Full Title: Association Between Blood Glucose-Related Indicators and Diabetic Retinopathy in Type 2 Diabetes: A Cross-Sectional Study

Full Title: Association Between Blood Glucose-Related Indicators and Diabetic Retinopathy in Type 2 Diabetes: A Cross-Sectional Study | Research Square window.SnipcartSettings = { analytics: { enabled: false } }; (function() { var accessVector = localStorage.getItem('access_vector') || ''; window.dataLayer = window.dataLayer || []; if (accessVector) { window.dataLayer.push({ user: { profile: { profileInfo: { snid: accessVector } } } }); } })(); (function(w,d,s,l,i){w[l]=w[l]||[];w[l].push({'gtm.start':new Date().getTime(),event:'gtm.js'});var f=d.getElementsByTagName(s)[0],j=d.createElement(s),dl=l!='dataLayer'?'&l='+l:'';j.async=true;j.src='https://www.googletagmanager.com/gtm.js?id='+i+dl;f.parentNode.insertBefore(j,f);})(window,document,'script','dataLayer','GTM-K279D39R'); Browse Preprints In Review Journals COVID-19 Preprints AJE Video Bytes Research Tools Research Promotion AJE Professional Editing AJE Rubriq About Preprint Platform In Review Editorial Policies Our Team Advisory Board Help Center Sign In Submit a Preprint Cite Share Download PDF Research Article Full Title: Association Between Blood Glucose-Related Indicators and Diabetic Retinopathy in Type 2 Diabetes: A Cross-Sectional Study Xiao Huang, Xuan Chen, Xiaomin Wu, Zhaohu Hao, Hailin Shao, Fei Ma This is a preprint; it has not been peer reviewed by a journal. https://doi.org/ 10.21203/rs.3.rs-8255216/v1 This work is licensed under a CC BY 4.0 License Status: Posted Version 1 posted You are reading this latest preprint version Abstract Objectives: To investigate the prevalence of diabetic retinopathy (DR) in patients with type 2 diabetes mellitus (T2DM) and to analyze the association between blood glucose-related indicators and the occurrence of DR. Methods: A cross-sectional study was conducted among hospital-based patients with T2DM. Participants were categorized into DR and non-diabetic retinopathy (NDR) groups based on fundus photography examinations. Data on demographic characteristics, lifestyle factors, and blood glucose-related indicators were collected. Univariate and multivariable logistic regression analyses were employed to examine the associations between these factors and DR in T2DM patients. Results: Among 5,498 patients with T2DM, 1,144 (20.81%) were diagnosed with DR. Univariate analysis revealed significant associations between DR and diagnosis age of T2DM, duration of T2DM, HbA1c, heart rate, smoking history, daily fruit consumption, and daily soy-products consumption (P<0.05). After adjusting for age, sex, and lifestyle factors, multivariable logistic regression demonstrated independent associations with DR for the following factors: diagnosis age of T2DM (OR: 0.543, 95%CI: 0.414-0.731), duration of T2DM (1-5 years: OR: 1.713, 95%CI: 1.416-2.073; 5-10 years: OR: 2.516, 95%CI: 2.012-3.145; ≥10 years: OR: 4.659, 95%CI: 3.748-5.790), HbA1c (OR: 1.111, 95%CI: 1.069-1.154), and heart rate (OR: 1.008, 95%CI: 1.003-1.014) (P<0.05). Conclusions: The prevalence of DR among T2DM patients was 20.81%, with non-proliferative diabetic retinopathy (NPDR) being the predominant type, accounting for 96.85% of cases. Elevated HbA1c levels, longer duration of T2DM, younger age at diagnosis of T2DM, and increased heart rate were identified as independent risk factors for DR. Diabetic retinopathy Risk factors Glycemic control Cross-sectional study Figures Figure 1 Figure 2 1. INTRODUCTION Type 2 diabetes mellitus (T2DM) is a chronic metabolic disorder caused by the interplay of genetic and environmental factors, accounting