上海市小学高年级学生近视与营养状况的相关性

Relationship between myopia and nutritional status among upper elementary students in Shanghai

目的探索上海市小学高年级学生近视与营养状况的关联,为开展儿童青少年近视防控提供依据。方法采用多层整群抽样的方法选取上海市16个区四至五年级5576名学生进行视力检查、体格测量和问卷调查。分别采用两水平多因素Logistic回归和混合线性模型分析近视和等效球镜度数与营养状况的关联。结果高年级学生超重、肥胖检出率分别为17.0%(949名)和18.7%(1042名),男、女生营养状况构成差异有统计学意义(χ^(2)=210.94,P<0.01),男生超重、肥胖占比高于女生。超重男生更倾向于发生近视(单因素:OR=1.23,P=0.04;多因素:OR=1.21,P=0.06);超重学生屈光度低于体重正常学生(多因素,男生:β=-0.19,女生:β=-0.24,P值均<0.05)。肥胖学生近视风险和屈光度与体重正常学生差异无统计学意义(P值均>0.05)。结论上海小学高年级超重学生屈光度低于体重正常学生,需更多的研究验证儿童青少年近视和营养状况间的关联,为近视防控提供理论依据。

Objective To explore the relationship between myopia and nutritional status among upper elementary students in Shanghai.Methods A stratified cluster sampling method was used to select 5576 fourth-and fifth-grade students from 16 districts in Shanghai,vision test,physical examination and questionnaire survey were administered.Two-level multivariate Logistic regression and mixed linear models were used to analyze the relationship between myopia,spherical equivalent(SE)and nutritional status.Results The detection rates of overweight and obesity were 17.0%(949)and 18.7%(1042),respectively.There was a statistical difference in the proportion of the nutritional status in boys and girls(χ^(2)=210.94,P<0.01),with overweight and obesity in boys higher than those of girls.The overweight boys were more likely to have myopia(univariate analysis:OR=1.23,P=0.04;multivariate analysis:OR=1.21,P=0.06)than the normal-weight boy.Overweight students tended to had more negative refractive than those with normal-weight in both boys and girls(multivariate analysis,boys:β=-0.19,girls:β=-0.24,P<0.05).Myopia risk and refractive power in obese students showed no statistical difference with normal-weight students(P>0.05).Conclusion Overweight students have lower SE than the normal-weight among upper elementary students of Shanghai,more researches are needed to confirm this finding and to provide theoretical bases for myopia prevention and control.