Prevalence and associated factors of diabetic retinopathy among diabetic residents in Longyan of Fujian Province
Objective To investigate the prevalence and associated factors of diabetic retinopathy(DR)among diabetic residents in Longyan of Fujian Province.Methods A investigative research.From January 2022 to December 2023,a total of 10 061 diabetic patients enrolled in the chronic disease follow-up management system from 112 towns and sub-districts in 7 counties and districts of Longyan of Fujian Province were selected as the target population.A questionnaire survey,routine physical examination,vision test,and non-mydriatic fundus photography were conducted.A total of 762 cases with missing height,weight,blood pressure,fasting plasma glucose(FPG),and diabetes duration,and 507 cases with unclear fundus photography were excluded,resulting in 8 792 cases included in the final statistical analysis.DR diagnosis and classification were based on the 2019 International Clinical Classification of DR.The prevalence of DR was calculated for single-eye or double-eye DR cases as 1 case;the more severe eye was used for DR grading in double-eye DR cases.Statistical analysis was performed by grouping based on the presence or absence of DR and dividing into age groups ≤67 years and＞67 years.x2 test was used to analyze factors associated with prevalence;binary multivariate logistic regression analysis was employed to identify influencing factors of DR.Results Among the 8 792 cases,888(10.1％,888/8 792)were diagnosed with DR(DR group),and 7 904(89.9％,7 904/8 792)had no DR(non-DR group).Compared to the non-DR group,the DR group showed significant increases in FPG(Z=-12.448),diabetes duration(Z=-18.936),systolic blood pressure(Z=-4.237),diastolic blood pressure(Z=-2.881),and body mass index(BMI)≥24 kg/m2(P＜0.001).Significant differences were also found between the two groups in hypertension(x2=11.450),hyperlipidemia(x2=5.100),kidney disease(x2=7.039),family history of diabetes(x2=5.025),and regular medication use(x2=66.034)(P＜0.05).There were 4 688 cases in the ≤67 years group and 4 104 in the＞67 years group.In the ≤67 years group,significant differences in DR prevalence were found for FPG levels(x2=1 11.754),diabetes duration(x2=231.658),BMI(x2=12.404),systolic blood pressure(x2=17.912),regular medication use(x2=40.727),hyperlipidemia(x2=6.816),and hypertension history(x2=6.775)(P＜0.05).In the＞67 years group,significant differences in DR prevalence were found for FPG levels(x2=59.916),diabetes duration(x2=128.362),systolic blood pressure(x2=5.183),regular medication use(x2=22.097),kidney disease(x2=6.251),and family history of diabetes duration(x2=4.967)(P＜0.05).No significant differences in DR prevalence were found based on sex,education level,smoking history,alcohol consumption,exercise habits,heart disease history,or other family disease history(P＞0.05).Logistics regression analysis results show that patients aged＞67 years,FPG[odds ratio(OR)=1.074,95％confidence interval(CI)1.046-1.102],diabetes duration(OR=1.088,95％CI 1.071-1.106),systolic blood pressure(OR=1.007,95％CI 1.001-1.013),and kidney disease(OR=3.617,95％CI 1.268-10.320)were identified as risk factors for DR(P＜0.05).In patients aged ≤67 years,FPG(OR=1.088,95％CI 1.067-1.110),diabetes duration(OR=1.108,95％CI 1.091-1.125),and systolic blood pressure(OR=1.008,95％CI 1.003-1.013)were identified as independent risk factors for DR(P＜0.05),while BMI ≥24 kg/m2(OR=0.934,95％CI 0.908-0.965)was a protective factor for DR(P＜0.05).Age,regular medication use,hypertension,and hyperlipidemia were identified as potential confounding factors for DR occurrence.Conclusions The prevalence of DR among diabetes patients in Longyan of Fujian Province,is 10.1％.FPG,diabete duration,and systolic blood pressure are independent risk factors for DR,while age,regular medication use,hypertension,and hyperlipidemia are potential confounding factors for DR occurrence.
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