石家庄市正定县青少年近视与营养相关的影响因素研究

doi:10.11852/zgetbjzz2023-0902

摘要/Abstract

摘要： 目的探究影响青少年近视患病情况的营养相关因素,为实现近视的一级预防提供参考依据。方法 2021年10月采用分层抽样的方法,抽取正定县青少年385人进行视力检测,体格检查及问卷调查(一般情况及膳食调查)。运用单因素分析及lasso回归筛选变量,Logistic回归探究近视可能的影响因素。因子分析对饮食模式进行提取,分析其与近视的关联性。结果 385名青少年近视患病率为68.6%。多因素分析发现进食油炸食品(OR=8.480, 95%CI:1.058~67.971)为近视的危险因素;摄入奶及奶制品(OR=0.994, 95%CI:0.991~0.999)、大豆及坚果(OR=0.997, 95%CI:0.994~0.999),父母双方均不近视(OR=0.312, 95%CI:0.115~0.845),每周4节体育课(OR=0.269, 95%CI:0.074~0.984)为近视的保护因素(P＜0.05)。因子分析共提取出3种饮食模式,分别是多样化、大豆杂粮及零食饮料饮食模式。Logistic分析发现大豆杂粮饮食模式对近视具有保护作用(OR=0.85, 95%CI:0.73～0.99, P＜0.05)。结论石家庄市正定县青少年近视问题较为严峻。青少年应增加奶及奶制品、大豆及坚果的摄入量,减少油炸食品的摄入,调整整体的饮食结构,以预防近视的发生发展。

关键词: 近视, 食物频率, 饮食模式, 青少年

Abstract: Objective To analyze nutrition-related factors that affect the prevalence of myopia in adolescents, in order to provide reference for primary prevention of myopia. Methods A stratified sampling method was used to select 385 adolescents from Zhengding County in October 2021. Adolescents in this study took vision testing, physical examination and completed a questionnaire survey. One-way analysis of variance and lasso regression were used to screen the variables, and Logistic regression was used to determine the possible influencing factors of myopia. Factor analysis was adopted to extract the dietary patterns of adolescents in Zhengding County, then the association between dietary patterns and myopia was analyzed. Results A total of 385 adolescents were surveyed, with the prevalence rate of myopia of about 68.6%. Multivariate analysis revealed that fried food(OR=8.480, 95%CI:1.058 - 67.971) was a risk factor for myopia, while intake of milk and dairy products(OR=0.994, 95%CI:0.991 - 0.999), soybeans and nuts(OR=0.997, 95%CI:0.994 - 0.999), no myopia in either parent(OR=0.312, 95%CI:0.115 - 0.845), physical education class 4 times per week(OR=0.269, 95%CI:0.074 - 0.984) were statistically associated with a lower risk of myopia(P＜0.05). Three dietary patterns was extracted through factor analysis, including diversified dietary pattern, soy-hybrid dietary pattern, and snack and beverage dietary pattern. Logistic analysis results indicated that soy-hybrid dietary pattern(OR=0.85, 95%CI:0.73 - 0.99,P<0.05) was statistically associated with myopia. Conclusions The problem of myopia among adolescents in Zhengding County is more serious. Increasing the intake of milk and dairy products, soybeans and nuts, reducing the intake of fried foods, and adjusting the overall dietary structure should be recommended in order to prevent the development of myopia in adolescents.

Key words: myopia, food frequency, dietary patterns, adolescents

中图分类号:

尤奕, 刘方芳, 秦宏宇, 徐腊梅, 景然, 高淑清. 石家庄市正定县青少年近视与营养相关的影响因素研究[J]. 中国儿童保健杂志, 2024, 32(4): 395-400.

YOU Yi, LIU Fangfang, QIN Hongyu, XU Lamei, JING Ran, GAO Shuqing. Nutrition-related influencing factors of myopia among adolescents in Zhengding County, Shijiazhuang City[J]. Chinese Journal of Child Health Care, 2024, 32(4): 395-400.

