南京市中小学生生活方式与近视和抑郁症状共患的关系

李俊同; 刘辉; 叶盛; 杨月; 卢雪蕾; 刘黎

doi:10.16835/j.cnki.1000-9817.2024146

南京市中小学生生活方式与近视和抑郁症状共患的关系

doi: 10.16835/j.cnki.1000-9817.2024146

南京医科大学附属南京疾病预防控制中心学校卫生科，江苏 210003

基金项目:

南京市卫生科技发展专项资金项目 YKK22192

详细信息

作者简介:
李俊同(1997-)，男，江西抚州人，在读硕士，主要研究方向为儿童青少年健康

通讯作者:
刘黎，E-mail: 895047907@qq.com

利益冲突声明 所有作者声明无利益冲突。
中图分类号: R179 R778.1⁺¹ G444 D432.7
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出版历程
- 收稿日期: 2023-11-29
- 修回日期: 2024-03-06
- 网络出版日期: 2024-05-30
- 刊出日期: 2024-05-25

Relationship between lifestyle and the comorbidity of myopia and depressive symptoms among primary and secondary school students in Nanjing

Section of School Health, Nanjing Municipal Center for Disease Control and Prevention Affiliated to Nanjing Medical University, Nanjing (210003), Jiangsu Province, China

摘要

摘要: 目的探讨南京市中小学生生活方式与近视和抑郁症状共患的关系，为制定有效预防措施提供科学依据。方法于2022年10月，采用分层整群随机抽样方法，选取南京市4个城区和4个郊区9~19岁中小学生作为研究对象，共纳入10 498人进行体检，采用学生健康状况及影响因素调查表和抑郁量表进行问卷调查。采用χ²检验进行单因素分析，采用多因素Logistic回归分析中小学生生活方式与近视和抑郁症状共患的关系。结果南京市中小学生筛查性近视和抑郁症状共患率为18.11%。女生共患率高于男生(20.97%，15.47%)，住校生共患率高于非住校生(31.31%，16.51%)，高中学段高于初中和小学(28.63%，19.10%，7.76%)，差异均有统计学意义(χ²值分别为53.49，149.31，522.55，P值均 < 0.01)。多因素Logistic回归分析结果显示，曾吸烟(OR=1.51)、曾饮酒(OR=2.36)、昏暗条件下看电子屏幕(OR=2.40)、视屏时间≥2 h/d(OR=1.50)、课后作业时间≥2 h/d(OR=1.48)与筛查性近视和抑郁症状共患的发生均呈正相关；健康饮食(OR=0.67)、课间休息在室外活动(OR=0.80)、睡眠时间充足(OR=0.64)、身体活动达标(OR=0.74)以及户外活动时间≥2 h/d(OR=0.84)与筛查性近视和抑郁症状共患的发生均呈负相关(P值均 < 0.05)。结论南京市中小学生的生活方式与筛查性近视和抑郁症状共患相关。学校和家庭应开展相关宣教和干预，促进学生养成良好的生活习惯，预防近视和抑郁症状的发生。
- 生活方式 /
- 近视 /
- 抑郁 /
- 共病现象 /
- 学生
Abstract: Objective To explore the relationship between lifestyle and myopia and depressive symptoms comorbidity among primary and secondary school students in Nanjing, so as to provide a scientific basis for developing effective prevention measures. Methods In October 2022, a stratified cluster random sampling method was used to select primary and secondary school students aged 9-19 years in 4 urban and 4 suburban districts in Nanjing as the research subjects. A total of 10 498 students were included for physical examination and questionnaire survey by using the student health condition and influencing factors questionnaire. Chi-square test was used for univariate analysis, and multi-factor Logistic regression analysis was used to analyze the relationship between students' lifestyle and the co-occurrence of myopia and depressive symptoms. Results The prevalence of comorbidity of screening positive myopia and depression among primary and secondary school students in Nanjing was 18.11%. The prevalence of comorbidity was higher in girls (20.97%) than in boys (15.47%), higher in boarding students (31.31%) than in non-boarding students (16.51%), and higher in high school students than in middle and primary school students (28.63%, 19.10%, 7.76%), with statistically significant differences (χ²=53.49, 149.31, 522.55, P < 0.01). Multivariate Logistic regression results showed that smoking (OR=1.51), drinking (OR=2.36), looking at electronic screens in dim conditions (OR=2.40), screen time ≥2 h/d(OR=1.50), after-school homework time ≥2 h/d(OR=1.48) were positively correlated with the prevalence of comorbidity of screening positive myopia and depressive symptoms, healthy diet (OR=0.67), outdoor activities during breaks (OR=0.80), sufficient sleep (OR=0.64), meeting physical activity standards (OR=0.74) and outdoor activity time ≥2 h/d(OR=0.84) were negatively correlated with the prevalence of comorbidity of screening positive of myopia and depressive symptoms (P < 0.05). Conclusions The lifestyle of primary and secondary school students in Nanjing is related to the comorbidity of myopia and depressive symptoms. Schools and families should carry out relevant education and intervention measures to promote students to develop good living habits and jointly prevent the occurrence of myopia and depressive symptoms.
- Life style /
- Myopia /
- Depression /
- Comorbidity /
- Students
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表 1 不同组别中小学生筛查性近视和抑郁症状共患率比较

