中小学生户外活动久坐行为和睡眠与视力不良的关系

徐星; 朱懿; 张瑞; 张亚新; 陶芳标; 许韶君

doi:10.16835/j.cnki.1000-9817.2024347

中小学生户外活动久坐行为和睡眠与视力不良的关系

doi: 10.16835/j.cnki.1000-9817.2024347

徐星¹,
朱懿¹,
张瑞¹,
张亚新¹,
陶芳标^{1, 2},
许韶君^{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/环境与人口健康安徽省重点实验室

基金项目:

安徽高校自然科学研究项目 KJ2021ZD0039

国家重点研发计划项目 2021YFC2702102

国家重点研发计划项目 2021YFC270210

详细信息

作者简介:
徐星(1996-)，女，浙江绍兴人，在读硕士，主要研究方向为儿童青少年卫生

通讯作者:
许韶君，E-mail：xushaojun@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 G806 Q428 R778.1⁺⁵
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- 被引次数: 0
出版历程
- 收稿日期: 2024-08-02
- 修回日期: 2024-09-26
- 网络出版日期: 2024-12-10
- 刊出日期: 2024-11-15

Relationship of outdoor activities and sedentary behaviors and sleep with poor vision among primary and secondary school students

XU Xing¹,
ZHU Yi¹,
ZHANG Rui¹,
ZHANG Yaxin¹,
TAO Fangbiao^{1, 2},
XU Shaojun^{1, 2
, ,}

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

摘要

摘要: 目的分析中小学生户外活动、久坐行为和睡眠时长相互替代后对视力不良风险的影响，为儿童青少年近视防控精准干预提供参考依据。方法 2023年3—5月，采用分层整群随机抽样方法，选取安徽省合肥市、芜湖市、宿州市和池州市6 132名四至十二年级中小学生，通过问卷调查收集基本信息及户外活动、久坐行为和睡眠时长，采用5 m标准对数视力表进行视力检查。分别采用单一活动模型、分割模型以及等时替代模型分析中小学生户外活动、久坐行为和睡眠时长与视力不良之间的关联，并按性别进行分层分析。结果 6 132名中小学生视力不良检出率为76.9%，其中女生视力不良检出率(81.1%)高于男生(72.6%)，差异有统计学意义(χ²=61.37，P < 0.01)。单一活动模型和分割模型结果显示，中小学生户外活动和睡眠时长与视力不良风险降低均相关(OR值分别为0.87，0.88；0.88, 0.91)，久坐行为时长与视力不良风险增加均相关(OR值分别为1.05, 1.03)(P值均 < 0.05)。等时替代模型分析结果显示，用1 h/d的户外活动时长替代相同时间的久坐行为可降低15%的视力不良风险(OR=0.85)；用1 h/d的睡眠时长替代相同时间的久坐行为可降低12%的视力不良风险(OR=0.88)(P值均 < 0.05)。按性别分层后等时替代模型分析结果显示，用1 h/d的户外活动和睡眠时长替代相同时间的久坐行为可降低男生22%和8%的视力不良风险(OR值分别为0.78，0.92)；用1 h/d的睡眠时长替代相同时间的久坐行为可降低女生18%的视力不良风险(OR=0.82)(P值均 < 0.05)。结论男生每日用1 h户外活动替代久坐行为以及男、女生每日用1 h睡眠替代久坐行为均可减少视力不良风险。
- 运动活动 /
- 久坐生活方式 /
- 睡眠 /
- 视力，低 /
- 等时替代 /
- 学生
Abstract: Objective To analyze the effects of outdoor activities, sedentary behaviors and sleep duration on the risk of poor vision among primary and secondary school students after replacing them with each other, so as to provide a reference for precise intervention in the prevention and control of myopia among children and adolescents. Methods From March to May 2023, a stratified cluster random sampling method was used to select 6 132 students in grades 4 to 12 in Hefei, Wuhu, Suzhou and Chizhou cities in Anhui Province. A questionnaire survey was conducted to collect the basic information, outdoor activities, sedentary behavior, and sleep duration, and a visual inspection was carried out by 5 m standard logarithmic visual acuity chart. The single activity model, segmentation model and isotemporal substitution model were used to analyze the relationship between outdoor activities, sedentary behaviors, sleep, and poor vision, and stratified analysis was performed by gender. Results The detection rate of poor vision among the 6 132 primary and secondary school students was 76.9%, and the detection rate of poor vision was higher for girls (81.1%) than for boys (72.6%), and the difference was statistically significant (χ²=61.37, P < 0.01). The results of the single activity model and segmentation model showed that outdoor activity and sleep duration were correlated with a reduced risk of poor vision in primary and secondary school students (OR=0.87, 0.88; 0.88, 0.91), while sedentary behavior was correlated with an increased risk of poor vision (OR=1.05, 1.03) (P < 0.05). The results of the isotemporal substitution model showed that replacing the same amount of sedentary behavior with 1 h/d of outdoor activity was associated with 15% reduction in the risk of poor vision (OR=0.85), and replacing the same amount of sedentary behavior with 1 h/d of sleep was associated with a 12% reduction in the risk of poor vision (OR=0.88) (P < 0.05). The results of the isotemporal substitution model stratified by gender showed that replacing the same amount of sedentary behavior with 1 h/d of outdoor activity and 1 h/d of sleep were associated with 22% and 8% reduction in the risk of poor vision in male students (OR=0.78, 0.92), and replacing the same amount of sedentary behavior with 1 h/d of sleep was associated with 18% reduction in the risk of poor vision in female students (OR=0.82) (P < 0.05). Conclusion Replacing sedentary behavior with 1 h/d of outdoor activity for boys and 1 h/d of sleep for girls and boys could reduce the risk of poor vision.
- Motor activity /
- Sedentary lifestyle /
- Sleep /
- Vision, low /
- Isotemporal substitution /
- Students
注释:

