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Association between refraction characteristics and anthropometrics in 7- to 10-year-old Chinese primary school
Mingming Cui1, Donghao Song2, Yibo Niu2
1Capital Center for Children's Health, Capital Medical University, Capital Institute of Pediatrics, Beijing, China.
Insights
Accelerated physical growth in children shows modest links to axial elongation and myopia development, but not a causal relationship. Axial length to corneal curvature ratio (AL/CR) is a key biometric predictor for refractive error.
Area of Science:
- Ophthalmology
- Pediatric Health
- Human Growth and Development
Background:
- Refractive errors, particularly myopia, are increasingly prevalent in children.
- Understanding the interplay between physical development and ocular health is crucial for early intervention.
Purpose of the Study:
- To investigate the relationship between refractive status and physical growth parameters in children aged 7-10 years.
- To explore potential correlations between height-for-age z-score (HAZ), body mass index z-score (z-BMI), and ocular biometric data.
Main Methods:
- A cohort of 1260 primary school students in Beijing underwent anthropometric measurements (height, weight, BMI) and cycloplegic refraction.
- Ocular biometrics including axial length (AL), anterior chamber depth (ACD), and corneal curvature (CR) were measured.
- Statistical analyses, including multiple linear regression, were used to assess correlations between growth parameters and ocular metrics.
Main Results:
- Myopia prevalence was 21.19% and increased with age; boys exhibited longer AL and deeper ACD than girls.
- Accelerated physical growth (higher HAZ and z-BMI) correlated positively with increased AL and CR.
- Axial length to corneal curvature ratio (AL/CR) emerged as a significant biometric predictor of refractive error.
Conclusions:
- While accelerated physical growth is statistically linked to axial elongation and myopia development, the clinical significance is modest.
- No causal link between growth and refractive changes was established, highlighting the need for further research.
- AL/CR is a key predictor, suggesting its utility in myopia risk assessment and prevention strategies.
Objective:
The increasing prevalence of refractive errors in children has raised interest in exploring potential associations with physical development. This study aimed to explore a potential relationship between refractive status and growth parameters among children aged 7-10 years.
Methods:
A multistage stratified random sampling method was adopted to select 1260 primary school students in Pinggu District of Beijing in 2023, to measure their height and weight to calculate the body mass index (BMI). The height-for-age z-score (HAZ) and body mass index z-score(z-BMI) were calculated using the Least Mean Squares (LMS) method. Cycloplegic refraction was performed to determine spherical equivalent (SE). Ocular biometric data were collected, including axial length (AL) and anterior chamber depth (ACD). The ratio of AL to average corneal curvature (AL/CR) were calculated. Group comparisons used χ² test, t-test, analysis of variance (ANOVA) and Wilcoxon rank-sum test. Multiple linear regression models were used to analyze correlations between HAZ, z-BMI and ocular parameters.
Results:
The myopia rate was 21.19% and increased with age. Compared to girls, boys had significantly longer AL, deeper ACD, steeper CR, and higher AL/CR. As myopia severity increased, AL lengthened, ACD deepened, CR steepened and AL/CR increased. In the overall group, HAZ showed a positive correlation with AL (β = 0.208, Adjusted R²=0.084) and CR (β = 0.201, Adjusted R²=0.049), z-BMI showed a positive correlation with AL (β = 0.136, Adjusted R²=0.084) and AL/CR (β = 0.108, Adjusted R²=0.014), and a negative correlation with SE (β=-0.069, Adjusted R²=0.007). In the emmetropia group, pre-myopia group, and myopia group, HAZ showed a positive correlation with both AL and CR, while z-BMI demonstrated a positive correlation with AL.
Conclusions:
This exploratory study suggests that accelerated physical growth shows statistically significant but clinically modest correlations with axial elongation and myopia development. The findings do not demonstrate causal relationships between growth and refractive changes. AL/CR appears to be a key biometric predictor of refractive error. These hypothesis-generating results underscore the potential value of growth monitoring in myopia prevention and for further investigation into distinct physiological pathways in ocular development.
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