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.