儿童肥胖是近视发展的一个预测因素

T. Sorokman, S. Sokolnyk
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For detailed examination 205 persons were selected: with overweight (OW, 65 persons), with obesity (75 persons) and with normal body weight (65 persons, comparison group). The ophthalmologic examination included: visometry without and with correction, autorefractokeratometry before and after cycloplegia, biomicroscopy, ophthalmoscopy, optical biometry of the eye. To reveal the statistical diff erence between indicators in normally distributed groups, the Student’s t criterion of reliability was used, the degree of signifi cance – r. Comparison of groups on a qualitative basis was performed using Pearson’s χ2 test. Diff erences were considered statistically signifi cant at p <0.05.The research design and all methods used in this study were reviewed and approved by the Bioethics Committee of theBukovinian State Medical University (Protocol No. 10, dated 18.05.2002). The study was conducted within the research work «Early diagnosis, treatment and prevention of combined pathology of gastrointestinal tract and thyroid gland in children» (state registration number 0116U002937, implementation period 02.2016-11.2022).Results. The frequency of myopia in children with OW and obesity was signifi cantly higher than in children with average body weight (χ2 = 3.2, p < 0.05). Children with obesity and myopia were 2.7 times more likely to have diseases of the musculoskeletal system, 1.8 times more likely to have pathology of the autonomic nervous system, and 3.1 times more likely to have chronic diseases of the oropharynx than children in the control group. In all groups of children, the additional risk was greatest in children whose mother or father was myopic (49.6 and 41.3 %, respectively). Minimal additional risk was associated with a history of childhood infections (<1.6 %), helminthiasis (<3.9 %), nasal polyps (<3.4 %), adenoids (<2.4 %), and spinal cord injury at birth (<9.1 %). The odds ratio for the development of low myopia in the group with OW and obesity compared to the control group (normal weight) were 1.25 [95 % CI 0.56-2.82] and 0.88 [95 % CI 0.49-1. 58], for the development of moderate myopia – 1.22 [95 % CI 0.57-2.59] and 0.82 [95 % CI 0.46-1.49], respectively, and for the development of high myopia–1.37 [95 % CI 0.51-3.66] and 0.80 [95 % CI 0.49-2.09], respectively.Conclusion. 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引用次数: 0

