Wang Meng, Cui Jiantao, Shan Guangliang, Peng Xia, Pan Li, Yan Zhimei, Zhang Jie, Zhong Yong, Ma Jin
Department of Ophthalmology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, No. 1 Shuaifu Yuan, Dongcheng District, Beijing, 100730, China.
School of Medicine, Tsinghua University, Beijing, China.
BMC Ophthalmol. 2019 Jan 25;19(1):33. doi: 10.1186/s12886-019-1042-0.
Few studies have investigated the prevalence of refractive error (RE) in older adults in China, and most have focused on East China. Our study determined the prevalence and risk factors of RE in Han and Yi adults aged 40-80 years in rural and urban areas in Yunnan Province, Southwest China.
Our cross-sectional study is part of the China National Health Survey (CNHS). The age-adjusted prevalence rates of RE in Han and Yi adults aged 40-80 years in Yunnan were compared. We used a multivariate logistic regression model to identify risk factors for myopia and hyperopia.
Among 1626 participants, the age-adjusted prevalence rates of myopia, hyperopia, high myopia and astigmatism were 26.35% (95%CI 24.01-28.70%), 19.89% (95%CI 18.16-21.61%), 2.64% (95%CI 1.75-3.53%), and 56.82% (95%CI 54.31-59.34%). Compared to the Yi population, the Han population had higher prevalence of myopia (31.50% vs 16.80%, p < 0.0001), high myopia (3.34% vs 1.31%, p = 0.049) and astigmatism (60.07% vs 50.67%, p = 0.026) but lower prevalence of hyperopia (16.58% vs 27.37%, p < 0.0001). In the multivariate logistic regression, individuals aged 45-49 (p < 0.001), 50-54 (p < 0.001), 55-59 (p = 0.014), and 60-64 years (p = 0.005) had a lower myopia risk than those aged 40-44 years, and individuals aged 50-54 (p = 0.002), 55-59, 60-64 and 65 years and older (all p < 0.001) had a higher hyperopia risk than those aged 40-44 years. Myopia was also associated with height (p = 0.035), time spent in rural areas (p = 0.014), undergraduate/graduate education level (p = 0.001, compared with primary school or lower education level) and diabetes (p = 0.008). The Yi population had a higher risk of hyperopia than the Han population (p = 0.025). Moreover, hyperopia was related to time spent in rural areas (p < 0.001) and pterygium (p = 0.019).
Our study investigated the overall prevalence of RE in older adults in rural and urban areas of Southwest China. Compared to the Yi population, the Han population had a higher prevalence of myopia, high myopia and astigmatism but a lower risk of hyperopia. The prevalence of myopia in the Han population in underdeveloped Southwest China was similar to that of residents in East China or of Chinese Singaporeans under urban or rural settings.
很少有研究调查中国老年人屈光不正（RE）的患病率，且大多数研究集中在中国东部地区。我们的研究确定了中国西南部云南省农村和城市地区40 - 80岁汉族和彝族成年人中RE的患病率及危险因素。
我们的横断面研究是中国国家健康调查（CNHS）的一部分。比较了云南省40 - 80岁汉族和彝族成年人中年龄调整后的RE患病率。我们使用多因素逻辑回归模型来确定近视和远视的危险因素。
在1626名参与者中，年龄调整后的近视、远视、高度近视和散光患病率分别为26.35%（95%CI 24.01 - 28.70%）、19.89%（95%CI 18.16 - 21.61%）、2.64%（95%CI 1.75 - 3.53%）和56.82%（95%CI 54.31 - 59.34%）。与彝族人群相比，汉族人群近视（31.50%对16.80%，p < 0.0001）、高度近视（3.34%对1.31%，p = 0.049）和散光（60.07%对50.67%，p = 0.026）的患病率较高，但远视患病率较低（16.58%对27.37%，p < 0.0001）。在多因素逻辑回归中，45 - 49岁（p < 0.001）、50 - 54岁（p < 0.001）、55 - 59岁（p = 0.014）和60 - 64岁（p = 0.005）的个体近视风险低于40 - 44岁的个体，50 - 54岁（p = 0.002）、55 - 59岁、60 - 64岁和65岁及以上（所有p < 0.001）的个体远视风险高于40 - 44岁的个体。近视还与身高（p = 0.035）、在农村地区的时间（p = 0.014）、本科/研究生教育水平（p = 0.001，与小学或更低教育水平相比）和糖尿病（p = 0.008）有关。彝族人群远视风险高于汉族人群（p = 0.025）。此外，远视与在农村地区花费的时间（p < 0.001）和翼状胬肉（p = 0.019）有关。
我们的研究调查了中国西南部农村和城市地区老年人RE的总体患病率。与彝族人群相比，汉族人群近视、高度近视和散光的患病率较高，但远视风险较低。中国西南部欠发达地区汉族人群的近视患病率与中国东部地区居民或城乡环境下的新加坡华人相似。