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表 1 不同人口统计学特征中小学生视力不良检出率比较

Table 1. Comparison of poor vision rate among primary and se- condary school students with different demographic characteristics

人口统计学指标	选项	人数	视力不良人数	χ²值	P值
性别	男	2 998	2 177(72.62)	61.37	< 0.01
	女	3 134	2 540(81.05)
父母近视情况	一方近视	1 655	1 362(82.30)	91.34	< 0.01
	均近视	486	423(87.04)
	均不近视	3 708	2 703(72.90)
	不确定	283	229(80.92)
父亲文化程度	初中及以下	3 112	2 425(77.92)	20.97	< 0.01
	高中或中专	1 360	1 043(76.69)
	大专及以上	1 091	854(78.28)
	不确定	569	395(69.42)
母亲文化程度	初中及以下	3 442	2 709(78.70)	20.17	< 0.01
	高中或中专	1 191	907(76.15)
	大专及以上	929	697(75.03)
	不确定	570	404(70.88)
注：()内数字为检出率/%。

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表 2 不同性别中小学生行为变量及其改变对视力不良的影响

Table 2. Behavioural variables and the modification on poor vision among primary and secondary school students of different genders

性别	替代模型	户外活动		久坐行为		睡眠
性别	替代模型	OR值(95%CI)	P值	OR值(95%CI)	P值	OR值(95%CI)	P值
男	单一活动模型	0.81(0.74~0.89)	< 0.01	1.05(1.01~1.09)	0.01	0.93(0.85~1.00)	0.06
(n=2 998)	分割模型	0.82(0.75~0.89)	< 0.01	1.04(1.00~1.08)	0.05	0.95(0.88~1.04)	0.26
	等时替代模型
	其他活动替代户外活动	—		1.28(1.16~1.41)	< 0.01	1.17(1.03~1.33)	0.02
	其他活动替代久坐行为	0.78(0.71~0.86)	< 0.01	—		0.92(0.84~1.00)	0.05
	其他活动替代睡眠	0.86(0.75~0.97)	0.02	1.09(1.00~1.19)	0.04	—
女	单一活动模型	0.95(0.85~1.06)	0.36	1.04(0.99~1.09)	0.10	0.83(0.75~0.92)	< 0.01
(n=3 134)	分割模型	0.97(0.87~1.08)	0.57	1.01(0.97~1.06)	0.56	0.84(0.75~0.93)	< 0.01
	等时替代模型
	其他活动替代户外活动	—		1.05(0.93~1.18)	0.44	0.86(0.74~1.01)	0.07
	其他活动替代久坐行为	0.96(0.85~1.08)	0.44	—		0.82(0.74~0.92)	< 0.01
	其他活动替代睡眠	1.16(0.99~1.36)	0.07	1.21(1.09~1.35)	< 0.01	—
注：所有模型均调整社会人口学因素(年龄、父亲文化程度、母亲文化程度)和父母近视情况。

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