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The association between menarche and myopia and its interaction with related risk behaviors among Chinese school-aged girls: a nationwide cross-sectional study

Published online by Cambridge University Press:  17 August 2020

Rongbin Xu
Affiliation:
Institute of Child and Adolescent Health, School of Public Health, Peking University, Beijing, China Department of Epidemiology and Preventive Medicine, School of Public Health and Preventive Medicine, Monash University, Melbourne, VIC, Australia
Catherine Jan
Affiliation:
Institute of Child and Adolescent Health, School of Public Health, Peking University, Beijing, China The George Institute for Global Health, School of Medicine, University of New South Wales, Sydney, Australia
Yi Song
Affiliation:
Institute of Child and Adolescent Health, School of Public Health, Peking University, Beijing, China Stanford Prevention Research Center, Department of Medicine, Stanford University, Stanford, CA, USA
Yanhui Dong
Affiliation:
Institute of Child and Adolescent Health, School of Public Health, Peking University, Beijing, China
Peijin Hu
Affiliation:
Institute of Child and Adolescent Health, School of Public Health, Peking University, Beijing, China
Jun Ma
Affiliation:
Institute of Child and Adolescent Health, School of Public Health, Peking University, Beijing, China
Randall S. Stafford
Affiliation:
Stanford Prevention Research Center, Department of Medicine, Stanford University, Stanford, CA, USA
Corresponding

Abstract

Nearly 80% of new cases of myopia arise between 9 and 13 years old when puberty development also progresses rapidly. However, little is known about the association between myopia and puberty. We aim to evaluate the association between myopia and menarche, the most important puberty indicator for girls, and to test whether menarche could modify the effects of myopia-related behaviors. The participants came from two consecutive national surveys conducted in 30 provinces in mainland China in 2010 and 2014. We included 102,883 girls (61% had experienced menarche) aged 10–15 years. Risk behaviors for myopia which included sleep duration, homework time, and outdoor activity were measured by self-administrated questionnaire. Myopia was defined according to a validated method, and its relationships with menarche status and behaviors were evaluated by robust Poisson regression models based on generalized estimated equation adjusting for cluster effect of school. We found that postmenarche girls were at 13% (95% confidence interval: 11%–16%) higher risk of myopia than premenarche girls, after adjusting for exact age, urban–rural location, survey year, and four behavioral covariates. Short sleep duration (<7 h/d), long homework time (>1 h/d) and low frequency of weekend outdoor activity tended to be stronger (with higher prevalence ratios associated with myopia) risk factors for myopia in postmenarche girls than in premenarche girls, and their interaction with menarche status was all statistically significant (P < 0.05). Overall, our study suggests that menarche onset may be associated with increased risk of myopia among school-aged girls and could also enhance girls’ sensitivity to myopia-related risk behaviors.

Type
Original Article
Copyright
© The Author(s), 2020. Published by Cambridge University Press in association with the International Society for Developmental Origins of Health and Disease

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The association between menarche and myopia and its interaction with related risk behaviors among Chinese school-aged girls: a nationwide cross-sectional study
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