Joint effect of sitting posture habits and screen viewing distance on screening myopia among primary school students
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摘要:
目的 探讨小学生筛查性近视与坐姿习惯和视屏距离的关联，为小学生近视预防与干预提供科学依据。 方法 2024年4—6月，采用方便抽样方法选取北京市某区4所小学1 394名四年级学生进行视力检查和问卷调查，采用Logistic回归模型分析小学生筛查性近视与坐姿习惯和视屏距离的关系。 结果 小学生筛查性近视检出率为63.8%；13.1%自我报告坐姿不端，47.1%自我报告视屏距离≤20 cm。Logistic回归分析结果显示，调整年龄、性别、学校、睡眠质量、父母近视情况、体质健康水平、每日中高强度体力活动、周末每天户外活动时间及课后服务类型等协变量后，与坐姿正常的小学生相比，坐姿不端的小学生筛查性近视检出风险更高(OR=1.73，95%CI=1.03~2.92)；与视屏距离>20 cm的小学生相比，视屏距离≤20 cm的小学生筛查性近视检出风险更高(OR=1.32，95%CI=1.02~1.71)；坐姿习惯与筛查性近视的关联在男生中更明显(OR=2.00，95%CI=1.03~3.88)(P值均＜0.05)。坐姿习惯与视屏距离存在相乘交互作用，与坐姿正常且视屏距离>20 cm相比，坐姿不端且视屏距离>20 cm的小学生筛查性近视检出风险更高(OR=1.82，95%CI=1.12~2.96，P＜0.05)。 结论 坐姿习惯、视屏距离均与小学生筛查性近视有关，坐姿不端相较于视屏距离有更高的近视风险，两者与小学生筛查性近视风险存在交互作用。 Abstract:Objective To explore the association of screening myopia and sitting posture habits as well as screen viewing distance among primary school students, providing a scientific basis for myopia prevention and intervention among primary school students. Methods From April to June 2024, a convenient sampling method was used to enroll 1 394 fourth-grade students from four primary schools in a district of Beijing for vision examinations and questionnaire surveys. Logistic regression models were employed to analyze the relationship of screening myopia detection and sitting posture habits as well as viewing distance. Results The screening myopia prevalence among primary school students was 63.8%. About 13.1% of students self-reported poor sitting posture, and 47.1% self-reported a viewing distance of ≤20 cm. After adjusting for covariates including age, gender, school, sleep quality, parental myopia status, physical fitness level, daily high-intensity physical activity, weekend outdoor activity time and types of after-school services, Logistic regression analysis showed that students with poor sitting posture were more likely to have screening myopia than those with normal sitting posture (OR=1.73, 95%CI=1.03-2.92); students with a viewing distance of ≤20 cm were more likely to have screening myopia than those with a viewing distance of >20 cm(OR=1.32, 95%CI=1.02-1.71)(P < 0.05). The association between sitting posture and screening myopia was more significant among boys(OR=2.00, 95%CI=1.03-3.88, P < 0.05). A multiplicative interaction was observed between sitting posture and viewing distance. Compared to primary school students with normal posture and a viewing distance of >20 cm, those with poor posture and a viewing distance of >20 cm were more likely to have screening myopia (OR=1.82, 95%CI=1.12-2.96, P < 0.05). Conclusions Both sitting posture habits and screen viewing distance are related to screening myopia in primary school students. Poor sitting posture poses a higher risk than screen distance, and the two factors exhibit an interactive effect on myopia risk. -
Key words:
- Sitting position /
- Fixation, ocular /
- Myopia /
- Regression analysis /
- Students
1) 第二十七届中国科协年会学术论文2) 利益冲突声明 所有作者声明无利益冲突。3) 赵瑞兰与彭涛为共同第一作者。 -
表 1 不同组别小学生筛查性近视检出率比较
Table 1. Comparison of detection rates of screening myopia among different groups of primary school students
组别 选项 人数 筛查性近视 χ2值 P值 学校 1 266 171(64.3) 10.35 0.01 2 384 267(69.5) 3 367 214(58.3) 4 377 238(63.1) 性别 男 743 452(60.8) 6.25 < 0.01 女 651 438(67.3) 坐姿习惯 正常 1 212 758(62.5) 6.84 < 0.01 不端 182 132(72.5) 视屏距离/cm >20 737 452(61.3) 4.29 0.03 ≤20 657 438(66.7) 视屏姿势 正常 1 160 694(62.7) 2.79 0.10 异常 288 196(68.1) 睡眠质量 良好 1 223 794(64.9) 5.01 0.02 不佳 171 96(56.1) 父亲近视 是 683 472(69.1) 16.06 < 0.01 否 711 418(58.8) 母亲近视 是 818 559(68.3) 17.31 < 0.01 否 576 331(57.5) 每天中高强度体力 ≥1 512 317(61.9) 1.31 0.24 活动时间/h < 1 882 573(65.0) 周末每天户外活动 ≥1 1 136 711(62.6) 4.20 0.04 时间/h < 1 258 179(69.4) 是否参加课后服务 是 744 490(65.9) 5.22 0.09 否 650 400(61.5) 课后服务类型 体育类 265 177(66.8) 2.81 0.02 非体育类 385 223(57.9) 注： ()内数字为检出率/%。 
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表 2 小学生坐姿习惯与视屏距离对筛查性近视的联合作用
Table 2. Joint effect of sitting posture and screen viewing distance on screening myopia among primary school students
组别 分类 OR值(95%CI) P值 男生 坐姿正常×视屏距离>20 cm 1.00 (n=743) 坐姿正常×视屏距离≤20 cm 1.36(0.99~1.87) 0.06 坐姿不端×视屏距离>20 cm 2.54(1.31~4.91) 0.02 坐姿不端×视屏距离≤20 cm 1.70(0.93~3.91) 0.08 女生 坐姿正常×视屏距离>20 cm 1.00 (n=651) 坐姿正常×视屏距离≤20 cm 1.26(0.89~179) 0.19 坐姿不端×视屏距离>20 cm 1.26(0.61~2.58) 0.53 坐姿不端×视屏距离≤20 cm 2.08(0.87~4.95) 0.10 整体 坐姿正常×视屏距离>20 cm 1.00 (n=1 394) 坐姿正常×视屏距离≤20 cm 1.30(1.03~1.65) 0.03 坐姿不端×视屏距离>20 cm 1.82(1.12~2.96) 0.01 坐姿不端×视屏距离≤20 cm 1.72(1.06~2.81) 0.04
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