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Prevalence and associated factors for pterygium in a Chinese rural population with type 2 diabetes in a cross-sectional study: Jiangsu Diabetic Eye Disease Study (JDEDS)

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Abstract

Purpose

To investigate the pterygium prevalence and evaluate risk factors of pterygium in rural type 2 diabetic (D2M) patients aged 50 years and above in Funing Country, Jiangsu Province, China.

Methods

A cross-sectional ophthalmic survey was conducted in type 2 diabetes mellitus (D2M) patients aged ≥ 50 years in Funing County, Jiangsu Province, China, which was named Jiangsu Diabetic Eye Disease Study (JDEDS). All participants underwent a comprehensive questionnaire and ocular examination. Pterygium was diagnosed by slit lamp examination. The risk factors associated with pterygium were evaluated with logistic regression models.

Results

The prevalence of pterygium was 22.37% (n = 427) and 95% confidence interval (CI) (20.50–24.24%) in D2M patients aged 50 years and above in JDEDS. The prevalence of pterygium was 18.32% (95% CI 15.33–21.32%) in men and 24.43% (95% CI 22.06–26.80%) in women. Women had a higher prevalence than men (p = 0.001). Multivariate analysis showed, for male participants with D2M, pterygium was independently associated with increasing age [70–79 years: OR and 95% CI 2.49(1.20–5.18), p = 0.014; ≥ 80 years: 4.84(2.04–11.47), p < 0.001], while cigarette smoking was the protective factors, especially in current smoker [OR and 95% CI 0.79(0.67–0.92); p = 0.003]. For female participants with D2M, age [60–69 years OR and 95% CI 1.68(1.07–2.62), p = 0.023; 70–79 years: 2.62(1.69–4.06), p < 0.001; ≥ 80 years:3.24(1.70–5.90), p < 0.001], hypertension [OR and 95% CI 1.40(1.05–1.87), p = 0.024], BMI 24–27.9 [OR and 95% CI 1.20(1.00–1.44), p = 0.047], higher HbA1c [(5.6–7.9) % OR and 95% CI 1.42(1.10–1.82), p = 0.006; (8.0–9.9) %: 1.32(1.10–1.58), p = 0.003] were risk factors.

Conclusions

D2M patients aged over 50 years has a high prevalence of pterygium in JDEDS. The pterygium prevalence is higher in female D2M participants. Diabetes and related factors may be risk factors of pterygium in female D2M patients. Further studies are needed to explore the gender difference in the pathogenesis of pterygium in D2M subjects.

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Acknowledgements

We thank the participants of this study. We also thank faculties of Funing Country Center for Chronic Disease Control and Prevention for continuous support, assistance and cooperation.

Funding

The study was supported by grants from the Science and Technology Project of Nantong Municipality, Jiangsu Province, China (JC2019078, MS12019030).

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Author notes

  1. Junfang Zhang and Bai Qin contributed equally to this work.

Authors and Affiliations

  1. Department of Ophthalmology, Affiliated Hospital of Nantong University, Nantong, 226001, China

    Junfang Zhang, Bai Qin, Shiyi Wang, Mei Yang & Rongrong Zhu

  2. Funing Shizhuang Eye Hospital, Yancheng, 224000, China

    Bihong Liu & Dajun Sun

  3. Funing County Center for Disease Prevention and Control, Yancheng, 224000, China

    Congkai Liang

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  1. Junfang Zhang
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Contributions

ZJF and QB contributed equally to the paper. ZJF, QB and YM performed the statistical analysis and drafted the manuscript. ZRR conceived, designed and supervised the study. ZJF, QB, WSY, LBH, SDJ, LCK AND SYQ conducted the epidemiological survey. All authors contributed to acquisition, analysis or interpretation of data. All authors revised the report and approved the final version before submission.

Corresponding author

Correspondence to Rongrong Zhu.

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The authors report no conflicts of interest. The authors alone are responsible for the content and writing of the paper.

Ethics approval

The study was conducted in accordance with the tenets of the Declaration of Helsinki and approved by the Ethics Committee of Affiliated Hospital of Nantong University (No.2014–071). All participants signed the informed consent forms after fully informed of the purpose and procedures.

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Zhang, J., Qin, B., Liu, B. et al. Prevalence and associated factors for pterygium in a Chinese rural population with type 2 diabetes in a cross-sectional study: Jiangsu Diabetic Eye Disease Study (JDEDS). Int Ophthalmol 43, 411–422 (2023). https://doi.org/10.1007/s10792-022-02438-8

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