for over 90% of all diabetes cases 1 . Diabetic retinopathy (DR) represents one of the most frequent and severe microvascular complications associated with T2DM 2 . The growing prevalence of T2DM has led to a continuous rise in DR cases, considerably impairing patients’ quality of life 3 . In developed countries, DR is the primary cause of vision impairment among adults of working age 4 . DR is classified into two major forms: non-proliferative diabetic retinopathy (NPDR) and proliferative diabetic retinopathy (PDR). NPDR, which lacks retinal neovascularization, is further subdivided into mild, moderate, and severe stages. PDR, the most advanced stage, involves the growth of abnormal new blood vessels and, if not treated promptly, can result in vision loss or blindness 5 . Accumulating evidence indicates that clinical indicators related to blood glucose play a crucial role in the pathogenesis of DR. Both fasting blood glucose (FBG) and hemoglobin A1c (HbA1c) reflect glycemic control. Sustained hyperglycemia promotes the excessive formation of advanced glycation end products (AGEs), which bind to receptors on retinal cells, impair endothelial function, trigger inflammatory responses, and ultimately compromise retinal microvascular integrity 6-8 . Additionally, factors such as age at diabetes diagnosis, duration of diabetes, and hypertension are strongly correlated with the development and progression of DR. With increasing age and longer disease duration, the body’s self-repair mechanisms and vascular function progressively decline. Hypertension and other vascular comorbidities often coexist with diabetes, and their synergistic interaction with hyperglycemia promotes vascular endothelial growth factor (VEGF) overexpression and disrupts the blood-retinal barrier, thereby accelerating the progression of DR 9,10 . Various lifestyle factors influence DR progression through distinct pathways: high sugar and low fruit/vegetable intake elevate FBG/HbA1c and body mass index (BMI) to initiate DR, while high salt intake, smoking, excessive alcohol consumption, and poor sleep accelerate it by promoting vascular damage and inflammation; conversely, fish and soy intake preserve retinal microvessels via anti-inflammatory and vascular protective mechanisms 11,12 . Hence, these lifestyle factors were incorporated as confounding variables in the analysis of DR progression. In China, the vast population of 233 million people with diabetes presents a substantial clinical and socioeconomic burden, particularly due to the potential impact of DR 13 . There is an urgent need to strengthen preventive strategies, early detection, and innovative treatments. Current research on DR has largely focused on regional populations, while hospital-based studies remain relatively limited 14 . Hospital-based cohorts often provide data with high completeness, diagnostic accuracy, and phenotypic uniformity, which are advantageous for improved comparability in terms of disease severity and subtype stratification, thereby supporting more robust risk factor analyses. This cross-sectional study of hospital-based T2DM patients was designed to examine the associations between blood glucose-related indicators and the occurrence of DR. It aimed to determine the prevalence of DR in this population and to elucidate the relationship between key glucose-related indicators and DR. The findings are expected to contribute valuable evidence for early screening and prevention initiatives, assist in identifying high-risk groups, and establish a foundation for targeted clinical interventions. 