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To describe risk factors associated with diabetic retinopathy (DR) in a population-based sample of rural Chinese with type 2 diabetes. The Handan Eye Study is a population-based cross-sectional study surveyed 6830 Chinese people aged 30+ years from 13 randomly selected villages in 2006-2007. All participants underwent a standardized interview and extensive examinations including ophthalmologic and systemic conditions. Diabetic retinopathy was graded from fundus photographs according to the modified Early Treatment Diabetic Retinopathy Study classification system. Logistic regression models were used to assess risk factors associated with DR. Of 7577 eligible persons, 6830 (90.4%) participated, of which 5597 (81.9%) had fasting plasma glucose (FPG) data. There were 387 (6.9%) participants with diabetes, and 368 (95.1%) had gradable fundus photographs. The age-standardized prevalence of DR was 43.1%. In multivariable-adjusted logistic regression models for all diabetic participants, independent risk factors for DR were longer duration of diabetes (odds ratio [OR] 3.07, 95% confidence interval [CI] 1.94, 4.85, per 5 years of duration), higher FPG levels (OR 1.17; 95% CI: 1.08, 1.27, per mmol/l increase) and higher systolic blood pressure (OR 1.22; 95% CI: 1.08, 1.37, per 10 mmHg increase). For newly diagnosed diabetes, the only significant factor of DR was higher FPG levels (OR 1.17; 95% CI: 1.05, 1.29, per mmol/l increase). In rural Chinese persons with diabetes, longer diabetes duration, hyperglycaemia and elevated blood pressure are risk factors for DR. These findings underscore the importance of controlling classic risk factors for DR in developing countries, where diabetes prevalence is increasing. [ABSTRACT FROM AUTHOR]

Purpose: To describe the age- and gender-specific prevalence, characteristics, and severity of diabetic retinopathy (DR) in a rural population in northern China. Design: A population-based cross-sectional study. Participants: A total of 6830 Han Chinese aged 30 years and older from 13 villages of Yongnian County, Handan City, Hebei Province, China. Methods: All participants underwent a standardized interview, a comprehensive eye examination, and fasting blood glucose testing according to the American Diabetes Association diagnostic criteria (fasting plasma glucose ≥7.0 mmol/l). Retinal photographs obtained after pupil dilation were graded for the presence and severity of DR according to the modified Early Treatment Diabetic Retinopathy Study classification system. Main Outcome Measures: Any DR, retinopathy grades, macular edema, or vision-threatening retinopathy. Results: Of the 6830 eligible individuals participating in the study, 5597 (81.9%) had fasting blood glucose results available. Of these, 387 participants (6.9%) were diagnosed with diabetes mellitus, including 247 subjects with new diabetes mellitus (NDM) and 140 subjects with known diabetes mellitus (KDM). For these, gradable photographs were available for 368 subjects (95.1%). The overall prevalence of DR was 43.1% (95% confidence interval, 38.1–48.4) and was higher in persons with KDM (65.2%) than NDM (33.5%). The prevalence of proliferative DR, macular edema, and vision-threatening retinopathy was 1.6%, 5.2%, and 6.3%, respectively, with 12.1% with KDM having untreated vision-threatening DR. No age- or gender-related differences were present. The prevalence of DR was strongly related to duration of disease. Conclusions: Our study reports a high prevalence of DR among adults 30 years and older with diabetes in rural China. On the basis of estimates obtained from our study, we projected that in rural China, 21.1 million persons aged 30+ years have diabetes and 9.2 million have DR, including 1.3 million with vision-threatening DR. There is a pressing need for appropriate screening and management of diabetes and its complications in rural China. Financial Disclosure(s): The author(s) have no proprietary or commercial interest in any materials discussed in this article. [Copyright &y& Elsevier]

Purpose: To describe the rationale, design, methodology and baseline characteristics of the Handan Eye Study (HES), a population-based study to determine the prevalence and impact of visual impairment and major ocular diseases in Chinese adults living in a rural region north China. Methods: Population-based, cross-sectional study. 6830 Han people aged 30 years and older from 13 villages of Yongnian County, Handan city, Hebei province, China were recruited. The interviews covered demographic, behavioral, and ocular risk factors as well as health-related and vision-related quality of life. Ocular examination included measurement of visual acuity (VA), intraocular pressure, anterior and posterior segment examinations, visual field testing, and anterior segment, fundus and optic disc photography/imaging. Physical examination included measurement of height and weight, blood pressure, electrocardiogram, fasting blood glucose, lipid levels, urea nitrogen and creatinine as well as tests of physical function including walking speed. Results: Of the 7557 individuals eligible for the Handan Eye Study (HES), 6830 (90.4%) subjects participated the study. The majority of participants were female (53.6%), the average (± standard deviation) age was 52.3 (± 12.3) years, and 100% were self-identified Han people. In contrast to the non-participants, those who participated were more likely to be female, elderly, married, and had more years of education (P < 0.05). Conclusion: The HES successfully examined over 90% of eligible Han Chinese adults aged 30 and older from a rural region of north China. Results from the HES will provide key information about the prevalence, risk factors, impact, and trends of ocular disease in rural regions of China. [ABSTRACT FROM AUTHOR]