Height, Stunting, and Refractive Error Among Rural Chinese Schoolchildren: The See Well to Learn Well Project
Accepted 13 August 2009. published online 29 October 2009.
Purpose
To evaluate the hypothesis that changes in nutritional status could be partly responsible for observed increases in myopia prevalence among Chinese children.
Design
Cross-sectional cohort study.
Methods
Rural Chinese secondary school children participating in a study of interventions to promote spectacle use were randomly sampled (20% of children with uncorrected vision >6/12 bilaterally, and 100% of remaining children) and underwent cycloplegic refraction with subjective refinement and measurement of height and weight. Stunting was defined according to the World Health Organization standard population.
Results
Among 3226 children in the sample, 2905 (90.0%) took part. Among 1477 children undergoing refraction, 1371 (92.8%) had height and weight measurements. These children had a mean age of 14.5 ± 1.4 years, 59.8% were girls, and mean spherical equivalent refraction was −1.93 ± 1.82 diopters. Stunting was present in 87 children (6.4%). While height was inversely associated with refractive error (RE) (taller children were more myopic) among boys (r = −0.147, P = .001), this disappeared when adjusting for age, and no such association was observed among girls. Neither girls nor boys with stunting differed significantly in refraction from children without stunting, and neither stunting nor height was associated with RE when adjusting for age, height, and parental education. The power of this study to have detected a 0.75 diopters difference in RE between children with and without stunting was 0.96.
Conclusion
Results from this cross-sectional study are not consistent with the hypothesis that nutritional status is a determinant of RE in this setting.
aOxford University Department of Public Health, Oxford, United Kingdom
bChinese University of Hong Kong Department of Ophthalmology and Visual Sciences, Hong Kong, China
cJoint Shantou International Eye Center of Shantou University and Chinese University of Hong Kong, Shantou, China
dChinese University of Hong Kong School of Public Health, Hong Kong, China
eShantou University Faculty of Medicine, Shantou, China
Inquiries to Liping Li, Shantou University Medical College, Shantou, People's Republic of China
ABSTRACT