摘要

尽管有大量科学研究致力于近视风险因素的研究,但肥胖对儿童近视风险程度的影响尚未得到充分研究,这促使我们以儿童为例研究这一问题。我们的目的是研究超重和肥胖儿童近视风险的频率和程度。研究中的儿童样本是通过随机化过程逐步形成的。第一阶段是在切尔诺夫策和切尔诺夫策地区的学校进行预防性检查时,对 10-18 岁的儿童(1035 人)进行一次性流行病学调查。初筛包括人体测量和身体发育评估。详细检查选取了 205 人:超重(OW,65 人)、肥胖(75 人)和体重正常(65 人,对比组)。眼科检查包括:未校正和校正后的视力测定、回旋前和回旋后的自动屈光度测定、生物显微镜检查、眼底镜检查、眼球光学生物测量。为了揭示正态分布各组指标之间的统计差异,采用了学生 t 可靠性标准,即显著性-r。本研究中使用的研究设计和所有方法均经过布科维尼亚国立医科大学生物伦理委员会的审查和批准(2002 年 5 月 18 日第 10 号协议)。本研究是在 "儿童胃肠道和甲状腺合并病变的早期诊断、治疗和预防 "研究工作(国家注册号0116U002937,实施期2016年2月至2022年11月)范围内进行的。OW和肥胖儿童的近视发生率明显高于体重一般的儿童(χ2 = 3.2,P < 0.05)。肥胖和近视儿童患肌肉骨骼系统疾病的几率是对照组儿童的 2.7 倍,患自主神经系统疾病的几率是对照组儿童的 1.8 倍,患口咽部慢性疾病的几率是对照组儿童的 3.1 倍。在所有儿童组中,母亲或父亲是近视眼的儿童的额外风险最大(分别为 49.6% 和 41.3%)。儿童感染史(<1.6%)、蠕虫病(<3.9%)、鼻息肉(<3.4%)、腺样体(<2.4%)和出生时脊髓损伤(<9.1%)带来的额外风险最小。与对照组(体重正常)相比,OW 组和肥胖组发生低度近视的几率分别为 1.25 [95 % CI 0.56-2.82] 和 0.88 [95 % CI 0.49-1.58],发生中度近视的几率为 1.22[95%CI为0.57-2.59]和0.82[95%CI为0.46-1.49],发展为高度近视的风险分别为1.37[95%CI为0.51-3.66]和0.80[95%CI为0.49-2.09]。超重和肥胖儿童患近视的风险更高,这强调了考虑儿童身体状况的重要性和必要性。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
OBESITY IN CHILDREN AS A PREDICTOR OF THE DEVELOPMENT OF MYOPIA
Despite a suffi cient number of scientifi c studies devoted to the study of myopia risk factors, the infl uence of obesity on the degree of myopia risk in childhood has not been suffi ciently studied, which prompted us to study this issue using children as an example. The aim is to study the frequency and degree of myopia risk in overweight and obese children.Material and Methods. The sample of children for the study was formed step by step in the process of randomization. Thefi rst stage included a one-time epidemiological study of children aged 10-18 years during preventive examinations in schools of Chernivtsi and Chernivtsi region (1,035 persons). The primary screening included anthropometry and assessment of physical development. For detailed examination 205 persons were selected: with overweight (OW, 65 persons), with obesity (75 persons) and with normal body weight (65 persons, comparison group). The ophthalmologic examination included: visometry without and with correction, autorefractokeratometry before and after cycloplegia, biomicroscopy, ophthalmoscopy, optical biometry of the eye. To reveal the statistical diff erence between indicators in normally distributed groups, the Student’s t criterion of reliability was used, the degree of signifi cance – r. Comparison of groups on a qualitative basis was performed using Pearson’s χ2 test. Diff erences were considered statistically signifi cant at p <0.05.The research design and all methods used in this study were reviewed and approved by the Bioethics Committee of theBukovinian State Medical University (Protocol No. 10, dated 18.05.2002). The study was conducted within the research work «Early diagnosis, treatment and prevention of combined pathology of gastrointestinal tract and thyroid gland in children» (state registration number 0116U002937, implementation period 02.2016-11.2022).Results. The frequency of myopia in children with OW and obesity was signifi cantly higher than in children with average body weight (χ2 = 3.2, p < 0.05). Children with obesity and myopia were 2.7 times more likely to have diseases of the musculoskeletal system, 1.8 times more likely to have pathology of the autonomic nervous system, and 3.1 times more likely to have chronic diseases of the oropharynx than children in the control group. In all groups of children, the additional risk was greatest in children whose mother or father was myopic (49.6 and 41.3 %, respectively). Minimal additional risk was associated with a history of childhood infections (<1.6 %), helminthiasis (<3.9 %), nasal polyps (<3.4 %), adenoids (<2.4 %), and spinal cord injury at birth (<9.1 %). The odds ratio for the development of low myopia in the group with OW and obesity compared to the control group (normal weight) were 1.25 [95 % CI 0.56-2.82] and 0.88 [95 % CI 0.49-1. 58], for the development of moderate myopia – 1.22 [95 % CI 0.57-2.59] and 0.82 [95 % CI 0.46-1.49], respectively, and for the development of high myopia–1.37 [95 % CI 0.51-3.66] and 0.80 [95 % CI 0.49-2.09], respectively.Conclusion. The risk of myopia is higher in children with overweight and obesity, which emphasizes the importance andnecessity of taking into account the somatic condition of the child.
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