学龄前儿童体质量指数与可疑远视储备不足的关联

doi:10.11852/zgetbjzz2025-0137

摘要/Abstract

摘要： 目的分析学龄前儿童体质量指数(BMI)与可疑远视储备不足之间的关联,为制定儿童近视防控措施提供依据。方法于2024年5—6月,采用随机整群抽样的方法,抽取丽水城区23所幼儿园,对3 353名儿童进行体格检查以及眼屈光筛查,按《0～6岁儿童眼保健及视力检查工作规范(试行)》进行评估,分析不同BMI与学龄前儿童可疑远视储备不足的关联。结果 3 353名儿童中,检出可疑远视储备不足620人,检出率18.49%,男童可疑远视储备不足检出率(19.94%, 352/1 765)高于女童(16.88%, 268/1 588)差异有统计学意义(χ²=5.216,P=0.022),男女童BMI分布情况差异无统计学意义(P＞0.05)。消瘦组、正常体重组、超重组和肥胖组四组儿童平均远视储备分别为+1.26±0.43D、+1.26±0.75D、+1.18±0.48D、+1.17±0.74D,差异有统计学意义(F=2.922 P=0.033);组间两两多重比较显示,正常体重组儿童远视储备均值高于超重组和肥胖组,差异具有统计学意义(P＜0.001)。可疑远视储备不足组儿童的平均体重和BMI大于远视储备正常儿童(F=5.812,4.519,P<0.05);肥胖儿童可疑远视储备不足检出85人,检出率为22.49%,高于体重消瘦、正常、超重组儿童的检出率,差异有统计学意义(H =7.916,P=0.048);肥胖男童可疑远视储备不足检出60人,检出率30.15%,高于肥胖女童可疑远视储备不足的检出率(χ²=14.161,P=0.001)。结论学龄前儿童BMI与可疑远视储备不足相关,建议将儿童体重管理纳入儿童近视一级预防策略。

关键词: 体质量指数, 远视储备, 近视防控, 学龄前儿童

Abstract: Objective To investigate the association between body mass index (BMI) and suspected insufficient hyperopic reserve in preschool children, in order to provide evidence for developing myopia prevention strategies. Methods From May to June 2024, a randomized cluster sampling method was used to select 3 353 children from 23 kindergartens in urban Lishui.Physical examinations and refractive screenings were conducted following the Guidelines for Eye Health and Vision Examination in Children Aged 0 - 6 Years (Trial).The association between BMI categories and suspected insufficient hyperopic reserve was analyzed. Results Among 3 353 children, 620 (18.49%) showed suspected insufficient hyperopic reserve.The detection rate was higher in boys (19.94%, 352/1 765) than in girls (16.88%, 268/1 588) (χ²=5.216, P=0.022), though BMI distribution did not differ by sex (P>0.05).The mean hyperopia reserve of children in the emaciated group, the normal weight group, the hypertrophic group and the obese group was +1.26±0.43D, +1.26±0.75D, +1.18±0.48D, +1.17±0.74D, respectively, and post-hoc comparisons revealed higher reserves in normal-weight children versus overweight/obese groups (F=2.922, P=0.033) .Children with suspected insufficient reserve had greater mean weight and higher BMI values (F=5.812, 4.519, P<0.05).The detection rate of hyperopia reserve insufficiency was highest in obese children (85/378, 22.49%; H=7.916, P=0.048), particularly obese boys (60/199, 30.15%; χ²=14.161, P=0.001). Conclusions Preschool children's BMI is associated with suspected insufficient hyperopic reserve.Integrating weight management into primary myopia prevention strategies is recommended.

Key words: body mass index, hyperopia reserve, myopia prevention and control, preschool children

中图分类号:

R179

雷军, 周小燕, 何建勇, 刘丽芳. 学龄前儿童体质量指数与可疑远视储备不足的关联[J]. 中国儿童保健杂志, 2025, 33(10): 1151-1155.

LEI Jun, ZHOU Xiaoyan, HE Jianyong, LIU Lifang. Association between body mass index and suspected insufficient hyperopia reserve in preschool children[J]. Chinese Journal of Child Health Care, 2025, 33(10): 1151-1155.