2. METHODS 2.1 Study Participants Patients with T2DM were recruited from the Endocrinology Department of Tianjin 4th Central Hospital between October 2017 and April 2023. 2.1.1 Inclusion criteria: 1) Met the diagnostic criteria for T2DM. 2) Underwent DR examination and satisfied the diagnostic criteria for DR. 3) Age ≥ 18 years. 2.1.2 Exclusion criteria: 1) Active tuberculosis or other infectious diseases. 2) Coexisting ocular pathologies. 3) History of congenital or traumatic fundus disorders. 4) Refractive media opacities preventing clear fundus visualization. 5) Severe chronic conditions, including hepatobiliary, hematological, cardiopulmonary diseases, or malignancies. 6) Major trauma or perioperative stress. 2.1.3 T2DM diagnostic criteria T2DM was diagnosed according to the Guideline for the Prevention and Treatment of Type 2 Diabetes Mellitus in China (2020 edition) 15 , using FBG, 2-hour oral glucose tolerance test (OGTT), and HbA1c as key biomarkers. Patients with classic diabetes symptoms (polyuria, polydipsia, polyphagia, unexplained weight loss) and FBG≥7.0 mmol/L, OGTT 2-h glucose≥11.1 mmol/L, HbA1c≥6.5%, or random glucose≥11.1 mmol/L were diagnosed. For asymptomatic individuals, confirmation required repeat testing on a separate day. Type 1 diabetes, latent autoimmune diabetes in adults (LADA), and other specific types were excluded based on age of onset, body habitus, treatment response, islet function, and autoimmune antibodies (e.g., anti-GAD antibodies) 16,17 . 2.1.4 DR diagnostic criteria DR was diagnosed and graded according to the International Clinical Diabetic Retinopathy Disease Severity Scale (2019) 18 . Dilated fundus examination was performed to evaluate four retinal quadrants (superotemporal, inferotemporal, superonasal, inferonasal) surrounding the optic disc. Cases were classified as: NDR, NPDR (mild: microaneurysms only; moderate: additional non-proliferative features; severe: ≥20 intraretinal hemorrhages in all quadrants, venous beading in ≥2 quadrants, or prominent intraretinal microvascular abnormalities in ≥1 quadrant), or PDR (neovascularization, vitreous/preretinal hemorrhage). After T2DM confirmation, participants underwent DR screening using non-mydriatic fundus cameras, with at least two images captured per eye focusing on the macular and optic disc regions. Images were uploaded to a dedicated ophthalmologist platform for quality control and evaluated by three independent physicians. Discrepancies were resolved by a panel of five senior specialists. 2.1.5 Sample size estimation Based on a reported DR prevalence of 22.4% in the Chinese diabetic population 19 , the sample size was calculated using the formula: . With a two-sided α = 0.05 ( =1.96), margin of error d = 2.5%, and P = 0.224, a minimum of 4,352 participants was required. Accounting for potential invalid responses, the sample size was increased by 10%, yielding a final requirement of at least 5,223 participants. 2.2 Questionnaires in Study A self-designed questionnaire, titled Questionnaire on Blood Glucose-Related Indicators in Patients with Type 2 Diabetes Mellitus in Tianjin, was administered to collect demographic and lifestyle factors. Items included: 1) Basic Information: age, sex, age at T2DM diagnosis, disease duration, history of hypertension/coronary heart disease, family history of T2DM. 2) Smoking History 20 : defined per criteria as none, small amount (<20 cigarettes/day), or substantial amount (≥20 cigarettes/day); individuals smoking ≥1 cigarette daily for ≥1 year were considered smokers. 3) Alcohol consumption 21 : classified as none, small amount (≤20 g/day for men, ≤10 g/day for women) or substantial amount (>20 g/day for men or >10 g/day for women). 