Aims: To investigate if the gender is a risk factor of the prevalence of diabetic retinopathy (DR) among type 2 diabetic patients, we designed and performed a cross-sectional study in twelve provinces in the mainland of China.

Methods: Patients with type 2 diabetes, age of 18 years or older, were recruited from 76 cities/counties of 12 provinces in the mainland of China, during January 2015 to December 2018. All participants received a standard interview, eye examinations and digital fundus photography. The presence and severity of DR were diagnosed and graded by retinal specialists according to the DR domestic typing method.

Results: A total of 12,766 eligible participants (5963 males and 6803 females) were included in this study. The overall prevalence of DR was 30.1%. Females exhibited a significantly higher prevalence of DR than males (31.1%% vs. 29.0%, P=0.011). A multivariate logistic regression analysis confirmed that the female sex was an independent predictor for higher prevalence of DR after adjusting for age, duration of diabetes, economic status and presence of hypertension (OR: 1.096, 95% CI: 1.013-1.186, P=0.023). Even after stratification by diabetic duration, age and economic status, the female sex was still independently associated with the presence of DR in patients whose T2DM history was more than 10 years (OR 1.150, 95% CI:1.012-1.306, P=0.032), whose ages were over 60 years (OR 1.141,95% CI:1.031-1.262, P=0.010) or who were in a relatively intermediate economic area (OR 1.123, 95% CI: 1.001-1.259, P=0.048).

Conclusion: Chinese T2DM females had a higher prevalence of DR than T2DM males. In addition, the female sex remains as an independent predictor for DR in patients with diabetes for more than 10 years, ages over 60 years or a relatively intermediate economic status.


M. Li: None. P. Mu: None. Y. Tan: None. Y. Chen: None.


Research and Development Plans in Key Areas of Guangdong Province (2019B020227003); National Natural Science Foundation of China (81770826); National Key Research and Development Program of China (2017YFA0105803)

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