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中国幼儿近视预测模型的开发与验证

Development and validation of a model for predicting myopia in young children in China.

作者信息

Hu Ting, Wu Rong, He Xi, Hua Zi-Yu, Peng Tian-Li, Peng Xiao-Yan, Li Shi-Ming

机构信息

Beijing Yanqing District Hospital (Peking University Third Hospital Yanqing Hospital), Yanqing District, Beijing, China.

Department of Ophthalmology, Beijing Tongren Hospital, Capital Medical University, Beijing, China.

出版信息

BMC Ophthalmol. 2025 Jul 31;25(1):439. doi: 10.1186/s12886-025-04267-6.

DOI:10.1186/s12886-025-04267-6
PMID:40745285
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC12312385/
Abstract

BACKGROUND

Early detection of myopia risk and timely intervention are key to reducing the incidence of myopia. This study aimed to construct a myopia prediction model that included perinatal factors and evaluate the correlation between each factor and myopia.

METHODS

A cross-sectional study was conducted. A questionnaire was used to investigate the related factors. The predictors of myopia onset were determined via univariate analysis (Model A), LASSO regression and 10-fold cross validation (Model B). The perinatal factors in Model B were removed to form Model C. Binary logistic regression was used to establish the model. Then, internal and external verification were performed. The differentiation, calibration, and clinical benefits of the three models were compared.

RESULTS

A total of 1322 participants with an average age of 7.85 ± 1.58 years were included in the study. Model B included age, axial length (AL), AL to corneal curvature (AL/CR) ratio, steep K (K2) value, parental myopia, and maternal history of gestational hypertension. Neither Model A nor Model C included perinatal factors. Model B had the best discrimination ability in the development, internal validation, and external validation groups and showed the best consistency and clinical benefit in all three groups. After model standardization, the effects of the respective variables on the results were as follows: AL/CR ratio: 59.14, maternal history of gestational hypertension: 44.03, AL: 30.47, K2: 5.65, parental myopia: 4.55, and age: 0.35.

CONCLUSIONS

A maternal history of gestational hypertension was associated with myopia. The effect of perinatal factors on myopia deserves attention.

TRIAL REGISTRATION

ChiCTR2200065398. November 3, 2022. (http://www.chictr.org.cn).

摘要

背景

早期发现近视风险并及时干预是降低近视发病率的关键。本研究旨在构建一个包含围产期因素的近视预测模型,并评估各因素与近视之间的相关性。

方法

进行了一项横断面研究。采用问卷调查相关因素。通过单因素分析(模型A)、LASSO回归和10倍交叉验证(模型B)确定近视发病的预测因素。去除模型B中的围产期因素以形成模型C。采用二元逻辑回归建立模型。然后进行内部和外部验证。比较了三种模型的区分度、校准度和临床效益。

结果

本研究共纳入1322名参与者,平均年龄为7.85±1.58岁。模型B包括年龄、眼轴长度(AL)、眼轴与角膜曲率(AL/CR)比值、角膜陡峭曲率(K2)值、父母近视以及母亲妊娠期高血压病史。模型A和模型C均未包括围产期因素。模型B在发育组、内部验证组和外部验证组中具有最佳的区分能力,并且在所有三组中均显示出最佳的一致性和临床效益。模型标准化后,各变量对结果的影响如下:AL/CR比值:59.14,母亲妊娠期高血压病史:44.03,AL:30.47,K2:5.65,父母近视:4.55,年龄:0.35。

结论

母亲妊娠期高血压病史与近视有关。围产期因素对近视的影响值得关注。

试验注册

ChiCTR2200065398。2022年11月3日。(http://www.chictr.org.cn)

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/f560/12312385/1a0b93881047/12886_2025_4267_Fig5_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/f560/12312385/2d06eacb170b/12886_2025_4267_Fig1_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/f560/12312385/36dbb2a282a6/12886_2025_4267_Fig2_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/f560/12312385/8424855b6f59/12886_2025_4267_Fig3_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/f560/12312385/724ea900e5af/12886_2025_4267_Fig4_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/f560/12312385/1a0b93881047/12886_2025_4267_Fig5_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/f560/12312385/2d06eacb170b/12886_2025_4267_Fig1_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/f560/12312385/36dbb2a282a6/12886_2025_4267_Fig2_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/f560/12312385/8424855b6f59/12886_2025_4267_Fig3_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/f560/12312385/724ea900e5af/12886_2025_4267_Fig4_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/f560/12312385/1a0b93881047/12886_2025_4267_Fig5_HTML.jpg

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本文引用的文献

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Evaluation of risk factors for childhood myopia progression: A systematic review of the literature.评估儿童近视进展的风险因素:文献系统评价。
Indian J Ophthalmol. 2024 Nov 1;72(Suppl 5):S721-S727. doi: 10.4103/IJO.IJO_1909_23. Epub 2024 Aug 14.
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Inflammatory markers and their association with preeclampsia among pregnant women: A systematic review and meta-analysis.
炎症标志物及其与孕妇子痫前期的关联:系统评价和荟萃分析。
Clin Biochem. 2024 Jul;129:110778. doi: 10.1016/j.clinbiochem.2024.110778. Epub 2024 Jun 12.
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Analysis of factors related to the development of ocular biometric parameters in Chinese children aged 6-10 years: a cross-sectional study.分析 6-10 岁中国儿童眼生物测量参数发育相关因素:一项横断面研究。
BMJ Open. 2024 Feb 6;14(2):e080066. doi: 10.1136/bmjopen-2023-080066.
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Axial length to corneal radius of curvature ratio and refractive error in Chinese preschoolers aged 4-6 years: a retrospective cross-sectional study.4-6 岁中国学龄前儿童眼轴长度与角膜曲率半径比和屈光不正的关系:一项回顾性横断面研究。
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