4) Dietary Patterns: daily vegetables/ fruit consumption (<200 g, 200-400 g, 400-600 g, ≥600 g); daily soy-products consumption (<100 g, 100-250 g, 250-400 g, 400-500 g, ≥500 g); daily salt intake (<4g, 4-6g, 6-8g, ≥8g); weekly fish consumption (≤1 time/week, ≥2 times/week with <100g/serving, ≥2 times/week with ≥100g/serving); weekly sugar-sweetened beverage intake (none, <250 ml, 250 -1000 ml, ≥1000 ml ). 5) Sleep and Rest: sleep quality (medication-dependent, poor, optimal); siesta habits, and nighttime bedtime (early sleeper or late sleeper if ≥23:30). Medical histories were cross-verified using self-reports and hospital records to ensure accuracy. 2.3 Physical E xamination The following assessments were performed: 1) Blood pressure: measured using an Omron HBP-1300 sphygmomanometer by trained nurses. Three measurements were taken from each arm at 5-minute intervals in a resting state, and the average value was recorded. 2) Heart rate: assessed by stethoscope for 1 minute at rest; repeated three times, with the mean value used. 3) BMI: calculated as weight (kg)/height² (m²). Categories followed Chinese criteria: <18.5 (underweight), 18.5-24.0 (normal), 24.0-28.0 (overweight), ≥28.0 (obese) 22 . 2.4 Laboratory Examinations Standardized protocols were employed: 1) FBG: Measured using the glucose oxidase method. Venous blood samples were collected after ≥8 hours of fasting and analyzed within 24 hours. 2) HbA1c : Quantified via high-performance liquid chromatography (HPLC). All assays were performed in an accredited clinical laboratory under strict quality control. 2.5 Statistical Methods Data were analyzed using SPSS version 27.0. Continuous variables are presented as mean ± SD ( ±s) if normally distributed; categorical variables are reported as frequencies (n, %). Group comparisons utilized independent t-tests or χ² tests, as appropriate. Multicollinearity was assessed using tolerance and variance inflation factor (VIF). Multivariable logistic regression was used to analyze associations between blood glucose-related indicators and DR risk . A two-sided P<0.05 was considered statistically significant. 3. RESULTS 3.1 Basic Information of DR in T2DM A total of 6,855 patients with T2DM initially underwent fundus examination for DR screening and provided informed consent. After applying inclusion and exclusion criteria, 5,498 participants were included in the final analysis (Insert Fig. 1 about here). Based on standardized grading criteria, DR was identified in 1,144 patients (20.81%), among whom 1,108 (20.15%) were classified as NPDR and 36 (0.65%) as PDR (Insert Fig. 2 about here). The study population had a mean age of 55.67 ± 10.75 years, comprising 3,256 males (59.22%) and 2,242 females (40.78%). Univariate analysis revealed that several lifestyle factors were significantly associated with the presence of DR. Specifically, smoking history, daily fruit consumption, and daily soy-products consumption showed statistically significant correlations with DR (P<0.05). No statistically significant differences were observed in age, sex, alcohol consumption, daily vegetables consumption, daily salt intake, weekly fish consumption, weekly sugar-sweetened beverage intake, sleep quality, siesta habits, or nighttime bedtime between the DR and NDR groups (P>0.05) (Table 2). Table 2 Demographic distribution characteristics of DR in T2DM patients Variables Total population DR NDR χ² p- value Age(years) 1.774 0.183 ＜40 580(10.54) 133(11.63) 447(10.27) ≥40 4918(89.46) 1011(88.37) 3907(89.73) Sex 1.739 0.187 female 2242(40.78) 447(39.07) 1795(41.23) male 3256(59.22) 697(60.93) 2559(58.77) Smoking history 9.113 0.010 none 2948(53.62) 576(50.35) 2372(54.48) small amount 258(4.69) 