Diabetic retinopathy in adult diabetic patients in rural Guangxi, China: a multicentre cross-sectional study

Xiaomin Xian ¹ Jingfeng Chen ¹ Yanping Zhang ^1* Guifen Fu ^2* Ziqiang Li ¹ Wang Miao ³ Qiuping Zheng ¹ Xiaoxue Lei ¹ Chaoqun Bai ¹

• ¹ Department of Geriatric Endocrinology and Metabolism, People's Hospital of Guangxi Zhuang Autonomous Region, Nanning, Guangxi Zhuang Region, China
• ² Department of Nursing, People's Hospital of Guangxi Zhuang Autonomous Region, Nanning, Guangxi Zhuang Region, China
• ³ Department of Otorhinolaryngology, People's Hospital of Guangxi Zhuang Autonomous Region, Nanning, Guangxi Zhuang Region, China

Objective: This study sought to ascertain the prevalence of retinopathy in diabetic patients in rural Guangxi, China, and to discover the influencing factors. Our findings offer pragmatic insights for enhancing diabetes management in remote communities. Method: Between January 2022 and July 2022, a multi-stage stratified sampling method was employed to select the study subjects. In the first stage, five cities, namely Nanning, Guilin, Hechi, Chongzuo, and Yulin, were randomly selected based on the geographical regions of the Guangxi Zhuang Autonomous Region (central, eastern, southern, western, and northern). In the second stage, three counties were randomly chosen within each of the selected cities, resulting in a total of 15 counties for the survey. In each eachcounty, one internal medicine department from a local hospital was selected for the investigation. A total of 152 individuals were resurveyed in each hospital, resulting in 2280 patients being beingsurveyed in total. We gathered extensive baseline data from all participants, encompassing age, gender, diabetes duration, education level, marital status, annual per capita disposable household income, smoking and drinking behaviors, family history of diabetes, utilization of oral hypoglycemic agents and insulin therapy, along with total scores for diabetes knowledge and social support evaluations. We measured levels of glycated hemoglobin (HbA1c, %), creatinine, uric acid, total cholesterol, triglycerides, high-density lipoprotein (HDL), and low-density lipoprotein (LDL) in the lab. Then, we used multivariate logistic regression analysis to find out how common diabetic retinopathy was among the participants and what risk factors were associated with it. Result: The study included 2,178 diabetes patients, consisting of 1,204 males (55.28%) and 974 females (44.72%), with a mean age of 63.25±12.71 years. Our findings indicated a 22.35% prevalence of diabetic retinopathy among rural diabetes patients in Guangxi. Multivariate logistic regression analysis revealed that advanced age (OR=1.015, 95% CI: 1.001-1.029, P=0.042), increased hemoglobin A1c levels (OR=4.004, 95% CI: 3.435-4.666, P<0.001), and elevated triglyceride levels (OR=1.493, 95% CI: 1.267-1.758, P<0.001) were significantly correlated with the onset of diabetic retinopathy in patients with diabetes. Conclusion: Our research reveals a 22.35% prevalence of diabetic retinopathy among rural diabetes patients in Guangxi.