中小学生用更多的户外活动和睡眠时长替代久坐行为可以获得更多的视力健康效益

Analysis of the relationship between outdoor activities sedentary behaviour and sleep and poor vision among primary and secondary school students

中小学生户外活动久坐行为和睡眠与视力不良的关系分析

Author：Xu Xing, Zhu Yi, Zhang Rui, Zhang Yaxin, Tao Fangbiao, Xu Shaojun

source：Chinese Journal of School Health

DOI：10.16835/j.cnki.1000-9817.2024347

Abstract

Background：Analysing the effects of outdoor activities, sedentary behaviours and sleep duration on the risk of poor vision in primary and secondary school students after replacing them with each other based on the isotemporal substitution model, and providing a reference basis for precise intervention in the prevention and control of myopia in children and adolescents.

Methods：From March 2023 to May 2023, a stratified cluster random sampling method was used to select 6 132 students in grades 4 to 12 in Hefei, Wuhu, Suzhou, and Chizhou cities in Anhui Province. The basic information, outdoor activities, sedentary behavior, and sleep, were collected through a questionnaire survey. Single-factor model, partition model and isotemporal substitution model were used to analyze the relationship between outdoor activities, sedentary behaviors, sleep, and poor vision, and stratified analysis was performed by gender.

Results：The results showed that the detection rate of poor vision among the 6 132 primary and secondary school students was 76.9%, the detection rate of poor vision is higher for girls (81.1%) than for boys (72.6%), and the difference was statistically significant (c²＝61.37, P＜0.01). The results of single-factor model and partition model show that outdoor activities and sleep duration of primary and secondary school students are related to the risk reduction of poor vision (OR＝0.87,； 0.88; 0.88, 0.91), the duration of sedentary behavior was correlated with the increased risk of poor vision (OR＝1.05, 1.03) (P＜0.05). The results of the isotemporal substitution model showed that replacing the same amount of sedentary behaviour with 1 h/d of outdoor activity was associated with a 15.1% reduction in the risk of poor vision (OR＝0.85), and replacing the same amount of sedentary behaviour with 1 h/d of sleep was associated with a 12.3% reduction in the risk of poor vision (OR＝0.88) (P < 0.05). The results of the isotemporal substitution model stratified by gender showed that replacing the same amount of sedentary behaviour with 1 h/d of outdoor activity and 1 h/d of sleep was associated with a 21.6% and 8.4% reduction in the risk of poor vision in male students (The OR values were 0.78,0.92 respectively), and replacing the same amount of sedentary behaviour with 1 h/d of sleep was associated with a 17.6% reduction in the risk of poor vision in female students (OR＝0.82) (P<0.05). Conclusions  Replacing sedentary behaviour with 1 h of outdoor activity per day for boys and 1 h of sleep per day for girls and boys reduces the risk of poor vision.

Keywords：Motor activity；Sedentary lifestyle；Sleep；Vision，Low；Isotemporal；substituition；Students

摘要

背景：分析中小学生户外活动、久坐行为和睡眠时长相互替代后对视力不良风险的影响，为儿童青少年近视防控精准干预提供参考依据。

方法：2023年3—5月，采用分层整群随机抽样方法，选取安徽省合肥市、芜湖市、宿州市和池州市6 132名4～12年级中小学生，通过问卷调查收集基本信息及户外活动、久坐行为和睡眠时长，采用5米标准对数视力表进行视力检查，分别采用单一活动模型、分割模型以及等时替代模型分析中小学生户外活动、久坐行为和睡眠时长与视力不良之间的关联，并按性别进行分层分析。

结果：6 132名中小学生视力不良检出率为76.9%，其中女生视力不良检出率（72.62%）高于男生（81.05%），差异具有统计学意义（c²＝61.365，P＜0.001）。单一活动模型和分割模型结果显示，单一活动模型和分割模型结果显示，中小学生户外活动和睡眠时长与视力不良风险降低均相关（OR值分别0.87, 0.88; 0.88, 0.91）, 久坐行为时长与视力不良风险增加均相关（OR值分别1.05,1.03）（P值均＜0.05）。等时替代模型分析结果显示，用1 h/d的户外活动时长替代相同时间的久坐行为可降低15.1%的视力不良风险（OR＝0.85）；用1 h/d的睡眠时长替代相同时间的久坐行为可降低12.3%的视力不良风险（OR＝0.88）（P值均＜0.05）。按性别分层后的等时替代模型分析结果显示，用1 h/d的户外活动时长替代相同时间的久坐行为可降低男生22%与8%的视力不良风险（OR分别为0.78，0.92）；用1 h/d的睡眠时长替代相同时间的久坐行为可降低女生18%的视力不良风险（OR＝0.82）（P值均＜0.05）。

结论：男生每日用1 h户外活动替代久坐行为以及男、女生每日用1h睡眠替代久坐行为均可减少视力不良风险。