68(5.94) 190(4.36) substantial amount 2292(41.69) 500(43.71) 1792(41.16) Alcohol consumption 4.974 0.083 none 3114(56.64) 615(53.76) 2499(57.40) small amount 1487(27.05) 327(28.58) 1160(26.64) substantial amount 897(16.31) 202(17.66) 695(15.96) Daily vegetables consumption (g) 1.839 0.606 <200 359(6.53) 75(6.56) 284(6.52) 200-400 2942(53.51) 628(54.90) 2314(53.15) 400-600 2097(38.14) 424(37.06) 1673(38.42) ≥600 100(1.82) 17(1.48) 83(1.91) Daily fruit consumption (g) 16.457 <0.001 <200 4397(79.66) 956(83.57) 3423(78.62) 200-400 942(17.13) 166(14.51) 776(17.82) 400-600 162(2.94) 21(1.84) 141(3.23) ≥600 15(0.27) 1(0.08) 14(0.33) Daily soy-products consumption (g) 10.839 0.028 <100 2451(44.58) 557(48.69) 1894(43.50) 100-250 1625(29.56) 324(28.32) 1301(29.88) 250-400 1214(22.08) 225(19.67) 989(22.71) 400-500 181(3.29) 33(2.88) 148(3.40) ≥500 27(0.49) 5(0.44) 22(0.51) Daily salt intake (g) 5.872 0.118 <4 83(1.51) 19(1.66) 64(1.47) 4-6 755(13.73) 181(15.82) 574(13.18) 6-8 2435(44.29) 487(42.57) 1948(44.74) ≥8 2225(40.47) 457(39.95) 1768(40.61) Weekly fish consumption 0.109 0.947 ≤1 times 4384(79.74) 914(79.90) 3470(79.70) ≥2 times/week with <100g/serving 211(3.84) 42(3.67) 169(3.88) ≥2 times/week with ≥100g/serving 903(16.42) 188(16.43) 715(16.42) Weekly sugar-sweetened beverage intake 1.361 0.715 none 4841(88.05) 1018(88.99) 3823(87.80) <250 ml 300(5.46) 58(5.07) 242(5.56) Continue table 2 250-1000 ml 155(2.82) 31(2.71) 124(2.85) ≥1000 ml 202(3.67) 37(3.23) 165(3.79) Sleep quality 1.375 0.503 medication-dependent 306(5.57) 62(5.42) 244(5.60) poor 1312(23.86) 288(25.17) 1024(23.52) optimal 3880(70.57) 794(69.41) 3086(70.88) Siesta habits 0.268 0.605 no 3183(57.89) 670(58.57) 2513(57.72) yes 2315(42.11) 474(41.43) 1841(42.28) Nighttime bedtime 0.507 0.476 early sleeper 4127(75.06) 868(75.87) 3259(74.85) late sleeper 1371(24.94) 276(24.13) 1095(25.15) Abbreviations: DR, Diabetic retinopathy; T2DM, Type 2 diabetes mellitus; NDR, Non-diabetic retinopathy. Note: Categorical variables are presented as n (%). 3.2 Univariate Analysis of Blood Glucose-related Indicators Associated with DR in T2DM Patients Significant differences were observed between the DR and NDR groups regarding clinical characteristics: age at diagnosis of T2DM, duration of T2DM, HbA1c levels, and heart rate were all significantly associated with DR (P0.05) (Table 3). Table 3 Associations of blood glucose-related indicators with DR in T2DM patients Variables Total population DR NDR χ²/t p-value Diagnosis age of T2DM (years) 55.580 <0.001 <40 846(15.39) 257(22.47) 589(13.52) ≥40 4652(84.61) 887(77.53) 3765(86.48) Duration of T2DM (years) 312.299 <0.001 <1 3708(67.44) 566(49.48) 3142(72.12) 1-5 813(14.79) 193(16.87) 620(14.24) 5-10 464(8.44) 146(12.76) 318(7.30) Continue table 3 ≥10 513(9.33) 239(20.89) 274(6.34) History of hypertension 0.035 0.851 no 2548(46.34) 533(46.59) 2015(46.28) yes 2950(53.66) 611(53.41) 2339(53.72) History of coronary heart disease 1.474 0.225 no 4583(83.36) 940(82.17) 3643(83.67) yes 915(16.64) 204(17.83) 711(16.33) F amily history of T2DM 1.106 0.293 no 2416(43.94) 487(42.57) 1929(44.30) yes 3082(56.06) 657(57.43) 2425(55.70) FBG (mmol/L) 9.13±2.68 9.15±2.81 9.12±2.64 -0.324 0.746 HbA1c (%) 8.94±1.88 9.10±1.84 8.90±1.89 -3.246 0.001 BMI (kg/m 2 ) 5.448 0.142 <18.5 17(0.31) 4(0.35) 13(0.30) 18.5-24.0 976(17.75) 229(20.02) 747(17.16) 24.0-28.0 2389(43.45) 490(42.83) 1899(43.62) ≥28 2116(38.49) 421(36.80) 1695(38.92) Heart rate (beats per minute) 83.40±12.15 84.23±12.32 83.19±12.10 -2.577 0.010 Abbreviations: DR, Diabetic retinopathy; T2DM, Type 2 diabetes mellitus; NDR, Non-diabetic retinopathy; FBG, Fasting blood glucose; HbA1c, Hemoglobin A1c; BMI, Body mass index. Note: Categorical variables are presented as n (%); Continuous variables are presented as mean ± SD (X̅ ± S). 