中国六省市低年级小学生近视与父母近视和学龄前文化课学习的关联

Association between parental myopia and extracurricular activities before school age with myopia among lower grade students in 6 provinces and cities in China

目的 探讨一至三年级小学生近视与父母近视情况和学龄前文化课学习的关联,为低年级小学生近视预防提供依据。方法 2020年11月至2022年6月,采用分层整群随机抽样与概率抽样相结合的方法,选取中国六省市(北京、辽宁、浙江、河南、重庆、陕西)8 368名一至三年级小学生进行眼科检查和问卷调查,采用多因素Logistic回归模型分析低年级小学生近视和父母近视情况及学龄前文化课学习的关联。结果 中国六省市一至三年级小学生近视检出率为23.7%,中部地区、三年级、住校、每日放学后做作业或读写时间≥1 h、过去一周参加课外班时间≥1 h、上小学前参加过课外学习班、父母近视、读写姿势不良、每天睡眠时间<10 h、因作业/上学习班减少孩子运动时间、每年有视力检查的小学生近视检出率较高,组间差异均有统计学意义(χ^(2)值分别为36.41,487.72,15.97,21.35,43.95,15.33,54.04,6.67,3.88,20.02,20.06,P值均<0.05)。调整混杂因素后,学龄前文化课学习与父母近视的相乘交互作用有统计学意义(P_(交互)<0.01)。调整混杂因素后,多因素Logistic回归分析显示,与学龄前无文化课学习的小学生相比,学龄前有文化课学习的小学生近视报告率更高(OR=1.33,95%CI=1.19~1.56);与父母均不近视组相比,父母近视组的小学生近视报告率更高(OR=1.64,95%CI=1.45~1.84)(P值均<0.05);父母近视与学龄前文化课学习的RERI、API、Index S分别为0.35,0.27,1.37。结论 父母近视、学龄前文化课学习均与低年级小学生近视发生风险有关,并且两者对低年级小学生近视有交互作用。

Objective To explore the association between parental myopia and extracurricular activities before school age with myopia among lower grade students, so as to provide evidence for myopia prevention on low grade students. Methods From November 2020 to June 2022, a total of 8 368 students of grade 1-3 were selected from Beijing, Liaoning, Zhejiang, Henan, Chongqing, Shaanxi Province by the stratified cluster random sampling and probability sampling methods, and were administered with a questionnaire survey and eye examinations.Multivariate Logistic regression was used to analyze the association between parental myopia and extracurricular activities before school age with myopia among lower grade students. Results The prevalence of myopia in grade 1-3 was 23.7% in 6 provinces in China.Students who in central area, grade 3, boarding at school, doing homework/reading/writing time ≥1 h/d after school, extracurricular activities ≥1 h in the past week, extracurricular activities before school age, parental myopia, poor reading and writing posture, sleeping time < 10 h/d, less exercise time because of homework or extracurricular activities, having annual vision examination had a higher myopia detection rate, with statistically significant differences (χ^(2)=36.41, 487.72, 15.97, 21.35, 43.95, 15.33, 54.04, 6.67, 3.88, 20.02, 20.06, P < 0.05).After adjusted for the confounding factors, there was a significant interaction between parental myopia and extracurricular activities before school age with myopia (P_(interaction) < 0.01).After adjusting for confounding factors, Logistic regression analysis showed that those having extracurricular activities before school age had a higher risk of myopia (OR=1.33, 95%CI=1.19-1.56), compared with those who did not.Compared with children without nearsighted parents, children with nearsighted parents had higher prevalence of myopia (OR=1.64, 95%CI=1.45-1.84)(P < 0.05);and the values of indicators (RERI, API, Index S) for interaction between parental myopia and extracurricular activities before school age were 0.35, 0.27, 1.37, respectively. Conclusion Both parental myopia and extracurricular activities before school age are associated with myopia among lower grade students, with interactive effects.