Association Between Serum 25(OH)D Concentration And Myopia In Children And Adolescents

ObjectivesTo analyze the serum 25?OH?D concentration in children and adolescents and the epidemiological distribution of vitamin D deficiency in children and adolescents,and to explore the correlation between serum 25?OH?D concentration and myopia in children and adolescents.MethodsAll students in grades 2-9 of a boarding school in Shenyang were selected to collect relevant demographic characteristics,vision care behaviors,etc.according to the principle of informed consent.At the same time,fasting venous blood samples were collected and high performance liquid chromatography-tandem mass spectrometry was used.The concentration of serum 25?OH?D was determined by HPLC-MS/MS.The computerized refractometer was used to measure the diopter of the students without dilated pupils,and the height and weight of the students were measured.A total of 829primary and middle school students?494 male students and 335 female students?were included in the study.Serum 25?OH?D concentration was non-normally distributed,expressed as P₅₀(P₂₅^P₇₅).The Mann-Whitney U rank sum test was used to compare the difference of serum 25?OH?D concentration among different genders,different school sections,different ethnic groups,and whether there were extracurricular tutoring classes.Kruskal-Wallis test with k independent samples was used to compare serum 25?OH?D concentrations between different myopia levels,different learning burden status,different body weight status,different parental myopia status,different parent smoking status,and total outdoor activities.The subjects were divided into four groups according to the degree of myopia?non-myopia group,mild myopia group,moderate myopia group,high myopia group?.The?² test was used to compare the school segment,gender,ethnicity,weight status,learning burden,and parental myopia.Parental smoking status,whether there is an extracurricular tutoring class,the difference in the ratio between each group of myopia.The serum 25?OH?D concentration was divided into four groups from Q1 to Q4 according to quartiles,and the serum 25?OH?D concentration was used as the independent variable?Q1 as the reference group?,and the myopia status was the dependent variable?0=non-myopia,1=myopia?,adjusting gender,learning burden,parental myopia,with or without extracurricular tutoring,eye relaxation behavior,reading and writing posture and eye exercises,and other factors,using logistic regression model to analyze The OR value and 95%CI of myopia occurred in children and adolescents in the different serum25?OH?D concentration group.The correlation between serum 25?OH?D concentration and equivalent spherical power?SE?was analyzed by multiple linear regression model.ResultsA total of 829 primary and middle school students were investigated,including 494male students and 335 female students,with an average age of?11.00±2.09?years old.The detection rate of myopia was 61.8%?512 people?,among which the detection rate of mild myopia was 42.4%?351 people?,the detection rate of moderate myopia was16.0%?133 people?,and the detection rate of high myopia was 3.4%?28 persons?.Univariate analysis showed that the high myopia detection rate?0.4%?was lower than that of junior high school students?7.2%?,and the difference was statistically significant??²=80.14,P<0.01?;The detection rate of high myopia in Han students was lower than that of minority students?6.8%?,and the difference was statistically significant(??²=8.08,P<0.05?;The high myopia detection rate?3.0%?of students with low learning burden was lower than that of students with heavy learning burden?4.7%?,the difference was statistically significant??²=17.39,P<0.05?;The high myopia detection rate?2.3%?of the parents who were not myopia was lower than that of the parents with myopia?10.2%?,the difference was statistically significant??²=20.39,P<0.05?;The high myopia detection rate?2.1%?of students with extracurricular remedial classes was lower than that of students without extracurricular remedial classes?4.5%?,and the difference was statistically significant??²=9.12,P<0.05?.The median[interquartile range]concentration of serum 25?OH?D was 14.30[IQR:11.40,17.95]ng/ml.Serum 25?OH?D concentration was significantly different between the non-myocardic group,mild myopia group,moderate myopia group and high myopia group??²=30.14,P<0.001?;boys were higher than girls,the difference was Statistical significance?Z=-4.26,P<0.001?;primary school students were higher than junior high school students,the difference was statistically significant?Z=-9.18,P<0.001?;serum 25?OH?D concentration was light in learning burden,learning burden There was a statistically significant difference between the three groups in the general and learning burden??²=9.05,P<0.05?.The 25?OH?D deficiency detection rate was 56.2%.The detection rate of serum25?OH?D deficiency was statistically significant in the non-myopic group?49.2%?,mild myopia group?56.4%?,and middle-high myopia group?69.6%???²=17.98,P<0.001?.The detection rate of 25?OH?D deficiency in boys was lower than that of girls?55.4%?,and the difference was statistically significant??²=19.17,P<0.001?.Pupils?44.9%?were lower than junior high school students?71.0%?,and the difference was statistically significant??²=57.92,P<0.001?.Multivariate binomial logistic regression analysis showed that in primary school students,adjustment of gender,learning burden,parental myopia,presence or absence of extracurricular remedial classes,eye relaxation behavior,reading and writing postures,and eye exercises were affected by mixed factors.compared to the serum25?OH?D concentration in the Q1 group,The risk of myopia in primary school students in serum 25?OH?D was Q2 group?OR=0.42,95%CI=0.23-0.83?,Q3 group?OR=0.49,95%CI=0.26-0.91?,Q4 group?OR=0.50,95%CI=0.27-0.92?was significantly reduced.However,compared to the serum 25?OH?D concentration in the Q1 group,There was no significant change in the risk of myopia in junior high school students with serum 25?OH?D concentration was Q2 group?OR=1.05,95%CI=0.55-2.01?and Q3 group?OR=0.75,95%CI=0.38-1.46?and Q4 group?OR=1.07,95%CI=0.50-2.28?.There was a positive correlation between the equivalent spherical degree and serum25?OH?D concentration after adjusting for age and gender??=0.03,P<0.05?.Adjusting age,gender,ethnicity,learning burden,parental myopia,parental smoking status,presence or absence of extracurricular remedial classes,eye relaxation behavior,reading and writing posture,and eye exercises are equivalent to spherical fluoroscopic and serum 25?OH?D concentrations.Positive correlation??=0.03,P<0.05?.ConclusionThe study found that serum 25?OH?D concentration is closely related to the risk of myopia in primary and secondary school students.The results further support the conclusion that children with a higher level of serum 25?OH?D have a lower risk of myopia.The results of this study provide a basis for further research into the relationship between vitamin D and visual development in adolescents and its mechanisms.