3.3 Multivariable Logistic Regression A nalysis of the A ssociation B etween Blood G lucose-related I ndicators and DR in T2DM patients Multivariable logistic regression was performed to evaluate the association between blood glucose-related indicators and DR, after including relevant variables in the model. Tolerance values ranged from 0.343 to 0.988, and VIF values ranged from 1.047 to 2.917, indicating the absence of significant multicollinearity among the included risk factors. After adjusting for age, sex, and lifestyle factors, the results showed that the diagnosis age of T2DM (OR: 0.543, 95%CI: 0.414-0.731), duration of T2DM (1-5 years: OR: 1.713, 95%CI: 1.416-2.073; 5-10 years: OR: 2.516, 95%CI: 2.012-3.145; ≥ 10 years: OR: 4.659, 95%CI: 3.748-5.790), HbA1c (OR: 1.111, 95%CI: 1.069-1.154) and heart rate (OR: 1.008, 95%CI: 1.003-1.014) were significantly associated with the occurrence of DR in T2DM (P<0.05) (Table 4). Table 4 Multivariable analysis of the association between blood glucose-related indicators and DR in T2DM patients Variables Model 1 Model 2 Model 2 OR 95%CI p-value OR 95%CI p-value OR 95%CI p-value FBG (mmol/L) 1.000 0.975-1.025 0.977 0.999 0.974-1.024 0.922 0.997 0.972-1.023 0.840 Diagnosis age of T2DM (years) 0.619 0.576-0.828 <0.001 0.550 0.421-0.720 <0.001 0.543 0.414-0.713 <0.001 Duration of T2DM (years) <1 <0.001 <0.001 <0.001 1-5 1.787 1.480-2.157 <0.001 1.777 1.471-2.145 <0.001 1.713 1.416-2.073 <0.001 5-10 2.616 2.101-3.256 <0.001 2.535 2.032-3.163 <0.001 2.516 2.012-3.145 <0.001 ≥10 5.071 4.118-6.245 <0.001 4.771 3.847-5.917 <0.001 4.659 3.748-5.790 <0.001 History of hypertension 1.042 0.904-1.202 0.567 1.031 0.894-1.189 0.672 1.029 0.891-1.188 0.696 History of coronary heart disease 1.022 0.848-1.232 0.818 1.017 0.843-1.225 0.863 1.004 0.831-1.213 0.966 Family history of T2DM 0.998 0.871-1.145 0.982 1.001 0.871-1.149 0.985 1.006 0.876-1.154 0.937 HbA1c (%) 1.100 1.060-1.142 <0.001 1.103 1.062-1.145 <0.001 1.111 1.069-1.154 <0.001 BMI (kg/m 2 ) <18.5 0.942 0.949 0.962 18.5-24.0 1.103 0.344-3.540 0.869 1.107 0.346-3.543 0.864 1.067 0.332-3.428 0.913 24.0-28.0 1.045 0.327-3.339 0.941 1.046 0.328-3.336 0.939 1.019 0.319-3.261 0.975 ≥28.0 1.042 0.325-3.337 0.945 1.058 0.331-3.380 0.925 1.051 0.328-3.372 0.933 Heart rate (beats per minute) 1.008 1.002-1.014 0.005 1.009 1.003-1.014 0.003 1.008 1.003-1.014 0.004 Abbreviations: OR, Odds ratio; T2DM, Type 2 diabetes mellitus; FBG, Fasting blood glucose; HbA1c, Hemoglobin A1c; BMI, Body mass index. Note: Model 1 variables were unadjusted. Model 2 was adjusted for sex and age. Model 3 further adjusted for lifestyle factors based on Model 2. 4. DISCUSSION This study revealed an overall DR prevalence of 20.81% among patients with T2DM. Furthermore, significant associations were identified between the occurrence of DR and elevated HbA1c, younger age at diagnosis of T2DM, longer duration of T2DM, and increased heart rate. 4.1 DR P revalence in T2DM: R egional and H ospital-based Comparison The prevalence of DR among hospital-based T2DM patients in Tianjin was 20.81%, which is lower than the pooled prevalence of 22.4% (95%CI: 18.8%-26.1%) reported in a meta-analysis of Chinese diabetic populations by Deng et al. 19 . This rate is also notably lower than those reported in single-center studies from regions such as Heilongjiang (34.5%) 23 and Dongguan (28.3%) 24 . The relatively lower prevalence in Tianjin may be attributable to more effective diabetes management strategies, including sustained glycemic control and systematic complication monitoring. Although the overall DR prevalence in northern China was reported as 27.7% 19 , the rate in Tianjin was 6.89 percentage points lower. Of particular note, the substantial discrepancy between community-based populations (1.7%) 19 and hospital-based patients (20.81%) underscores that hospitalized T2DM patients represent a higher-risk group, necessitating targeted DR screening efforts. 