Table 1. Comparison of the prevalence of comorbidity of screening positive myopia and depressive symptoms in different groups among primary and secondary school students

组别	选项	人数	共患人数	χ²值	P值
性别	男	5 457	844(15.47)	53.49	< 0.01
	女	5 041	1 057(20.97)
住校	否	9 364	1 546(16.51)	149.31	< 0.01
	是	1 134	355(31.31)
学段	小学	3 737	290(7.76)	522.55	< 0.01
	初中	3 404	650(19.10)
	高中	3 357	961(28.63)
民族	其他	267	44(16.48)	0.49	0.48
	汉族	10 231	1 857(18.15)
曾吸烟	否	10 072	1 727(17.15)	154.79	< 0.01
	是	426	174(40.85)
曾饮酒	否	8 818	1 253(14.21)	564.78	< 0.01
	是	1 680	648(38.57)
超重肥胖	非超重肥胖	6 407	1 190(18.57)	3.98	0.14
	超重	2 143	357(16.66)
	肥胖	1 948	354(18.17)
健康饮食	否	9 293	1 801(19.38)	88.33	< 0.01
	是	1 205	100(8.30)
课间休息活动场所	室内	8 567	1 663(19.41)	53.36	< 0.01
	室外	1 931	238(12.33)
昏暗条件下看电子屏幕	否	9 520	1 484(15.59)	437.60	< 0.01
	是	978	417(42.64)
睡眠时间	不足	8 290	1 666(20.10)	105.08	< 0.01
	充足	2 208	235(10.64)
身体活动	未达标	8 987	1 734(19.29)	59.26	< 0.01
	达标	1 511	167(11.05)
户外活动时间/(h·d^-1)	< 2	7 039	1 396(19.83)	42.83	< 0.01
	≥2	3 459	505(14.60)
视屏时间/(h·d^-1)	< 2	8 648	1 385(16.02)	144.96	< 0.01
	≥2	1 850	516(27.89)
课后作业时间/(h·d^-1)	< 2	6 024	863(14.33)	136.35	< 0.01
	≥2	4 474	1 038(23.20)
注：()内数字为共患率/%。

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表 2 中小学生筛查性近视和抑郁症状共患与生活方式的多因素Logistic回归分析(n=10 498)

Table 2. Multifactorial Logistic regression analysis of the prevalence of comorbidity of screening myopia positive and depressive symptoms and lifestyle among primary and secondary school students(n=10 498)

自变量	选项	β值	Wald χ²值	OR值(95%CI)	P值
曾吸烟	是	0.41	12.16	1.51(1.20~1.90)	< 0.01
曾饮酒	是	0.86	162.35	2.36(2.07~2.70)	< 0.01
超重肥胖	超重	-0.13	3.06	0.88(0.77~1.01)	0.08
	肥胖	0.10	2.12	1.11(0.96~1.28)	0.15
健康饮食	是	-0.40	12.68	0.67(0.53~0.83)	< 0.01
课间休息活动场所	室外	-0.27	11.82	0.76(0.65~0.89)	< 0.01
昏暗条件下看电子屏幕	是	0.93	143.12	2.53(2.17~2.94)	< 0.01
睡眠时间	充足	-0.45	29.48	0.64(0.55~0.75)	< 0.01
身体活动	达标	-0.29	8.98	0.75(0.63~0.90)	< 0.01
户外活动时间/(h·d^-1)	≥2	-0.16	6.89	0.85(0.75~0.96)	< 0.01
视屏时间/(h·d^-1)	≥2	0.31	22.15	1.37(1.20~1.57)	< 0.01
课后作业时间/(h·d^-1)	≥2	0.39	47.43	1.47(1.32~1.64)	< 0.01

