Objective: To explore the relationship between myopic refraction and near work in children and adolescents with different genetic risks. Methods: From September to December 2016, Nankai District and Hongqiao District of Tianjin were taken as the study sites. Using the method of stratified cluster random sampling, 533 children and adolescents aged 6-14 years from one primary school and one junior middle school in each of the two districts were included as the study subjects. Refraction measurements by an auto-kerato-refractor and questionnaire survey about near work were conducted. 11 single nucleotide polymorphisms in the selected myopia susceptibility genes were detected, and the genetic risk of each individual was scored. After grouping by genetic risk score, the relationship between myopia and near work was analyzed by the multivariate logistic regression, and the relationship between near work and refraction was analyzed by the multivariate linear regression. Results: The age of 553 subjects was (9.8±2.5) years, including 295 boys (53.3%). The overall detection rate of myopia was 62.0%. The spherical equivalent refraction (SER) was (-1.30±1.85) D. The results of the multivariate logistic regression showed that in the low risk group of GRS, compared with those with continuous near work time less than half an hour, those with continuous near work time no less than half an hour had a higher risk of myopia [OR (95%CI) = 2.64 (1.07, 6.52)]. In the moderate risk group of GRS, the risk of myopia increased with the increase of daily computer use [OR (95%CI) = 2.14 (1.03, 4.77)]. In the high risk group of GRS, the risk of myopia increased with the increase of the total daily reading and writing time [OR (95%CI) = 1.27 (1.01, 1.59)]. The results of the multivariate linear regression showed that in the low risk group of GRS, with increase of 1 hour in the total daily reading and writing time and mobile phone time, the SER decreased by 0.18 D (95%CI:-0.30, -0.07) and 0.95 D (95%CI:-1.51, -0.39), respectively. In the moderate risk group of GRS, with increase of 1 hour in the total daily reading and writing time and computer use time, the SER decreased by 0.25 D (95%CI:-0.31, -0.18) and 0.57 D (95%CI:-0.97, -0.18), respectively. In the high risk group of GRS, with increase of 1 hour in the daily total reading and writing time, the SER decreased by 0.33 D (95%CI:-0.43, -0.22). Conclusion: Continuous near work time no less than half an hour, daily computer use time, the total daily reading and writing time, and daily mobile phone use time were associated with myopic refraction in children and adolescents.
目的： 探讨处于不同遗传风险下的儿童少年近视屈光与近距离工作的关联。 方法： 于2016年9—12月，以天津市南开区和红桥区为研究现场，采用整群随机抽样的方法，抽取两个区各1所小学和初中的553名6~14岁儿童少年为研究对象。使用全自动电脑验光仪测量屈光度并进行近距离工作情况问卷调查；对选定的近视易感基因中11个单核苷酸多态性进行检测，并对个体的遗传风险（GRS）进行评分。根据遗传风险评分分组后，采用多因素logistic回归模型分析近视与近距离工作的关系，采用多重线性回归模型分析近距离工作与屈光度的关联。 结果： 553名对象的年龄为（9.8±2.5）岁，其中男生295名（53.3%）；近视的总体检出率为62.0%；等效球镜屈光度（SER）为（-1.30±1.85）D。多因素logistic回归模型分析结果显示，GRS低风险组中，与持续近距离工作时长<0.5 h者相比，持续近距离工作时长≥0.5 h者近视患病风险较高［OR（95%CI）值为2.64（1.07， 6.52）］；GRS中度风险组中，随着每日使用电脑时长的增加，近视患病风险升高［OR（95%CI）值为2.14（1.03， 4.77）］；GRS高风险组中，随着每日读写总时长的增加，近视患病风险随之增加［OR（95%CI）值为1.27（1.01， 1.59）］。多重线性回归模型分析结果显示，GRS低风险组中，每日读写总时长和使用手机时长每增加1 h，SER分别下降0.18 D（95%CI：-0.30， -0.07）和0.95 D（95%CI：-1.51， -0.39）；GRS中度风险组中，每日读写总时长和使用电脑时长每增加1 h，SER则分别下降0.25 D（95%CI：-0.31， -0.18）和0.57 D（95%CI：-0.97， -0.18）；GRS高风险组中，每日读写总时长每增加1 h，SER则下降0.33 D（95%CI：-0.43， -0.22）。 结论： ≥0.5 h的持续近距离工作、每日使用电脑时长、每日读写总时长和每日使用手机时长与儿童少年近视屈光有关联。.