4.2 Association of Elevated HbA1c and Longer D uratio n of DM in T2DM This study found that elevated HbA1c (OR: 1.111, 95%CI: 1.069-1.154, P<0.001) and longer duration of T2DM (≥10 years: OR: 4.659, 95%CI: 3.748-5.790, P<0.001) were significant risk factors for DR, consistent with other cross-sectional studies 25,26 . Chronic hyperglycemia is a well-established major contributor to the development and progression of DR. Previous evidence indicates that each 1% reduction in HbA1c is associated with a 22% decrease in the risk of DR 27 , highlighting the crucial importance of glycemic control in DR prevention and management. Additionally, 67.44% of the participants in this study had a disease duration of less than one year. Generally, a longer duration of diabetes is associated with a higher prevalence of DR. Studies have reported that the prevalence of DR among patients with long-standing diabetes is twice that of newly diagnosed cases 28 . Zhang et al. demonstrated that each additional year of diabetes duration increases the risk of retinopathy by approximately 9% 29 , attributable to cumulative retinal vascular damage and neovascularization 30 . Similarly, Yin et al. confirmed a significant association between longer diabetes duration and DR 26 . Prolonged exposure to hyperglycemia, hypertension, and dyslipidemia over the disease course exacerbates microvascular damage, facilitating the onset and progression of DR. These findings reinforce the recommendation for annual fundus screening in patients with diagnosed diabetes. Individuals with persistently elevated HbA1c should be promptly referred to ophthalmologists. 4.3 Association Between Age at Diagnosis of T2DM and DR After adjusting for sex and lifestyle factors, this study demonstrated a significant inverse association between age at diabetes diagnosis and the risk of DR (OR:0.543, 95%CI: 0.414-0.713, P<0.001), indicating that later diagnosis may serve as a protective factor against DR in T2DM. Patients with early-onset T2DM face a higher risk of developing DR compared to those with late-onset T2DM, a finding consistent with multiple cohort studies. For example, Huo et al. 31 reported that early-onset T2DM patients (diagnosed before age 40) had a 2.3-fold higher risk of microvascular complications than late-onset patients. Klein et al. 32 and Raman et al. 33 also observed a significantly higher prevalence of DR among early-onset diabetes patients. The elevated DR risk in early-onset diabetes may be explained by the cumulative burden of prolonged disease duration. Younger patients often exhibit more severe insulin resistance and β-cell dysfunction, leading to greater glycemic variability 34 . Animal studies suggest that early uncontrolled hyperglycemia may induce a "metabolic memory" effect through epigenetic modifications in retinal cells, resulting in sustained suppression of protective gene expression and accelerated microvascular damage, even after subsequent glycemic control 35 . Therefore, clinicians should implement intensive glycemic management for patients diagnosed with diabetes before age 40, aiming for an HbA1c target below 7% (or ≤6.5% in those without hypoglycemia risk). Quarterly HbA1c testing combined with continuous glucose monitoring is recommended to evaluate glycemic variability. Additionally, these patients should undergo a comprehensive dilated fundus examination with optical coherence tomography (OCT) at initial diagnosis, followed by personalized screening schedules based on retinopathy severity. 