Abstract
Objective
To determine associations between educational level and ophthalmic diseases in Chinese.
Methods
The population-based Beijing Eye Study, performed in 2006, enrolled 3,251 participants (age: 45+ years) out of 4,439 subjects invited to participate (response rate: 73.2%). The participants underwent an interview including questions concerning their educational level, and a detailed ophthalmic examination.
Results
Data on the level of education were available for 3,221 (99.1%) subjects, with 1,484 (46.1%) subjects living in the rural region. The mean age was 60.4 ± 10.1 years (range: 45–89 years). In a multivariate analysis, a higher level of education was significantly associated with myopic refractive error, higher best-corrected visual acuity, lower degree of nuclear cataract, and lower prevalence of angle-closure glaucoma, and with the systemic parameters of lower age, male gender, urban region, taller body height, and lower body mass index. It was not significantly associated with intraocular pressure, amount of subcapsular cataract and cortical cataract, cataract surgery, and the prevalences of diabetes mellitus, retinal vein occlusions, chronic open-angle glaucoma, and age-related macular degeneration, and with the systemic parameters of fasting serum concentrations of glucose, high-density lipoproteins, low-density lipoproteins, cholesterol and triglycerides, systolic and diastolic blood pressure.
Conclusions
In the Greater Beijing area, a higher level of education was associated with myopic refractive error, higher best-corrected visual acuity, and lower prevalence of nuclear cataract and angle-closure glaucoma, after adjusting for the systemic parameters of younger age, male gender, urban region, taller body height, lower body mass index less smoking and less alcohol consumption. Educational level was not significantly associated with intraocular pressure, cortical cataract, blood pressure, and frequencies of age-related macular degeneration, retinal vein occlusions and chronic open-angle glaucoma.
Similar content being viewed by others
References
Winkleby MA, Jatulis DE, Frank E, Fortmann SP (1992) Socioeconomic status and health: how education, income, and occupation contribute to risk factors for cardiovascular disease. Am J Public Health 82:816–820
Luoto R, Pekkanen J, Uutela A, Tuomilehto J (1994) Cardiovascular risks and socioeconomic status: differences between men and women in Finland. J Epidemiol Community Health 48:348–354
Lynch J, Kaplan GA, Salonen R, Cohen RD, Salonen JT (1995) Socioeconomic status and carotid atherosclerosis. Circulation 92:1786–1792
Yu Z, Nissinen A, Vartiainen E, Song G, Guo Z, Zheng G, Tuomilehto J, Tian H (2000) Associations between socioeconomic status and cardiovascular risk factors in an urban population in China. Bull World Health Organ 78:1296–1305
Sabanayagam C, Shankar A, Wong TY, Saw SM, Foster PJ (2007) Socioeconomic status and overweight/obesity in an adult Chinese population in Singapore. J Epidemiol 17:161–168
Metcalf PA, Scragg RR, Schaaf D, Dyall L, Black PN, Jackson RT (2008) Comparison of different markers of socioeconomic status with cardiovascular disease and diabetes risk factors in the Diabetes, Heart and Health Survey. N Z Med J 121:45–56
Marengoni A, Winblad B, Karp A, Fratiglioni L (2008) Prevalence of chronic diseases and multimorbidity among the elderly population in Sweden. Am J Public Health 98:1198–1200
van Hooijdonk C, Droomers M, Deerenberg IM, Mackenbach JP, Kunst AE (2008) Higher mortality in urban neighbourhoods in The Netherlands: who is at risk? J Epidemiol Community Health 62:499–505
Xu F, Ah Tse L, Yin X, Yu IT, Griffiths S (2008) Impact of socio-economic factors on stroke prevalence among urban and rural residents in Mainland China. BMC Public Health 8:170
Livingston PM, McCarty CA, Taylor HR (1997) Visual impairment and socioeconomic factors. Br J Ophthalmol 81:574–577
Yip JL, Aung T, Wong TY, Machin D, Khaw PT, Khaw KT, Seah S, Foster PJ (2007) Socioeconomic status, systolic blood pressure and intraocular pressure: the Tanjong Pagar Study. Br J Ophthalmol 91:56–61
Beijing Municipal Statistical Bureau (2002) Beijing Statistical Yearbook 2001. China Statistical Press, Beijing
Xu L, Wang Y, Wang S, Wang Y, Jonas JB (2007) High myopia and glaucoma susceptibility. The Beijing Eye Study. Ophthalmology 114:216–220
Xu L, Wang Y, Yang H, Jonas JB (2007) Differences in parapapillary atrophy between glaucomatous and normal eyes: the Beijing Eye Study. Am J Ophthalmol 144:541–546
