浙江省瑞安地区学龄期儿童前房深度与屈光状态的相关研究

目的分析学龄期儿童前房深度（ACD）对屈光状态的影响。方法横断面研究。在浙江省瑞安地区随机选取小学一年级至六年级各2个班共513名学生（1 025眼）,年龄为7~14岁。在瑞安市人民医院门诊进行相关眼科检查,包括裂隙灯显微镜、眼屈光度、IOLMaster检查等,记录等效球镜度（SE）、眼轴长度（AL）、前房深度（ACD）、年龄等相关基本信息。通过线性混合效应模型来分析ACD、AL与年龄、屈光度的关系。结果7～14岁学龄期儿童,平均AL为（23.68±1.09）mm,平均ACD为（3.48±0.26）mm,平均屈光度为-1.06（-11.37～+6.25）D;ACD与SE呈负相关（?茁=-0.048,P<0.01）。正视眼和近视眼的ACD和AL存在差异。结论在学龄期儿童,ACD与年龄相关,随着年龄增长,ACD有轻微加深趋势。ACD影响屈光状态,近视眼的ACD较正视眼更长。     

Epidemiology of hepatitis B virus infection in Albania

AIM： To assess the prevalence and socio-demographic distribution of hepatitis B virus （HBV） infection in Albania. METHODS： Blood samples from 410 unselected schoolboys, 666 students, 500 military personnel, 1286 casual blood donors, 378 voluntary blood donors and 640 pregnant women （total 3880 non-vaccinated residents of rural and metropolitan areas from all over Albania; 2354 （60.7%） male and 1526 （39.3%） female; mean age of 26.3 years） were tested during 2004-2006 for hepatitis B surface antigen （HBsAg） and antibodies to hepatitis B virus （anti-HBs） by ELISA. RESULTS： The HBsAg and anti-HBs prevalence were 9.5% and 28.7%, respectively. The highest HI3sAg prevalence was evident in the younger age group, such as in schoolchildren （11.8%） and the military （10.6%）. Consequently, the anti-HBs prevalence increased with age, from 21.2% in schoolchildren （mean age： 15.7 years）, to 36.3% in pregnant women （mean age： 26.3 years） and 29.7% in voluntary blood donors （mean age： 40.1 years）. There were no significant differences between males and females. CONCLUSION： Despite the estimated two-fold reduction of HBsAg prevalence in the general population from about 18%-19% to 9.5%, Albania remains a highly endemic country （i.e. over 8% of HBsAg prevalence rate）.     

Prevalence of nonspecific low back pain in schoolchildren aged between 13 and 15 years

AIM: To investigate the annual (2005) prevalence of nonspecific low back pain (LBP), defined as lumbago not attributed to recognizable, known specific pathology, in a population of adolescents. METHODS: We investigated 7542 school teenagers with a structured questionnaire consisting of demographic and anthropometric items, psychosocial factors and life style, presence and intensity of LBP, family history of LBP, and questions about whether the teenager had been referred to a physician for this problem. Univariate (t-test, Mann-Whitney U-test and chi-square test) and multivariate analyses (logistic regression) were performed. RESULTS: A total of 1180 (20.5%) teenagers reported one or more episodes of LBP, of whom 900 (76.3%) had consulted a health provider. A significantly greater percentage of LBP was found in the students who practised aerobics and swimming compared to the other sports. The search for risk factors in the whole population revealed no associations between LBP and the investigated anthropometrics or lifestyle items, whereas a significant association was found for gender (to be female), positive family history of LBP and absence of sports activity. CONCLUSIONS: Our study shows that nonspecific LBP is a frequent event in teenagers, particularly in females, sedentary children and those with a family history of LBP.     