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参考文献(35)

[1]	YOU Q S, WU L J, DUAN J L, et al. Prevalence of myopia in school children in greater Beijing: the Beijing childhood eye study[J]. Acta Ophthalmol, 2014, 92(5): e398-406.
[2]	MA Y, LIN S, LI L, et al. Socioeconomic mechanisms of myopia boom in China: a nationwide cross-sectional study[J]. BMJ Open, 2021, 11(6): e044608. doi: 10.1136/bmjopen-2020-044608
[3]	ŁAZARCZYK J B, URBAN B, KONARZEWSKA B, et al. The differences in level of trait anxiety among girls and boys aged 13-17 years with myopia and emmetropia[J]. BMC Ophthalmol, 2016, 16(1): 201. doi: 10.1186/s12886-016-0382-2
[4]	GEOFFROY M C, ORRI M, GIRARD A, et al. Trajectories of suicide attempts from early adolescence to emerging adulthood: prospective 11-year follow-up of a Canadian cohort[J]. Psychol Med, 2021, 51(11): 1933-1943. doi: 10.1017/S0033291720000732
[5]	潘臣炜. 积极探索可控性环境和行为因素在儿童青少年近视防控中的作用[J]. 中国学校卫生, 2022, 43(9): 1281-1283, 1292. doi: 10.16835/j.cnki.1000-9817.2022.09.001 PAN C W. Actively explore the role of controllable environmental and behavioral factors in the prevention and control of myopia among children and adolescents[J]. Chin J Sch Health, 2022, 43(9): 1281-1283, 1292. (in Chinese) doi: 10.16835/j.cnki.1000-9817.2022.09.001
[6]	吴慧攀, 干敏雷, 尹小俭, 等. 青少年抑郁症状影响因素研究进展[J]. 中国学校卫生, 2023, 44(5): 786-790. doi: 10.16835/j.cnki.1000-9817.2023.05.033 WU H P, GAN M L, YIN X J, et al. Research progress on influencing factors of depressive symptoms in adolescents[J]. Chin J Sch Health, 2023, 44(5): 786-790. (in Chinese) doi: 10.16835/j.cnki.1000-9817.2023.05.033
[7]	江苏省卫生健康委员会. 2022年江苏省学生常见病和健康影响因素监测与干预工作手册[Z]. 2022. Jiangsu Provincial Health Commission. 2022 Jiangsu Province student common diseases and health impact factors monitoring and intervention work manual[Z]. 2022. (in Chinese)
[8]	中华人民共和国国家卫生和计划生育委员会. 学生健康检查技术规范: GB/T 26343—2010[S]. 北京: 中国标准出版社, 2011. National Health and Family Planning Commission of the PRC. Technical standard for physical examination for students: GB/T 26343-2010[S]. Beijing: Standards Press of China, 2011. (in Chinese)
[9]	中华人民共和国国家卫生健康委员会. 中小学生屈光不正筛查规范: WS/T 663—2020[S]. 北京: 中国标准出版社, 2020. National Health Commission of the PRC. Screening standards for refractive errors in primary and secondary school students: WS/T 663-2020[S]. Beijing: China Standards Publishing House, 2020. (in Chinese)
[10]	中华人民共和国国家卫生健康委员会. 学龄儿童青少年超重与肥胖筛查: WS/T 586—2018[S]. 北京: 中国标准出版社, 2018. National Health Commission of the PRC. Screening for overweight and obesity among school-age children and adolescents: WS/T 586-2018[S]. Beijng: Standards Press of China, 2018. (in Chinese)
[11]	陶芳标. 《儿童青少年近视防控公共卫生综合干预技术指南》专题解读[J]. 中国学校卫生, 2023, 44(10): 1445-1449. doi: 10.16835/j.cnki.1000-9817.2023.10.002 TAO F B. Expert interpretation of Comprehensive Public Health Intervention Technical Guidelines for Prevention and Control of Myopia among Children and Adolescents[J]. Chin J Sch Health, 2023, 44(10): 1445-1449. (in Chinese) doi: 10.16835/j.cnki.1000-9817.2023.10.002
[12]	张云婷, 马生霞, 陈畅, 等. 中国儿童青少年身体活动指南[J]. 中国循证儿科杂志, 2017, 12(6): 401-409. doi: 10.3969/j.issn.1673-5501.2017.06.001 ZHANG Y T, MA S X, CHEN C, et al. Physical activity guide for Chinese children and adolescents[J]. Chin J Evid Based Pediatr, 2017, 12(6): 401-409. (in Chinese) doi: 10.3969/j.issn.1673-5501.2017.06.001
