title: Retinopathy and mortality. The Beijing Eye Study.
abstract: BACKGROUND
  To assess the association between a retinopathy as defined by the Early Treatment of Diabetic Retinopathy Study (ETDRS) criteria, and mortality in a population-based setting.
  
  
  METHODS
  At baseline in 2001, the Beijing Eye Study examined 4,391 subjects for retinopathy lesions, with a detected frequency of 285/4391 (6.5%) subjects. Using fundus photographs, the retinopathy was graded according to the Early Treatment of Diabetic Retinopathy Study (ETDRS) criteria. The mean age was 56.05 +/- 10.51 years (range, 40-101 years). In 2006, all study participants were re-invited for a follow-up examination.
  
  
  RESULTS
  Out of the 4,391 subjects, 3,224 subjects (73.4%) returned for follow-up examination, while 140 subjects (3.2%) were dead and 1,027 subjects (23.4%) did not agree to be re-examined or had moved away. Mortality rate was significantly higher (P = 0.002; odds ratio [OR]: 2.20; 95% confidence intervals [CI]: 1.32, 3.67) in the 285 subjects with retinopathy (18/285 or 6.3 +/- 1.4%; 95%CI: 3.6%, 9.0%) than in the 4,106 participants without retinopathy (122/4,106 or 3.0 +/- 0.3% 95%CI: 2.4%, 3.6%). In binary logistic regression analysis, mortality was significantly associated with age (P < 0.001; OR: 1.10; 95%CI: 1.08, 1.12), gender (P = 0.006; OR: 0.61; 95%CI: 0.43, 0.86), rural versus urban region (P < 0.001; OR: 5.65; 95%CI: 3.81, 8.40), and presence of retinopathy (P = 0.005; OR: 2.13; 95%CI: 1.25, 3.62).
  
  
  CONCLUSIONS
  In addition to higher age, male gender, and living in a rural region, a retinopathy as defined by ETDRS criteria is a risk factor for an increased mortality in adult Chinese.
authors.affiliation: Beijing Institute of Ophthalmology, Beijing Tongren Hospital, Capital Medical University, 17 Hougou Street, Chong Wen Men, 100005 Beijing, China. xuliang5918@yahoo.com.cn
authors.forename: Liang
authors.initials: L
authors.lastname: Xu
authors.forename: Ya Xing
authors.initials: YX
authors.lastname: Wang
authors.forename: Xi Wei
authors.initials: XW
authors.lastname: Xie
authors.forename: Jost B
authors.initials: JB
authors.lastname: Jonas
mesh_terms: D000328:Adult; D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D002423:Cause of Death; D002681:China / Q000453:epidemiology; D003930:Diabetic Retinopathy / Q000401:mortality*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D012307:Risk Factors; D012424:Rural Population / Q000706:statistics & numerical data; D012737:Sex Factors; D014505:Urban Population / Q000706:statistics & numerical data