Iodine status and goitre prevalence in nitrate-exposed schoolchildren living in rural Bulgaria

Nitrate and perchlorate are well-known water pollutants that are harmful to human health. They may inhibit the accumulation of iodide in the thyroid gland. The present study investigated iodine status and goitre prevalence in schoolchildren aged 7–14 years from two villages in Bulgaria with high and low levels of nitrate, and negligible levels of perchlorate in drinking water. Comparison between the mean and median urinary iodine concentrations of the exposed and non-exposed children showed a statistically significant difference for the boys. A statistically significant difference was also found for goitre prevalence between the exposed and non-exposed children. The relative risk for schoolchildren exposed to a high level of nitrate in drinking water, expressed as an odds ratio, was 3.014 (95% confidence intervals 1.293–7.027; P=0.0105) and this was considered to be significant. This study confirmed that a high level of nitrate in drinking water is a risk factor for thyroid dysfunction in this population.     

Vitamin D status and its association with adiposity and oxidative stress in schoolchildren

ObjectiveThe aim of this study was to evaluate serum 25-hydroxyvitamin D [25(OH)D] level and its association with adiposity, inflammation, and oxidative stress in schoolchildren.MethodsA total of 1488 schoolchildren ages 7 to 11 y were recruited in Harbin, China (latitude: 44°04′N–46°40′N) in May. Serum 25(OH)D, which is an indicator of vitamin D status, was determined. Anthropometric data were collected following general physical examinations. Serum lipids, glucose metabolism indices, inflammatory molecules, and oxidative stress markers were determined. Dietary intake and physical activity also were assessed.ResultsThe median serum 25(OH)D concentration was 18.4 ng/mL. Of the 1488 schoolchildren included, 839 (56.4%) had vitamin D deficiency [25(OH)D < 20 ng/mL]. Children in the vitamin D deficiency group had significantly higher body weight (34.1 ± 3.8 versus 31.5 ± 3.3 kg; P < 0.001), body mass index (18.4 ± 2.2 versus 16.8 ± 1.7 kg/m²; P < 0.001), waist circumference (60.1 ± 8.5 versus 57.2 ± 7.7 cm; P < 0.001), percentage of body fat (20.2% ± 2.6% versus 19.1% ± 2.4%; P < 0.001), and significantly lower concentrations of serum superoxide dismutase (95.38 ± 12.22 versus 127.62 ± 15.98 U/mL; P < 0.001) compared with those in the vitamin D sufficiency group. After adjusting for sex, age, body mass index, and percentage of body fat, a positive association between serum 25(OH)D and superoxide dismutase was found (β = 0.230; P < 0.001).ConclusionsVitamin D deficiency is common in Harbin schoolchildren. Serum 25(OH)D is closely associated with adiposity and superoxide dismutase in schoolchildren, suggesting that vitamin D deficiency potentially increases the risk for diseases caused by higher adiposity and oxidative stress.     

Anthropometric measurements and obesity diagnosis in schoolchildren

Aim: To evaluate whether anthropometric methods such as arm muscle area, arm fat area, Rohrer index, conicity index, and waist‐to‐height ratio and the commonly used body mass index method are suitable for obesity screening in a multiethnic paediatric population. Method: A cross‐sectional population study was carried out in the city of Ouro Preto, Brazil, in 2006. Schoolchildren (n = 788) aged 6–15 years were selected by the stratified random sampling procedure by the proportion of students according to age and gender in all schools. Nonparametric receiver‐operating characteristic analysis was used to define the cut‐off for obesity for each method studied, using the tetrapolar bioelectrical impedance technique as the reference method. Results: Arm fat area measurements and Rohrer index were most suitable for adiposity screening in prepubertal and pubertal boys and in pubertal and prepubertal girls, respectively. In postpubertal period, the Rohrer index was the most suitable body fat assessment method in both genders. Conclusion: Body mass index presented the best balance between sensitivity and specificity only in the prepubertal period and postpubertal boys. Anthropometric measurements, especially arm fat area measurements and Rohrer index, are useful for screening of adiposity in a multiethnic paediatric population.     

