Xiao Baixiang, Duan Fang, Gu Xuejun, Zuo Jiahao, Chan Ving Fai, Virgili Gianni, Zhou Xiaojun, Price-Sanchez Carlos, Jin Ling, Liu Yuanping, Wang Yanfang, Zhong Yichun, Liao Qinghua, Fu Haoxiang, He Yun, Li Dongfeng, Xu Ping, Li Jia, Congdon Nathan
Affiliated Eye Hospital, Jiangxi Medical College, Nanchang University, Nanchang City, China.
Center for Public Health, Queen's University Belfast, Belfast, UK.
BMJ Open. 2025 Mar 21;15(3):e092526. doi: 10.1136/bmjopen-2024-092526.
To determine the prevalence of diabetic retinopathy (DR) and associated risk factors among rural and urban people diagnosed with type 1 or type 2 diabetes mellitus (PwDM) in southern China.
This is a cross-sectional study.
The study was conducted at primary health centres from 2 September to the end of December 2019.
All the 3646 PwDM being registered in Qujiang District, aged ≥18 years were informed, of whom 2677 attended the screening and were recruited.
The presence of DR was determined by trained graders using criteria of the UK National Health Service Diabetic Eye Screening Programme. Multiple logistic regression analyses were used to assess potential risk factors for the presence of DR.
The mean age of the participants (73.4% of the 3646 invited people) was 63.4 years (SD 10.1 years), 1503 (56.2%) were female, 1749 (65.3%) were rural residents, 1654 (71.0%) participants had glycated haemoglobin (HbA1c)≥6.5%, 1773 (66.3%) had high blood pressure and the median duration of diabetes mellitus (DM) was <5 years. Although half (52.0%) of these participants had brief (<5 years) exposure to DM, 831 (31.3%, 95% CI: 29.3 to 32.8%) had DR, among whom 412 (49.6%) had sight-threatening DR. Men (33.1%) had a significantly higher prevalence of any DR than women (29.4%, p<0.05). There were no significant differences in DR prevalence at any level between rural and urban residents. In multivariate regression models, risk factors for any DR were HbA1c>6.5% (OR=1.58, p<0.01), using insulin and antihyperglycaemic medications (OR=1.76, p<0.01), longer duration of DM and higher systolic blood pressure (OR=1.01 for each mm Hg, p<0.01).
The high prevalence of DR, hyperglycaemia and high blood pressure highlight the need for better management of non-communicable diseases in China.
确定中国南方城乡1型或2型糖尿病患者（PwDM）中糖尿病视网膜病变（DR）的患病率及相关危险因素。
这是一项横断面研究。
该研究于2019年9月2日至12月底在基层医疗中心开展。
曲江地区登记在册的所有3646名年龄≥18岁的PwDM均收到通知，其中2677人参加了筛查并被纳入研究。
由经过培训的分级人员依据英国国家医疗服务体系糖尿病眼部筛查计划的标准确定是否存在DR。采用多元逻辑回归分析评估DR存在的潜在危险因素。
参与者（占受邀的3646人的73.4%）的平均年龄为63.4岁（标准差10.1岁），女性1503人（56.2%），农村居民1749人（65.3%），糖化血红蛋白（HbA1c）≥6.5%的参与者有1654人（71.0%），高血压患者1773人（66.3%），糖尿病（DM）病程中位数<5年。尽管这些参与者中有一半（52.0%）患糖尿病的时间较短（<5年），但仍有831人（31.3%，95%置信区间：29.3至32.8%）患有DR，其中412人（49.6%）患有威胁视力的DR。男性（33.1%）的任何DR患病率显著高于女性（29.4%，p<0.05）。城乡居民在任何DR水平上的患病率均无显著差异。在多变量回归模型中，任何DR的危险因素包括HbA1c>6.5%（比值比[OR]=1.58，p<0.01）、使用胰岛素和降糖药物（OR=1.76，p<0.01）、糖尿病病程较长以及收缩压较高（每毫米汞柱OR=1.01，p<0.01）。
DR、高血糖和高血压的高患病率凸显了中国加强非传染性疾病管理的必要性。