参考文献

[1] 唐汉彦,孙建乐,周玉润.温州市学龄前儿童视力发育现况调查及影响因素分析[J].中国公共卫生管理,2024,40(4):603-606.
Tang HY,Sun JL,Zhou YR.Current situation of visual aciddevelopment of preschool children in Wenzhou City and its influencing factors[J].Chin J PHM, 2024, 40 (4):603-606.(in Chinese)
[2] 陶芳标.《儿童青少年近视防控公共卫生综合干预技术指南》专题解读[J].中国学校卫生,2023,449(10):1445-1449.
Tao FB.Thematic interpretation of Technical Guidelines for Comprehensive public Health Intervention in Prevention and control of Myopia in Children and Adolescents[J].Chin J Sch Health, 2023, 449(10):1445-1449.(in Chinese)
[3] 赵梦雅,朱懿,许韶君,等.儿童远视储备影响因素研究进展[J].中华流行病学杂志,2022,43(10):1671-1676.
Zhao MY, Zhu Y, Xu SJ, et al.Research progress on influencing factors of hyperopia reserve in children[J].Chin J Epid, 2022,43(10):1671-1676.(in Chinese)
[4] 何鲜桂,张欣,许迅.有序推进儿童青少年近视筛查建档和防控闭环管理[J].中华预防医学杂志,2021,55(4):551-555.
He XG, Zhang X, Xu X.Orderly promotion of myopia screening documentation and closed-loop prevention and control management in children and adolescents[J].Chin J Prev Med, 2021, 55(4):551-555.(in Chinese)
[5] 孙艺,刘伟佳,熊莉华,等.广州市6～12岁非近视儿童屈光及远视储备不足现状分析[J].现代预防医学,2022,49(3):435-440.
Sun Y, Liu WJ, Xiong LH, et al.Analysis of insufficient refractive and farsighted reserve in 6 ~ 12 years old non-myopic children in Guangzhou[J].Modern Preventive Medicine, 2022, 49 (3) :435-440.(in Chinese)
[6] Huang L,Schmid KL,Yin XN,et al.Combination effect of outdoor activity and screen exposure on risk of preschool myopia:Findings from Longhua child cohort study[J].Frontiers in Public Health,2021,9:607911.
[7] Rim TH,Kim SH,Lim KH,et al.Body stature as an age-dependent risk factor for myopia in a south korean population[J].Semin Ophthalmol,2017,32(3):326-336.
[8] Terasaki H,Yamashta T,Toshihara N,et al.Association of lifestyle and body structure to ocular axial length in Japanese elementary school children[J].BMC Ophthalmol,2017,17:123.
[9] 卫生部办公厅.儿童健康检查服务技术规范[EB/OL].(2012-04-20)[2024-12-26].http://baike.so.com/doc/6703135.html.
[10] 国家卫生健康委办公厅.关于印发0～6岁儿童眼保健及视力检查服务规范(试行)的通知[J].国家卫生健康委员会公报,2021 (6):8-37.
General Office of the National Health Commission.Notice on issuing standards of eye care and vision examination services for children aged 0 ～6 (Trial)[J].Bulletin of the National Health Commission, 2021 (6) :8-37.(in Chinese)
[11] 李辉,宗心南,季成叶,等.中国2-18岁儿童青少年超重和肥胖筛查体重指数界值点的研究[J].中华流行病学杂志, 2010,31(6):616-620.
Li H, Zong XN, Ji CY, et al.Study on body mass index threshold for overweight and obesity screening in Chinese children and adolescents aged 2-18 years[J].Chin J Epid, 2010,31(6):616-620.(in Chinese)
[12] 任浩然,于敬春,刘扬,等.山东某县3～6岁儿童筛查视力异常情况研究[J].中国生育健康杂志,2024,35(2):129-133.
Ren HR, Yu JC, Liu Y, et al.Study on visual abnormalities in children aged 3 - 6 years in a county of Shandong Province[J].Chinese Journal of Reproductive Health, 2024, 35 (2) :129-133.(in Chinese)
