Prevalence and Risk Factors of Refractive Error in Qinghai, China: A Cross-Sectional Study in Han and Tibetan Adults in Xining and Surrounding Areas
Abstract Background Our study aimed to explore the prevalence and risk factors of refractive error (RE) in Han and Tibetan population aged 50-79 years in Xining and surrounding areas in Qinghai Province on Qinghai-Tibet Plateau.Methods As part of the China National Health Survey, our cross-sectional study compared the age-adjusted prevalence of RE in Han and Tibetan elder adults aged 50-79 years in Xining and surrounding areas. A multivariate logistic regression model was used to identify risk factors for myopia and hyperopia.Results Among 769 Han participants and 476 Tibetan participants, the age-adjusted prevalence of myopia, hyperopia, high myopia and astigmatism were 28.56%, 22.82%, 2.80%, and 69.38%. Han population have higher age-adjusted prevalence of myopia (32.93% vs 21.64%, p<0.001), high myopia (3.93% vs 1.02%, p=0.001) and astigmatism (72.14% vs 64.94%, p=0.021) compared to Tibetan population. Being Tibetan is the protective factor of myopia compared to being Han (OR 0.58, 95%CI 0.42-0.79, p<0.001). Elder age (p=0.032), longer time length in rural area (p=0.048), undergraduate/graduate education level (p=0.031), lighter active level (p=0.007) and lower BMI index (p=0.015) are risk factors for myopia. Elder age (all p<0.001) and pterygium status of the same eye (p=0.013) also increases the hyperopia risk.Conclusions Our study found an overall prevalence of myopia of 28.56% in Xining and surrounding areas in adults elder than 50 years. Han population has higher myopia risk than Tibetan population. More medical and social resources should be allocated to improve the vision and life quality of elder adults.