内蒙古地区2021年中小学生近视与肥胖共患现状及生活方式的调节作用

Co-morbidity of myopia and obesity and the moderating role of lifestyle among primary and secondary school students in Inner Mongolia Autonomous Region in 2021

目的分析2021年内蒙古7~18岁学生近视与肥胖共患流行现状及生活方式的调节作用,为儿童青少年常见疾病“共病-共因-共防”机制的建立提供科学依据。方法2021年9月采用分层随机整群抽样方法,抽取内蒙古139630名7~18岁中小学生为研究对象。使用远视力检查及屈光度检查判断近视情况,依据中国学龄儿童青少年超重与肥胖筛查标准判定肥胖情况。根据美国心脏协会的健康生活方式评分,综合吸烟、饮酒、饮食、运动、视屏时间和睡眠时间6项总分对健康生活方式进行判定。采用χ^(2)检验比较近视与肥胖共患率的组间差异,采用多因素Logistic回归模型探索近视与肥胖共患的影响因素及分层分析不同群组生活方式对共患病的调节作用。结果2021年内蒙古7~18岁学生近视与肥胖共患率为13.7%,男生高于女生(15.5%,11.8%),10~12岁高于7~9,13~15,16~18岁(14.7%,13.7%,13.3%,12.0%),其他少数民族高于汉族及蒙古族(15.3%,14.0%,12.5%),城市高于郊县(15.3%,13.0%),经济水平中等片区高于差片区和好片区(14.8%,12.9%,12.6%)(χ^(2)值分别为392.37,115.73,62.80,119.02,121.60,P值均<0.05)。多因素Logistic回归模型显示,不健康生活方式(OR=1.24,95%CI=1.19~1.29)和中等水平生活方式(OR=1.15,95%CI=1.10~1.19)学生的共患病率均更高,在男生和女生,10~12,13~15,16~18岁年龄组以及汉族和蒙古族中结果均有统计学意义(P值均<0.05)。结论2021年内蒙古中小学生近视与肥胖共患和不健康生活方式现况不容乐观,不健康生活方式与共患病发生呈正相关。

Objective To describe the current status of the prevalence of co-morbid myopia and obesity among 7-18 years students in the Inner Mongolia Autonomous Region in 2021 and to analyze the moderating effect of lifestyle in this association,so as to provide scientific basis for the establishment of the mechanism of Co-morbidity,Shared Etiology,and Shared Prevention of com-mon diseases in children and adolescents.Methods A total of 139630 primary and secondary school students aged 7-18 years from Inner Mongolia Autonomous Region were selected by stratified random cluster sampling method in September,2021.Myopia was determined using distance visual acuity examination and refractive error examination,and obesity was determined according to the BMI classification criteria for overweight,obesity screening of Chinese school-age children and adolescents.Used a question-naire,healthy lifestyles were determined according to the American Heart Association's Healthy Lifestyle Score by totaling the six scores for smoking,alcohol consumption,diet,exercise,screen time,and sleep duration.The X test was used to compare the as-sociation between group differences in the co-morbidity rate of myopia and obesity.The multivariable Logistic regression model was used to explore the influencing factors of the co-morbidity of myopia and obesity,and the stratified analysis was used to analyze the moderating effect of lifestyles on the prevalence of the co-morbidity.Results The prevalence of myopia and obesity co-morbidity a-mong students aged 7-18 years old in the Inner Mongolia Autonmous Region in 2021 was 13.7%,higher among boys than girls(15.5%vs.11.8%),higher among those aged 10-12 years old than 7-9,13-15,and 16-18 years old(14.7%,13.7%,13.3%,12.0%),higher among other ethnic minorities than Han Chinese and Mongolians(15.3%,14.0%,12.5%),higher in urban areas than that in suburban areas(15.3%,13.0%),and middle economic level tracts were higher than poor and good tracts(14.8%,12.9%,12.6%)(χ^(2)=392.37,115.73,62.80,119.02,121.60,P<0.05).Multivariable Logistic regression modeling showed that un-healthy lifestyles(OR=1.24,95%CI=1.19-1.29)and middle level of lifestyle score(OR=1.15,95%CI=1.10-1.19)students had higher prevalence of co-morbidity,and the results were statistically significant among both boys and girls,the age groups of 10-12,13-15,and 16-18 years old,as well as the Han and Mongolian ethnic groups(all P<0.05).Conclusion In 2021,the current situation of myopia and obesity co-morbidity and unhealthy lifestyles among primary and secondary school students in the Inner Mongolia Autonomous Region are not optimistic.