[13]	RADLOFF L S. The CES-D scale: a self-report depression scale for research in the general population[J]. Appl Psychol Meas, 1977, 1(3): 385-401. doi: 10.1177/014662167700100306
[14]	叶盛, 杨月, 刘辉, 等. 中学生视屏和睡眠时间与抑郁症状的相关性[J]. 中国学校卫生, 2022, 43(7): 1015-1018. doi: 10.16835/j.cnki.1000-9817.2022.07.014 YE S, YANG Y, LIU H, et al. Relationship between screen time, sleep duration and depressive symptoms among middle school students[J]. Chin J Sch Health, 2022, 43(7): 1015-1018. (in Chinese) doi: 10.16835/j.cnki.1000-9817.2022.07.014
[15]	孙志颖, 刘忠慧, 冯宝佳, 等. 天津市中学生体力活动睡眠时间及超重肥胖与抑郁症状的关系[J]. 中国学校卫生, 2023, 44(4): 489-493. doi: 10.16835/j.cnki.1000-9817.2023.04.003 SUN Z Y, LIU Z H, FENG B J, et al. Relationship between physical activity, sleep duration and overweight, obesity with depressive symptoms among middle school students in Tianjin[J]. Chin J Sch Health, 2023, 44(4): 489-493. (in Chinese) doi: 10.16835/j.cnki.1000-9817.2023.04.003
[16]	许凤鸣, 王丽茹, 李凤娟, 等. 河南省中小学生视力状况与户外活动相关分析[J]. 中国健康教育, 2023, 39(7): 601-604. https://www.cnki.com.cn/Article/CJFDTOTAL-ZGJK202307005.htm XU F M, WANG L R, LI F J, et al. Association between eyesight and outdoor activity in primary and middle school students in Henan Province[J]. Chin J Health Educ, 2023, 39(7): 601-604. (in Chinese) https://www.cnki.com.cn/Article/CJFDTOTAL-ZGJK202307005.htm
[17]	SALK R H, HYDE J S, ABRAMSON L Y. Gender differences in depression in representative national samples: Meta-analyses of diagnoses and symptoms[J]. Psychol Bull, 2017, 143(8): 783-822. doi: 10.1037/bul0000102
[18]	MENÉNDEZ-ACEBAL C, MARTÍNEZ-GONZÁLEZ M A, BES-RASTROLLO M, et al. The influence of alcohol intake in myopia development or progression: the SUN cohort study[J]. Drug Alcohol Depend, 2021, 229(Pt A): 109149.
[19]	ZHANG Y, ZHANG X J, YUAN N, et al. Analysis of secondhand smoke exposure and myopia among children aged 6 to 8 years in Hong Kong[J]. JAMA Netw Open, 2023, 6(5): e2313006. doi: 10.1001/jamanetworkopen.2023.13006
[20]	奉琪, 陈艳, 吴鑫. 长沙市中学生抑郁症状流行状况及其影响因素分析[J]. 实用预防医学, 2023, 30(8): 949-954. doi: 10.3969/j.issn.1006-3110.2023.08.012 FENG Q, CHEN Y, WU X. Prevalence of depressive symptoms and its influencing factors among middle school students in Changsha City[J]. Pract Prev Med, 2023, 30(8): 949-954. (in Chinese) doi: 10.3969/j.issn.1006-3110.2023.08.012
[21]	LIM L S, GAZZARD G, LOW Y L, et al. Dietary factors, myopia, and axial dimensions in children[J]. Ophthalmology, 2010, 117(5): 993-997, e994. doi: 10.1016/j.ophtha.2009.10.003
[22]	YIN C, GAN Q, XU P, et al. Dietary patterns and associations with myopia in Chinese children[J]. Nutrients, 2023, 15(8): 1946. doi: 10.3390/nu15081946
[23]	顾文馨, 谭银亮, 陆唯怡, 等. 上海市青少年饮食行为现状以及抑郁焦虑情绪的影响[J]. 中国学校卫生, 2022, 43(6): 864-868. doi: 10.16835/j.cnki.1000-9817.2022.06.016 GU W X, TAN Y L, LU W Y, et al. Prevalence and influence of depression and anxiety on dietary behaviors among adolescents in Shanghai[J]. Chin J Sch Health, 2022, 43(6): 864-868. (in Chinese) doi: 10.16835/j.cnki.1000-9817.2022.06.016
