showed that the factors associated with myopia were grade, family history of myopia, gender, daily outdoor activity time, weekly frequency of fresh vegetable intake, daily paper materials reading and writing time, and time of using daily electronic devices time. Conclusions The lifestyle of primary school students in Tianjin is associated with myopia. The constructed nomogram model could provide a scientific basis for identifying key intervention populations for myopia prevention and taking targeted prevention and control measures.
- Life style /
- Myopia /
- Nomograms /
- 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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图 1 天津市小学生近视患病风险的列线图预测模型

Figure 1. A Nomogram model for predicting the risk of myopia among primary school students in Tianjin City

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表 1 天津市不同组别小学生近视检出率比较

Table 1. Comparison of myopia detection rates among different groups of primary school students in Tianjin

组别	选项	人数	近视人数	χ²值	P值
性别	男	194 497	69 658(35.8)	576.76	< 0.01
	女	178 683	70 807(39.6)
年级	一	64 293	9 353(14.5)	42 750.30	< 0.01
	二	67 529	15 406(22.8)
	三	65 200	22 391(34.3)
	四	62 755	27 960(44.6)
	五	58 699	31 340(53.4)
	六	54 704	34 015(62.2)
近视家族史	无	211 812	69 879(33.0)	4 510.33	< 0.01
	有	161 368	70 586(43.7)
每日睡眠时长/h	< 10	190 882	75 315(39.5)	564.58	< 0.01
	≥10	182 298	65 056(35.7)
每日户外活动时长/h	< 1	100 805	41 029(40.7)	651.35	< 0.01
	1~2	216 784	80 160(37.0)
	>2	55 591	19 276(34.7)
每日近距离电子产品使用时长/h	< 1	221 262	79 155(35.8)	1 086.72	< 0.01
	1~2	115 130	45 108(39.2)
	>2	36 788	16 202(44.0)
每日近距离纸质材料读写时长/h	< 1	108 044	37 262(34.5)	1 195.16	< 0.01
	1~2	190 153	71 378(37.5)
	>2	74 983	31 825(42.4)
每周新鲜水果摄入频率/次	≤1	9 093	3 743(41.2)	105.97	< 0.01
	2~6	55 533	21 645(39.0)
	≥7	308 554	115 077(37.3)
每周新鲜蔬菜摄入频率/次	≤1	15 644	6 076(38.8)	16.13	< 0.01
	2~6	56 737	21 588(38.0)
	≥7	300 799	112 801(37.5)
每周油炸烧烤类食品摄入频率/次	≤1	225 458	83 192(36.9)	160.73	< 0.01
	2~6	127 827	49 226(38.5)
	≥7	19 895	8 047(40.4)
每周碳酸饮料摄入频率/次	≤1	316 277	116 596(36.9)	539.29	< 0.01
	2~6	49 113	20 484(41.7)
	≥7	7 790	3 385(43.5)
注： ()内数字为检出率/%。

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表 2 天津市小学生生活方式与近视的多因素Logistic回归分析(n=373 180)

Table 2. Multivariate Logistic regression analysis of lifestyle and myopia among primary school students in Tianjin (n=373 180)

自变量	选项	β值	标准误	Wald χ²值	OR值(95%CI)	P值
每日睡眠时长/h	< 10				1.00
	≥10	0.01	0.01	0.57	1.02(0.99~1.04)	0.61
每日户外活动时长/h	< 1				1.00
	1~2	-0.06	0.01	48.00	0.94(0.93~0.96)	< 0.01
	>2	-0.18	0.01	223.83	0.84(0.82~0.86)	< 0.01
每日近距离电子产品使用时长/h	< 1				1.00
	1~2	-0.01	0.01	0.01	0.99(0.98~1.02)	0.91
	>2	0.03	0.01	5.58	1.03(1.01~1.06)	0.02
每日近距离纸质材料读写时长/次	< 1				1.00
	1~2	0.02	0.01	6.23	1.02(1.01~1.04)	0.01
	>2	0.08	0.01	57.03	1.09(1.06~1.11)	< 0.01
每周新鲜水果摄入频率/次	≤1				1.00
	2~6	-0.02	0.03	0.66	0.98(0.93~1.03)	0.42
	≥7	-0.01	0.03	0.02	0.99(0.95~1.11)	0.88
每周新鲜蔬菜摄入频率/次	≤1				1.00
	2~6	-0.08	0.02	14.19	0.93(0.89~0.96)	< 0.01
	≥7	-0.12	0.02	41.17	0.88(0.85~0.92)	< 0.01
每周油炸烧烤类食品摄入频率/次	≤1				1.00
	2~6	0.01	0.01	0.43	1.01(0.99~1.02)	0.51
	≥7	0.03	0.02	3.72	1.03(0.99~1.07)	0.06
每周碳酸饮料摄入频率/次	≤1				1.00
	2~6	0.01	0.01	0.47	1.01(0.99~1.03)	0.49
	≥7	0.01	0.03	0.16	1.01(0.96~1.06)	0.69

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