Department of Ophthalmology, Hadassah-Hebrew University Medical Center, Jerusalem, Israel.
Department of Military Medicine, Faculty of Medicine, Hebrew University of Jerusalem, Israel.
Clin Exp Ophthalmol. 2024 Aug;52(6):616-626. doi: 10.1111/ceo.14406. Epub 2024 May 27.
Existing research on the relationship between body mass index (BMI) and astigmatism yields inconsistent results. This study analyses this association in a nationally representative sample of adolescents.
This retrospective, cross-sectional study included Israeli adolescents who underwent medical assessments before mandatory military service between 2011 and 2022. BMI was categorised based on the US age- and sex-matched percentiles. Astigmatism was categorised by magnitude [low-moderate: 0.75 to <3.00 diopters (D), high: ≥3.00 D], and axis orientation [with-the-rule (WTR), against-the-rule (ATR), or oblique (OBL)]. Sex-stratified regression models adjusted for sociodemographic variables were used.
Of 935 989 adolescents evaluated, 887 325 were included [511 465 (57.6%) males, mean age 17.2 years]. Astigmatism was diagnosed in 123 675 (13.9%) adolescents, of whom 117 081 (13.2%) had low-moderate and 6594 (0.7%) had high astigmatism. WTR astigmatism was the most prevalent (8.2%), followed by ATR (4.1%) and OBL (1.6%) types. Compared with low-normal BMI (5th to 50th percentile), the adjusted ORs for total astigmatism increased with increasing BMI, peaking at 1.65 (1.57-1.74) in males and 1.74 (1.64-1.86) in females with severe obesity. ORs were accentuated for high astigmatism, reaching 3.51 (3.01-4.09) in males, and 3.45 (2.83-4.22) in females with severe obesity. WTR astigmatism demonstrated the strongest association with BMI, with ORs reaching 2.26 (2.13-2.40) in males and 2.04 (1.90-2.20) in females with severe obesity. The results persisted in a series of subgroup analyses.
Obesity is associated with higher odds of astigmatism in adolescence. Further investigation into the role of weight management in astigmatism development is warranted.
现有研究表明，体重指数（BMI）与散光之间的关系结果并不一致。本研究分析了在一个具有全国代表性的青少年群体中这种关联。
这是一项回顾性、横断面研究，纳入了 2011 年至 2022 年期间在以色列进行兵役前医学评估的青少年。BMI 按美国年龄和性别匹配的百分位数进行分类。散光按程度[低度-中度：0.75 至<3.00 屈光度（D），高度：≥3.00 D]和轴向方向[顺规性（WTR）、逆规性（ATR）或斜轴性（OBL）]进行分类。使用按性别分层的回归模型调整社会人口统计学变量。
在评估的 935989 名青少年中，有 887325 名青少年被纳入[511465 名（57.6%）男性，平均年龄 17.2 岁]。123675 名青少年被诊断出散光，其中 117081 名（13.2%）为低度-中度散光，6594 名（0.7%）为高度散光。WTR 散光最为常见（8.2%），其次是 ATR（4.1%）和 OBL（1.6%）类型。与低正常 BMI（第 5 至 50 百分位）相比，总散光的调整比值比随 BMI 增加而增加，在男性中最高为 1.65（1.57-1.74），在女性中最高为 1.74（1.64-1.86）。在严重肥胖的男性和女性中，高度散光的比值比更为显著，分别达到 3.51（3.01-4.09）和 3.45（2.83-4.22）。WTR 散光与 BMI 的关联最强，在严重肥胖的男性和女性中比值比分别达到 2.26（2.13-2.40）和 2.04（1.90-2.20）。这些结果在一系列亚组分析中仍然存在。
肥胖与青少年散光的几率增加有关。进一步研究体重管理在散光发展中的作用是有必要的。