[13] 崔明明,随光辉,张浩,等.安徽淮北地区1390名2～6岁儿童屈光筛查现状分析[J].中国儿童保健杂志,2023,31(9):1028-1032.
Cui MM, Sui GH, Zhang H, et al.Analysis of refractive screening status of 1390 children aged 2 to 6 years in Huaibei area of Anhui province[J].Chin J Child Health Care, 2023, 31 (9) :1028-1032.(in Chinese)
[14] 汪玉,朱虹,朱光伟,等.苏州市高新区学龄前儿童远视储备相关因素分析[J].中国学校卫生,2023,44(4):599-602 .
Wang Y, Zhu H, Zhu GW, et al.Analysis on related factors of hyperopia reserve of preschool children in Suzhou High-tech Zone[J].Chin J Sch Health, 2023, 44 (4) :599-602.(in Chinese)
[15] 刘明璐,赵桂兰,杨静,等.青岛地区学龄前儿童视觉屈光状况及影响因素研究[J].中国优生与遗传杂志,2024,32(1):107-111.
Liu ML, Zhao GL, Yang J, et al.Study on visual refraction status and its influencing factors of preschool children in Qingdao[J].Chinese Journal of Eugenics and Genetics, 2024, 32 (1) :107-111.(in Chinese)
[16] 任静,李进,郑晴天,等.学龄前儿童屈光状态及其影响因素[J].济宁医学院学报, 2023,46(2):136-139.
Ren J, Li J, Zheng QT, et al.Refractive status of preschool children and its influencing factors[J].Journal of Jining Medical College, 2023,46(2):136-139.(in Chinese)
[17] 陶芳标.《儿童青少年近视防控适宜技术指南》专题解读[J].中国学校卫生,2020,41(2):166-168.
Tao FB.Interpretation of appropriate technical guidelines for prevention and control of myopia in children and adolescents[J].Chin J Sch Health, 2020, 41(2):166-168.(in Chinese)
[18] 陶芳标.学校-学生-学业联动是打好儿童青少年近视防控攻坚战的基石[J].中国学校卫生,2019,40(1):3-6.
Tao FB.School-student-academic linkage is the cornerstone of fighting myopia prevention and control in children and adolescents[J].Chin J Sch Health, 2019,40 (1):3-6.(in Chinese)
[19] 王智勇,李国荣.沙眼、肥胖、龋齿防控比较以思考学生近视眼的防控策略[J].预防医学论坛,2021,27(12):959-961.
Wang ZY, Li GR.Comparison of prevention and control of trachoma, obesity and dental caries to consider the prevention and control strategy of myopia in students[J].Prev Med Trib, 2021, 27 (12) :959-961.(in Chinese)
[20] 齐文娟,杨东玲,周月芳,等.上海市小学高年级学生近视与营养状况的相关性[J].中国学校卫生,2022,43(1):112-116.
Qi WJ, Yang DL, Zhou YF, et al.The correlation between myopia and nutritional status of senior primary school students in Shanghai[J].Chin J Sch Health, 2022, 43(1):112-116.(in Chinese)
[21] 许佳舒,周宪君.小学生营养状况饮食行为及家长膳食素养对小学生筛查性近视的影响[J].预防医学论坛,2024,30(1):56-60.
Xu JS, Zhou XJ.Effects of nutritional status and dietary behavior of primary school students and parents' dietary literacy on screening myopia of primary school students[J].Prev Med Trib, 2024, 30 (1) :56-60.(in Chinese)
[22] Matsumura S, Dannoue K, Kawakami M, et al.Prevalence of myopia and its associated factors among Japanese preschool children[J].Front Public Health, 2022,10:901480.
[23] 於亭,宋继科,毕宏生,等.高糖饮食与近视相关信号通路关系的研究[J].眼科新进展, 2020,40(8):789-792.
Yu T, Song JK, Bi HS, et al.Study on the relationship between high-sugar diet and myopia related signaling pathways[J].Rec Adv Ophthalmol, 2020,40(8):789-792.(in Chinese)