Birth order and myopia.
Birth order and myopia.
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DOI：
10.3109/09286586.2013.848457
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发表时间：
2013-12
影响因子：
1.8
通讯作者：
Williams C
中科院分区：
文献类型：
--
作者：
Guggenheim JA;McMahon G;Northstone K;Mandel Y;Kaiserman I;Stone RA;Lin X;Saw SM;Forward H;Mackey DA;Yazar S;Young TL;Williams C
出生顺序与视力下降(近视的替代者)之间的关系已经被观察到了。我们在4组受试者中直接研究了出生顺序和近视之间的关系。受试者群体参加了1)雅芳亲子纵向研究(ALSPAC；英国；15岁；N=4,401)，2)新加坡近视风险因素队列研究(SCORM；新加坡，13岁；N=1,959)，3)Raine Eye Health研究(REHS，澳大利亚，20岁，N=1,344)，以及4)以色列国防军应征人员(IDFC；以色列，16-22岁；N=888,277)。主要结果：调整潜在危险因素后，第一胎近视与非第一胎近视的优势比(OR)。在所有研究组中，第一个出生的人近视的患病率在数字上高于非第一个出生的人，但证据的强度差异很大。调整后的OR值(95%CI)为：ALSPAC，1.31(1.05~1.64)；SCORM，1.25(0.89~1.77)；REHS，1.18(0.90~1.55)；IDFC，1.04(1.03~1.06)。在IDFC大样本中，效应大小(A)第一胎与第四胎或更高，第一胎与第二胎/第三胎比较(P<；0.001)和(B)近视严重程度增加(P<；0.001)。在所有研究中，第一个出生的个体患近视的风险增加是很低的(OR<；1.3)。事实上，只有对4000名参与者的研究为这种关联提供了强有力的统计支持。现有证据表明，这种关系独立于既定的风险因素，如户外活动时间/阅读，因此可能通过不同的因果机制产生。
An association between birth order and reduced unaided vision (a surrogate for myopia) has been observed previously. We examined the association between birth order and myopia directly in 4 subject groups. Subject groups were participants in 1) the Avon Longitudinal Study of Parents and Children (ALSPAC; UK; age 15 years; N=4,401), 2) the Singapore Cohort Study of Risk Factors for Myopia (SCORM; Singapore; age 13 years; N=1,959), 3) the Raine Eye Health Study (REHS; Australia; age 20 years; N=1,344), and 4) Israeli Defense Force recruitment candidates (IDFC; Israel; age 16-22 years; N=888,277). Main outcome: Odds ratio (OR) for myopia in first born versus non-first born individuals after adjusting for potential risk factors. The prevalence of myopia was numerically higher in first-born versus non-first-born individuals in all study groups, but the strength of evidence varied widely. The adjusted ORs (95% CI) were: ALSPAC, 1.31 (1.05-1.64); SCORM, 1.25 (0.89-1.77); REHS, 1.18 (0.90-1.55); IDFC, 1.04 (1.03-1.06). In the large IDFC sample, the effect size was greater (a) for the first born versus fourth or higher born comparison than for the first born versus second/third born comparison (P<0.001) and (b) with increasing myopia severity (P<0.001). Across all studies, the increased risk of myopia in first born individuals was low (OR <1.3). Indeed, only the studies with >4000 participants provided strong statistical support for the association. The available evidence suggested the relationship was independent of established risk factors such as time outdoors/reading, and thus may arise through a different causal mechanism.
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