title: Retinopathy in persons without diabetes: the Handan Eye Study.
abstract: OBJECTIVE
  To describe the prevalence and associations of retinopathy in a population-based nondiabetic sample of rural Chinese.
  
  
  METHODS
  Population-based cross-sectional study.
  
  
  METHODS
  We included 6830 Han Chinese aged > or =30 years from 13 villages of Yongnian County, Handan City, Hebei Province, China.
  
  
  METHODS
  All participants underwent a standardized interview and extensive examinations including retinal photography, measurement of blood pressure (BP) and fasting plasma glucose (FPG). Diabetes mellitus was defined as either FPG > or = 7.0 mmol/l, use of diabetic medication or a physician diagnosis of diabetes. Photographic grading of retinopathy followed the modified Early Treatment Diabetic Retinopathy Study classification system. Logistic regression models were used to assess associations of retinopathy.
  
  
  METHODS
  Any retinopathy.
  
  
  RESULTS
  The prevalence of retinopathy among participants without diabetes was 13.6% (95% confidence interval [CI], 12.6-14.6%). The age and gender standardized prevalence of retinopathy in the Chinese adult population (aged 30+ years) without diabetes was estimated to be 12.1% (95% CI 11.1-12.9%). Independent risk factors associated with retinopathy were age (odds ratio [OR], 1.02 ; 95% CI 1.01-1.03 per year increase), male gender (male vs. female, OR 1.27; 95% CI 1.08-1.49), higher FPG (OR 1.30; 95% CI 1.11-1.53 per mmol/l increase), higher systolic BP (OR 1.15; 95% CI 1.05-1.27 per 10 mmHg increase) and higher diastolic BP (OR 1.16; 95% CI 1.09-1.22 per 10 mmHg increase).
  
  
  CONCLUSIONS
  Retinopathy was common among rural Chinese adults without diabetes. Its association with FPG and BP suggests that early microvascular damage is occurring at "high normal" levels of blood glucose and BP.
authors.affiliation: Beijing Tongren Eye Center, Beijing Tongren Hospital, Capital Medical University and Beijing Ophthalmology & Visual Science Key Lab, Beijing, China.
authors.forename: Xiao Yan
authors.initials: XY
authors.lastname: Peng
authors.forename: Feng Hua
authors.initials: FH
authors.lastname: Wang
authors.forename: Yuan Bo
authors.initials: YB
authors.lastname: Liang
authors.forename: Jie Jin
authors.initials: JJ
authors.lastname: Wang
authors.forename: Lan Ping
authors.initials: LP
authors.lastname: Sun
authors.forename: Yi
authors.initials: Y
authors.lastname: Peng
authors.forename: David S
authors.initials: DS
authors.lastname: Friedman
authors.forename: Gerald
authors.initials: G
authors.lastname: Liew
authors.forename: Ning Li
authors.initials: NL
authors.lastname: Wang
authors.forename: Tien Yin
authors.initials: TY
authors.lastname: Wong
mesh_terms: D000328:Adult; D000368:Aged; D001786:Blood Glucose / Q000032:analysis; D001794:Blood Pressure; D002681:China / Q000453:epidemiology; D003430:Cross-Sectional Studies; D003920:Diabetes Mellitus / Q000453:epidemiology; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010781:Photography; D015995:Prevalence; D012164:Retinal Diseases / Q000453:epidemiology*; D012307:Risk Factors; D012424:Rural Population / Q000706:statistics & numerical data*
chemical_list: D001786:Blood Glucose