[24]	HE X, SANKARIDURG P, WANG J, et al. Time outdoors in reducing myopia: a school-based cluster randomized trial with objective monitoring of outdoor time and light intensity[J]. Ophthalmology, 2022, 129(11): 1245-1254. doi: 10.1016/j.ophtha.2022.06.024
[25]	HUANG P C, HSIAO Y C, TSAI C Y, et al. Protective behaviours of near work and time outdoors in myopia prevalence and progression in myopic children: a 2-year prospective population study[J]. Br J Ophthalmol, 2020, 104(7): 956-961. doi: 10.1136/bjophthalmol-2019-314101
[26]	徐星, 许韶君, 梁莉, 等. 紫光与近视关联的研究进展[J]. 中国学校卫生, 2023, 44(5): 782-785. doi: 10.16835/j.cnki.1000-9817.2023.05.032 XU X, XU S J, LIANG L, et al. Research progress on the association between violet light and myopia[J]. Chin J Sch Health, 2023, 44(5): 782-785. (in Chinese) doi: 10.16835/j.cnki.1000-9817.2023.05.032
[27]	POUDEL S, RAHIMI-NASRABADI H, JIN J, et al. Differences in visual stimulation between reading and walking and implications for myopia development[J]. J Vis, 2023, 23(4): 3. doi: 10.1167/jov.23.4.3
[28]	KHAN A, LEE E Y, ROSENBAUM S, et al. Dose-dependent and joint associations between screen time, physical activity, and mental wellbeing in adolescents: an international observational study[J]. Lancet Child Adolesc Health, 2021, 5(10): 729-738. doi: 10.1016/S2352-4642(21)00200-5
[29]	武海潭, 干敏雷, 尹小俭, 等. 青少年体力活动与抑郁症状的相关性[J]. 中国学校卫生, 2023, 44(5): 672-676, 681. doi: 10.16835/j.cnki.1000-9817.2023.05.008 WU H T, GAN M L, YIN X J, et al. Correlation between physical activity and depressive symptoms in adolescents[J]. Chin J Sch Health, 2023, 44(5): 672-676, 681. (in Chinese) doi: 10.16835/j.cnki.1000-9817.2023.05.008
[30]	董秀清, 周艺, 王冬梅, 等. 睡眠期间卧室夜灯暴露与儿童情绪症状的关联[J]. 中国学校卫生, 2023, 44(4): 572-576. doi: 10.16835/j.cnki.1000-9817.2023.04.022 DONG X Q, ZHOU Y, WANG D M, et al. Association between bedroom night light exposure during sleep and children's emotional symptoms[J]. Chin J Sch Health, 2023, 44(4): 572-576. (in Chinese) doi: 10.16835/j.cnki.1000-9817.2023.04.022
[31]	TSAI T H, LIU Y L, MA I H, et al. Evolution of the prevalence of myopia among Taiwanese school children: a review of survey data from 1983 through 2017[J]. Ophthalmology, 2021, 128(2): 290-301. doi: 10.1016/j.ophtha.2020.07.017
[32]	MOUGHARBEL F, GOLDFIELD G S. Psychological correlates of sedentary screen time behaviour among children and adolescents: a narrative review[J]. Curr Obes Rep, 2020, 9(4): 493-511. doi: 10.1007/s13679-020-00401-1
[33]	OKELY A D, KARⅡPPANON K E, GUAN H, et al. Global effect of COVID-19 pandemic on physical activity, sedentary behaviour and sleep among 3- to 5-year-old children: a longitudinal study of 14 countries[J]. BMC Public Health, 2021, 21(1): 940. doi: 10.1186/s12889-021-10852-3
[34]	来坚, 李能, 王琼琼, 等. 2018—2020年杭州市西湖区青少年近视流行病学调查[J]. 中国预防医学杂志, 2021, 22(6): 418-422. https://www.cnki.com.cn/Article/CJFDTOTAL-ZGYC202106004.htm LAI J, LI N, WANG Q Q, et al. Prevalence of myopia among school students and its influencing factors in Xihu district of Hangzhou during 2018 and 2020[J]. Chin J Prev Med, 2021, 22(6): 418-422. (in Chinese) https://www.cnki.com.cn/Article/CJFDTOTAL-ZGYC202106004.htm
[35]	KHAN A, AHMED R, BURTON N W. Prevalence and correlates of depressive symptoms in secondary school children in Dhaka City, Bangladesh[J]. Ethn Health, 2020, 25(1): 34-46. doi: 10.1080/13557858.2017.1398313