Zhang Junfang, Qin Bai, Liu Bihong, Sun Dajun, Liang Congkai, Wang Shiyi, Yang Mei, Zhu Rongrong
Department of Ophthalmology, Affiliated Hospital of Nantong University, Nantong, 226001, China.
Funing Shizhuang Eye Hospital, Yancheng, 224000, China.
Int Ophthalmol. 2023 Feb;43(2):411-422. doi: 10.1007/s10792-022-02438-8. Epub 2022 Aug 10.
To investigate the pterygium prevalence and evaluate risk factors of pterygium in rural type 2 diabetic (D2M) patients aged 50 years and above in Funing Country, Jiangsu Province, China.
A cross-sectional ophthalmic survey was conducted in type 2 diabetes mellitus (D2M) patients aged ≥ 50 years in Funing County, Jiangsu Province, China, which was named Jiangsu Diabetic Eye Disease Study (JDEDS). All participants underwent a comprehensive questionnaire and ocular examination. Pterygium was diagnosed by slit lamp examination. The risk factors associated with pterygium were evaluated with logistic regression models.
The prevalence of pterygium was 22.37% (n = 427) and 95% confidence interval (CI) (20.50-24.24%) in D2M patients aged 50 years and above in JDEDS. The prevalence of pterygium was 18.32% (95% CI 15.33-21.32%) in men and 24.43% (95% CI 22.06-26.80%) in women. Women had a higher prevalence than men (p = 0.001). Multivariate analysis showed, for male participants with D2M, pterygium was independently associated with increasing age [70-79 years: OR and 95% CI 2.49(1.20-5.18), p = 0.014; ≥ 80 years: 4.84(2.04-11.47), p < 0.001], while cigarette smoking was the protective factors, especially in current smoker [OR and 95% CI 0.79(0.67-0.92); p = 0.003]. For female participants with D2M, age [60-69 years OR and 95% CI 1.68(1.07-2.62), p = 0.023; 70-79 years: 2.62(1.69-4.06), p < 0.001; ≥ 80 years:3.24(1.70-5.90), p < 0.001], hypertension [OR and 95% CI 1.40(1.05-1.87), p = 0.024], BMI 24-27.9 [OR and 95% CI 1.20(1.00-1.44), p = 0.047], higher HbA1c [(5.6-7.9) % OR and 95% CI 1.42(1.10-1.82), p = 0.006; (8.0-9.9) %: 1.32(1.10-1.58), p = 0.003] were risk factors.
D2M patients aged over 50 years has a high prevalence of pterygium in JDEDS. The pterygium prevalence is higher in female D2M participants. Diabetes and related factors may be risk factors of pterygium in female D2M patients. Further studies are needed to explore the gender difference in the pathogenesis of pterygium in D2M subjects.
调查中国江苏省阜宁县50岁及以上农村2型糖尿病（D2M）患者翼状胬肉的患病率，并评估其危险因素。
在中国江苏省阜宁县对年龄≥50岁的2型糖尿病（D2M）患者进行了一项横断面眼科调查，即江苏糖尿病眼病研究（JDEDS）。所有参与者均接受了全面的问卷调查和眼部检查。通过裂隙灯检查诊断翼状胬肉。采用逻辑回归模型评估与翼状胬肉相关的危险因素。
JDEDS中50岁及以上D2M患者翼状胬肉的患病率为22.37%（n = 427），95%置信区间（CI）为（20.50 - 24.24%）。男性翼状胬肉患病率为18.32%（95%CI 15.33 - 21.32%），女性为24.43%（95%CI 22.06 - 26.80%）。女性患病率高于男性（p = 0.001）。多因素分析显示，对于患有D2M的男性参与者，翼状胬肉与年龄增长独立相关[70 - 79岁：比值比（OR）及95%CI为2.49（1.20 - 5.18），p = 0.014；≥80岁：4.84（2.04 - 11.47），p < 0.001]，而吸烟是保护因素，尤其是当前吸烟者[OR及95%CI为0.79（0.67 - 0.92）；p = 0.003]。对于患有D2M的女性参与者，年龄[60 - 69岁OR及95%CI为1.68（1.07 - 2.62），p = 0.023；70 - 79岁：2.62（1.69 - 4.06），p < 0.001；≥80岁：3.24（1.70 - 5.90），p < 0.001]、高血压[OR及95%CI为1.40（1.05 - 1.87），p = 0.024]、体重指数（BMI）24 - 27.9[OR及95%CI为1.20（1.00 - 1.44），p = 0.047]、较高的糖化血红蛋白（HbA1c）[（5.6 - 7.9）% OR及95%CI为1.42（1.10 - 1.82），p = 0.006；（8.0 - 9.9）%：1.32（1.10 - 1.58），p = 0.003]是危险因素。
JDEDS中50岁以上的D2M患者翼状胬肉患病率较高。女性D2M参与者的翼状胬肉患病率更高。糖尿病及相关因素可能是女性D2M患者翼状胬肉的危险因素。需要进一步研究探索D2M患者翼状胬肉发病机制中的性别差异。
