Tsui Ching-Kit, Hu Andina, Li Yuntong, Huang Wenyong, Wang Wei, Liu Kaiqun, Xie Liqiong, Li Yuting, Congdon Nathan, Liang Xiaoling
State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Guangdong Provincial Key Laboratory of Ophthalmology and Vision Science, Sun Yat-Sen University, Guangzhou, China.
Centre for Public Health, Queens University Belfast, Belfast, UK.
J Diabetes Investig. 2025 Jul;16(7):1254-1262. doi: 10.1111/jdi.70027. Epub 2025 Apr 10.
To compare the prevalence, incidence, and factors of diabetic retinopathy (DR) and macular edema (DME) in patients with early-onset (EOD) and late-onset diabetes (LOD).
Participants with type 2 diabetes mellitus (T2DM) were recruited from a community-based study conducted in southern urban China. Participants were followed up for 2 years. The prevalence and incidence of DR and DME were compared between EOD (≤40 years) and LOD (>40 years) groups, and potential factors were evaluated using multivariate logistic regression.
Among 2,703 participants, 173 (6.4%) with EOD had a higher prevalence of DR than 2,530 (93.6%) with LOD (27.8% vs 15.5%, P < 0.001). Participants with EOD had a higher incidence of DR, although this difference was not statistically significant (EOD: 8.1% vs LOD: 3.6%, P = 0.12). Insulin use and higher HbA1c levels were significantly associated with DR in both EOD and LOD groups (both P < 0.05). Additionally, longer diabetes duration, higher systolic blood pressure, and the presence of albuminuria independently associated with the presence of any DR in LOD patients (all P < 0.05). For DME, HbA1c level was a significant association in EOD, while in LOD, age, BMI, insulin use, and albuminuria were significant factors (all P < 0.05).
A higher prevalence of DR was observed among patients with early-onset T2DM in urban southern China. Timely diagnosis of DR and regular eye care services are needed for early-onset T2DM.
比较早发型（EOD）和晚发型糖尿病（LOD）患者糖尿病视网膜病变（DR）和黄斑水肿（DME）的患病率、发病率及相关因素。
从中国南方城市社区开展的一项研究中招募2型糖尿病（T2DM）患者。对参与者进行2年随访。比较EOD组（≤40岁）和LOD组（>40岁）DR和DME的患病率及发病率，并采用多因素logistic回归评估潜在因素。
在2703名参与者中，173名（6.4%）EOD患者的DR患病率高于2530名（93.6%）LOD患者（27.8%对15.5%，P<0.001）。EOD患者的DR发病率较高，尽管差异无统计学意义（EOD：8.1%对LOD：3.6%，P=0.12）。在EOD组和LOD组中，使用胰岛素和较高的糖化血红蛋白水平均与DR显著相关（均P<0.05）。此外，糖尿病病程较长、收缩压较高和存在蛋白尿在LOD患者中与任何DR的存在独立相关（均P<0.05）。对于DME，糖化血红蛋白水平在EOD中是显著相关因素，而在LOD中，年龄、体重指数、胰岛素使用和蛋白尿是显著因素（均P<0.05）。
在中国南方城市早发型T2DM患者中观察到较高的DR患病率。早发型T2DM患者需要及时诊断DR并接受定期眼科护理服务。