参考文献

[1] 吕建中.面对眼健康危机,共生、共享、共荣的视光生态圈雏形已现[J].中国眼镜科技杂志,2021(4): 25-27.
Lv JZ. In the face of the eye health crisis, a symbiotic, shared and co-prosperous optometric ecosystem has taken shape[J].China Glasses Science-Technology Magazine,2021(4):25-27.(in Chinese)
[2] 国家卫生健康委员会宣传司.国家卫生健康委员会2019年4月29日例行新闻发布会文字实录[EB/OL].(2019-04-29)[2021-05-21].http://wwwnhc.gov.cn/xcs/s78471201904/e9117ea8b6b84f48962e84401d305292.shtml
[3] 马爱平.《中国青少年近视防控大数据报告》发布[EB/OL].(2020-08-30) [2021-05-21] http://www.stdaily.com/index/kejixinwen/2020-08/30/content_1012515.shtml.
[4] Bhattarai D, Gnyawali S, Silwal A, et al. Student-led screening of school children for refractive error correction[J]. Ophthalmic Epidemiol,2018, 25(2):133-139.
[5] Temmerman M, Khosla R, Bhutta ZA, et al. Towards a newglobal strategy for women's, children's and adolescents' health[J].BMJ,2015,351:h4414.
[6] 中华人民共和国国家卫生和计划生育委员会.WS/T 586-2018学龄儿童青少年超重与肥胖筛查[S].北京:中国标准出版社,2018.
[7] 刘丹.营养、家庭经济因素与儿童期及成年后肥胖关系的研究[D].北京:中国疾病预防控制中心,2019.
Liu D. Study onrelationship between nutrition, family economic factors and childhood, adult obesity[D]. Beijing: Chinese Center for Disease Control and Prevention,2019.(in Chinese)
[8] Lee M, Karlsson M. Trimmed and winsorized semiparametric estimator for left-truncated and right-censored regression models[J]. Metrika,2015,78(4): 1-11.
[9] 王美琳,时瑞霞,丁婷婷,等.2020年河北省儿童青少年近视现状及其影响因素分析[J].现代预防医学,2023,50(7): 1234-1239,1244.
Wang ML, Shi RX, Ding TT,et al.Analysis of the current situation of myopia among children and adolescents and its influencing factors in Hebei Province in 2020[J]. Modern Preventive Medicine, 2023, 50(7):1234-1239,1244.(in Chinese)
[10] 琚腊红,张倩,杨振宇,等.2019—2021年中国不同地区6～17岁儿童主要食物摄入量[J].卫生研究,2023,52(1): 67-78.
Qu LH, Zhang Q, Yang ZY,et al.Major food intake of children aged 6-17 years in different regions of China, 2019-2021[J].J Hygiene Res,2023,52(1):67-78.(in Chinese)
[11] Lim LS, Gazzard G, Low YL, et al. Dietary factors, myopia, and axial dimensions in children[J]. Ophthalmology, 2010, 117(5): 993-997.
[12] 黄盈子.近视合并原发性开角型青光眼的视神经损伤区域特征研究[D].汕头:汕头大学,2022.
Huang YZ.Characterization of the area of optic nerve damage in myopia combined with primary open-angle glaucoma[D].Shantou:Shantou University,2022.(in Chinese)
[13] 张海芳,蔡晓湛.学生视力发育与营养状况的关系[J].中国校医,2012,26(3): 200-201.
Zhang HF, Qin XZ. Relationship between students' visual development and nutritional status[J].Chin J Sch Doctor, 2012, 26(3):200-201.(in Chinese)
[14] 冯琴,方美珠.微量元素与近视关系的研究现状[J].医学检验与临床,2014,25(6): 66-68.
Feng Q, Fang MZ. Current status of research on the relationship between micronutrients and myopia[J]. Medical Laboratory Science and Clin, 2014, 25(6):66-68.(in Chinese)
[15] 殷春杰,甘倩,张倩.营养素与近视[J].卫生研究,2022,51(5): 720-724.
Yin CJ, Gan Q, Zhang Q. Nutrients and myopia[J].J of Hygiene Res, 2022, 51(5):720-724.(in Chinese)
[16] Li M, Tan CS, Foo LL, et al.Dietary intake and associations with myopia in Singapore children[J].Ophthalmic Physiol Opt,2022,42(2):319-326.
[17] 慕璟玉,王雁,杨依宁,等.近视的流行病学、病因学与发病机制研究现状[J].眼科新进展,2021,41(11): 1089-1096.
Mu JY, Wang Y, Yang YN, et al. Current status of research on the epidemiology, etiology and pathogenesis of myopia[J]. Recent Advances in Ophthalmology, 2021,41(11):1089-1096.(in Chinese)
[18] Wang KK, Metlapally R, Wildsoet CF. Expression pro-file of the integrin receptor subunits in the guinea pig sclera?[J].Curr Eye Res,2017,42(6):857-863.
[19] Kennedy A, Martinez K, Chuang CC, et al. Saturated fatty acid-mediated inflammation and insulin resistance in adipose tissue: Mechanisms of action and implications[J].J Nutr,2009, 139(1):1-4.
[20] Chua SY, Sabanayagam C, Tan CS, et al. Diet and risk of myopia in three-year-old Singapore children: The GUSTO cohort[J].Clin Exp Optom,2018,101(5):692-699.
[21] 李小曼. 营养调查和近视相关信息研究[D].温州:温州医科大学,2014.
Li XM. Students nutrition survey and myopia evidence[D].Wenzhou:Wenzhou Medical College, 2014.
[22] 中国抗癌协会肿瘤营养专业委员会,中国营养学会社区营养与健康管理分会,中国营养学会临床营养分会.抗炎饮食预防肿瘤的专家共识[J].肿瘤代谢与营养电子杂志,2023,10(1):57-63.
Chinese Society of Nutritional Oncolog, Community Nutrition and Health Management Branch of Chinese Nutrition Society, Clinical Nutrition Branch of Chinese Nutrition Society.Expert consensus on anti-inflammatory diet for cancer prevention[J]. Electronic J of Metabolism and Nutrition of Cancer, 2023, 10(1):57-63.(in Chinese)
[23] Wei Q, Chang Q, Xu G, et al. Proinflammatory and angiogenesis-related cytokines invitreous samples of highly myopic patients[J]. Ctokine, 2021,137: 155308
[24] Liu Z, Wang Q, Zhao Q, et al. Association between whole-grain intake and myopia in Chinese children:A cross-sectional epidemiological study[J]. BMC Ophthalmol, 2023,23(1):1.