Van Herick W, Shafer RN, Schwartz A (1969) Estimation of width of angle of anterior chamber. Incidence and significance of the narrow angle. Am J Ophthalmol 68:626–629
Age-Related Eye Disease Study Research Group (2001) The Age-Related Eye Disease Study (AREDS) system for classifying cataracts from photographs: AREDS report no. 4. Am J Ophthalmol 131:167–175
Xu L, Cui T, Zhang S, Sun B, Zheng Y, Hu A, Li J, Ma K, Jonas JB (2006) Prevalence and risk factors of lens opacities in urban and rural Chinese in Beijing. Ophthalmology 113:747–755
Klein R, Davis MD, Magli YL, Segal P, Klein BE, Hubbard L (1991) The Wisconsin age-related maculopathy grading system. Ophthalmology 98:1128–1134
Xu L, Xie X, Wang S, Wang Y, Jonas JB (2008) Prevalence of diabetes mellitus in China. Exp Clin Endocrinol Diabetes 116:69–70
Perloff D, Grim C, Flack J, Frohlich ED, Hill M, McDonald M, Morgenstern BZ (1993) Human blood pressure determination by sphygmomanometry. Circulation 88:2460–2470
Klein R, Klein BE, Linton KL (1992) Prevalence of age-related maculopathy: the Beaver Dam Eye Study. Ophthalmology 99:933–943
McCarty CA, Mukesh BN, Fu CL, Mitchell P, Wang JJ, Taylor HR (2001) Risk factors for age-related maculopathy: the Visual Impairment Project. Arch Ophthalmol 119:1455–1462
Klein R, Klein BE, Jensen SC, Mares-Perlman JA, Cruickshanks KJ, Palta M (1999) Age-related maculopathy in a multiracial United States population: the National Health and Nutrition Examination Survey III. Ophthalmology 106:1056–1065
Kahn HA, Leibowitz HM, Ganley JP, Kini MM, Colton T, Nickerson RS, Dawber TR (1997) The Framingham Eye Study. II: Association of ophthalmic pathology with single variables previously measured in the Framingham Heart Study. Am J Epidemiol 106:33–41
Cackett P, Tay WT, Aung T, Wang JJ, Shankar A, Saw SM, Mitchell P, Wong TY (2008) Education, socio-economic status and age-related macular degeneration in Asians: the Singapore Malay Eye Study. Br J Ophthalmol 92:1312–1315
Winkleby MA, Kraemer HC, Ahn DK, Varady AN (1998) Ethnic and socioeconomic differences in cardiovascular disease risk factors: findings for women from the Third National Health and Nutrition Examination Survey, 1988–1994. JAMA 280:356–362
Mohan V, Shanthirani S, Deepa R, Premalatha G, Sastry NG, Saroja R, Chennai Urban Population Study (CUPS No. 4) (2001) Intra-urban differences in the prevalence of the metabolic syndrome in southern India—the Chennai Urban Population Study (CUPS No. 4). Diabet Med 18:280–287
Bandello F, Lafuma A, Berdeaux G (2007) Public health impact of neovascular age-related macular degeneration treatments extrapolated from visual acuity. Invest Ophthalmol Vis Sci 48:96–103
Berdeaux G, Brézin AP, Fagnani F, Lafuma A, Mesbah M (2007) Self-reported visual impairment and mortality: a French nationwide perspective. Ophthalmic Epidemiol 14:80–87
Kulmala J, Era P, Törmäkangas T, Pärssinen O, Rantanen T, Heikkinen E (2008) Visual acuity and mortality in older people and factors on the pathway. Ophthalmic Epidemiol 15:128–134
Wong TY, Foster PJ, Johnson GJ, Klein BE, Seah SK (2001) The relationship between ocular dimensions and refraction with adult stature: the Tanjong Pagar Survey. Invest Ophthalmol Vis Sci 42:1237–1242
Saw SM, Chua WH, Hong CY, Wu HM, Chia KS, Stone RA, Tan D (2002) Height and its relationship to refraction and biometry parameters in Singapore Chinese children. Invest Ophthalmol Vis Sci 43:1408–1414
Eysteinsson T, Jonasson F, Arnarsson A, Sasaki H, Sasaki K (2005) Relationships between ocular dimensions and adult stature among participants in the Reykjavik Eye Study. Acta Ophthalmol Scand 83:734–738
Wu HM, Gupta A, Newland HS, Selva D, Aung T, Casson RJ (2007) Association between stature, ocular biometry and refraction in an adult population in rural Myanmar: the Meiktila eye study. Clin Experiment Ophthalmol 35:834–839
Foster PJ, Buhrmann R, Quigley HA, Johnson GJ (2002) The definition and classification of glaucoma in prevalence surveys. Br J Ophthalmol 86:238–242
Author information
Authors and Affiliations
Corresponding author
Rights and permissions
About this article
Cite this article
Xu, L., Wang, Y.X. & Jonas, J.B. Level of education associated with ophthalmic diseases. The Beijing Eye Study. Graefes Arch Clin Exp Ophthalmol 248, 49–57 (2010). https://doi.org/10.1007/s00417-009-1204-5
Received:
Revised:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1007/s00417-009-1204-5