We used data from the China Health and Retirement Longitudinal Study (CHARLS) (2015). Logistic regressions estimated the odds ratio for associations of SEP with SIs. In addition, Mendelian randomization (MR) analysis was conducted to assess the causal relationship between them with the inverse variance weighting (IVW) estimator. MR-Egger, simple median, weighted median, maximum likelihood, and robust adjusted profile score were employed for sensitivity analyses.
In the observational survey, we enrolled 19,690 individuals aged 45 and above. SEP was negatively associated with SIs. Adjusted odds of vision impairment were higher for illiterate (1.50; 95%CI: 1.19, 1.91), less than elementary school diploma (1.76; 95%CI: 1.39, 2.25), middle school diploma (1.53; 95%CI: 1.21, 1.93) and lower income (all p < 0.001). The odds of hearing impairment were significantly higher for people with less than a high school diploma than those with a college degree or higher diploma, for agricultural workers than non-agricultural workers, and for people in low-income families (p < 0.01). The MR analysis also showed that occupation was associated with HI (1.04, 95%CI: 1.01, 1.09, p < 0.05) using IVW.
We found that both observational and causal evidence supports the theory that SEP can result in SIs and that timely discovery, targeted management, and education can prevent SIs among middle-aged and older adults.
■我们使用了中国健康与退休纵向研究(CHARLS)(2015)的数据。Logistic回归估计了SEP与SI关联的比值比。此外,进行孟德尔随机化(MR)分析以评估它们与逆方差加权(IVW)估计器之间的因果关系。MR-Egger,简单中位数,加权中位数,最大似然,和稳健调整后的概况评分用于敏感性分析。
■在观测调查中,我们纳入了19,690名45岁及以上的个体。SEP与SI呈负相关。调整后的文盲视力障碍几率更高(1.50;95CI:1.19,1.91),低于小学文凭(1.76;95CI:1.39,2.25),初中文凭(1.53;95CI:1.21,1.93)和较低收入(均p<0.001)。高中文凭以下人士的听力受损几率明显高于大学文凭或更高学历人士,农业工人比非农业工人,和低收入家庭的人(p<0.01)。MR分析还显示职业与使用IVW的HI(1.04,95CI:1.01,1.09,p<0.05)相关。
■我们发现,观察和因果证据都支持SEP可以导致SI和及时发现的理论,有针对性的管理,教育可以预防中年和老年人的SIs。