Associations between anthropometric indicators and refraction in school-age children during the post-COVID-19 era

PURPOSE: To explore the associations between anthropometric indicators and refraction in school-aged children in the post-COVID-19 era. METHODS: Data were collected from 25,644 children aged 7 to 12 years in 48 elementary schools in Tianjin. The comprehensive examination included height, weight, systolic blood pressure (SBP), diastolic blood pressure (DBP), refraction, and calculation of BMI, with a follow-up visit after 6 months. Myopia was defined as spherical equivalent refraction (SER) ≤-0.50 diopter (D). Bivariate correlation coefficients and multiple linear regression models were used to explore the cross-sectional and longitudinal associations between anthropometric indicators (height, weight, BMI, SBP, and DBP) and refraction. RESULTS: The mean changes in height, weight, BMI, SBP, DBP, and SER of the participants were 4.03 ± 2.18 cm, 3.10 ± 2.39 kg, 0.45 ± 1.16 kg/m(2), 2.26 ± 14.74 mmHg, 2.18 ± 11.79 mmHg and −0.17 ± 0.51 D, respectively. Overall, height, weight, BMI, SBP, and DBP were all correlated with SER (r = −0.324, r = −0.234, r = −0.121, r = −0.112, r = −0.066, both p < 0.001), and changes in height and weight were correlated with changes in SER (r = −0.034, −0.031, both p < 0.001). Furthermore, multiple linear regression analysis revealed that the association of BMI, SBP, and DBP with SER was significant in myopic children but not in non-myopic children. The association between changes in weight and changes in SER was only present in non-myopic children but not in myopic children. CONCLUSION: Height and weight were negatively correlated with SER in both cross-sectional analysis and longitudinal changes, indicating that children's height, weight and growth rate may be used as a reference indicator for myopia risk prediction and myopia progression monitoring.