Low back pain at school: unique risk deriving from unsatisfactory grade in maths and school-type recommendation

Psychosocial stress and pain may relate to educational selection. At the end of primary school (International Standard Classification of Education: ISCED level 1) children are recommended for one of three performance-based lower secondary level types of school (ISCED level 2). The study examines the association of educational selection and other risk factors with pain in the upper back (UBP), lower back pain (LBP), peripheral (limb) pain (PP), and abdominal pain (AP). Teacher reports of unsatisfactory grades in mathematics, and official school-type recommendation are included as objective psychosocial risk factors. One hundred and ninety-two schoolchildren, aged between 10 and 13 from 11 classes of 7 schools in Switzerland participated in the cross-sectional study. In logistic regression analysis, predictor variables included age, sex, BMI, participation in sport, physical mobility, weight of satchel, hours of daily TV, video, and computer use, pupils’ back pain reported by the mother and father, psychosocial strain, unsatisfactory grade in mathematics, and school-type recommendation. Analysis of pain drawings was highly reliable and revealed high prevalence rates of musculoskeletal pain in the last 4 weeks (UBP 15.3%, LBP 13:8%, PP 33.9%, AP 20.1%). Psychosocial risk factors were uniquely significant predictors of UBP (psychosocial strain), LBP (psychosocial strain, unsatisfactory grade in mathematics, school-type recommendation), and AP (school-type recommendation). In conclusion, selection in terms of educational school system was uniquely associated with LBP in schoolchildren. Stress caused by educational selection should be addressed in primary prevention of musculoskeletal pain in schoolchildren.     

Screening for hypercalciuria in schoolchildren: what should be the criteria for diagnosis?

The methodologies to diagnose hypercalciuria have not yet been standardized. The aims of this study were to assess the correlation between urinary calcium/creatinine ratio (UCa/Cr) ≥ 0.21 (mg/mg) and 24 h urinary calcium excretions and to determine the reference values of the UCa/Cr ratio among a large population of schoolchildren in southern Turkey. Non-fasting, second morning urine samples were collected from 2,143 children aged 7–14 years. In children with suspected hypercalciuria [UCa/Cr ≥ 0.21 (mg/mg)], 24 h urine samples were collected. The 95th percentile values of the UCa/Cr ratio for each age were calculated and showed a decrease in value with advancing age. In all, 269 (12.5%) of the children had UCa/Cr ≥ 0.21 (mg/mg), of whom 66 (24.5%) had daily urinary calcium excretion ≥4 mg/kg per day. A weak correlation was found between spot UCa/Cr ratios and daily urinary calcium excretions in children with UCa/Cr ≥ 0.21 (r = 0.27). We conclude that a spot UCa/Cr ratio of 0.21 (mg/mg) as the upper limit of normal cannot be used universally to define hypercalciuria. Age-specific reference values for UCa/Cr should be established for each population, to be used as a screening test for hypercalciuria, and the definite diagnosis should be established with 24 h urinary calcium excretion whenever possible.     

Multiple psychosomatic symptoms can indicate child physical abuse - results from a study of Swedish schoolchildren

Aim: To examine whether children with self‐reported experiences of either physical abuse alone or combined with intimate partner violence report more psychosomatic symptoms than other children and to explore whether these possible associations are enhanced by school‐related factors, chronic condition and demographic factors. Methods: A national cross‐sectional study of 2771 pupils in grades 4, 6 and 9 from 44 schools in Sweden was carried out in 2006 (91% response rate). Data were analysed with univariate tests (chi‐square), multiple logistic regression analyses and stratified logistic regression analyses, expressed as crude odds ratio (OR) and adjusted odds ratio (AOR) with 95% confidence intervals. Results: There was a strong association between reported physical abuse and multiple (three or more) psychosomatic symptoms among schoolchildren (AOR 2.12). Chronic condition was the only determinant that had an obvious enhancing effect on the association between physical abuse and psychosomatic symptoms in childhood. Conclusion: This study shows that multiple psychosomatic symptoms are associated with child physical abuse. Health professionals therefore need to pay special attention to schoolchildren who complain about the co‐occurrence of psychosomatic symptoms and pattern of symptoms, which could not be easily explained by other causes.