4.4 Association of Increased Heart Rate with DR in T2DM I ncreased heart rate was significantly associated with DR in T2DM (OR:1.008, 95%CI: 1.003-1.014, P=0.004). Diabetes often involves autonomic dysfunction 36 , characterized by sympathetic overactivity and impaired parasympathetic function. This imbalance can lead to increased heart rate, microcirculatory hypoperfusion, vascular endothelial dysfunction, and elevated inflammatory and oxidative stress levels, all of which may contribute to retinal microvascular injury and DR progression. Clinically, resting heart rate should be incorporated as a routine monitoring parameter in T2DM management. For patients with diabetes duration exceeding five years, annual heart rate variability (HRV) assessment is recommended. 4.5 Limitations of Study: As a single-center study, the sample may not be fully representative of the broader hospital-based population, limiting the generalizability of the results. Moreover, the cross-sectional design precludes causal inference. Future multicenter longitudinal studies are needed to validate the observed associations and elucidate the underlying mechanisms linking these factors to DR incidence in T2DM. Finally, the assessment of lifestyle factors (e.g., diet, smoking) relied on self-report, which is subject to recall and social desirability bias. 5. CONCLUSIONS A total of 5498 patients with T2DM were enrolled in this study, and the overall prevalence of T2DM complicated with DR was found to be approximately 20.81%. Multivariate analysis indicated that poor glycemic control, prolonged disease duration, early-onset diabetes mellitus, and elevated heart rate were all significantly associated with an increased risk of DR in T2DM patients. Abbreviations Table 1 List of abbreviations Full spelling Abbreviation Diabetic retinopathy DR Non-diabetic retinopathy NDR Type 2 diabetes mellitus T2DM Fasting blood glucose FBG Hemoglobin A1c HbA1c Body mass index. BMI Odds ratio OR Declarations 6.1 Ethics Approval and Consent to Participate This study was conducted in accordance with the principles of the Declaration of Helsinki and was approved by the Tianjin Fourth Central Hospital Ethics Committee (Approval No. 2017-SZXLL020). All participants provided written informed consent. 6.2 Consent for P ublication Not applicable. 6.3 Availability of Data and Materials The datasets used and analyzed during the current study are available from the corresponding author on reasonable request. 6.4 Competing Interests The authors declare that they have no competing interests relevant to the content of this article. 6.5 Funding This work was supported by the General Program of the National Natural Science Foundation of China [grant numbers 82373573]; Tianjin Municipal Science and Technology Program [project numbers 24KPHDRC00330]; Tianjin Health Research Project [project numbers TJWJ2023MS019]; Tianjin Key Medical Discipline Construction Project [project numbers TJYXZDXK-3-007B]. 6.6 Authors' Contributions Xiao Huang: Data curation, Formal analysis, Methodology, Validation, Writing-original draft, Writing - review & editing. Xuan Chen: Data curation, Formal analysis, Visualization, Writing-original draft, Writing - review & editing. Xiaomin Wu: Data curation, Formal analysis, Validation. Zhaohu Hao: Methodology, Resources. Hailin Shao: Funding acquisition, Resources, Project administration, Writing - review & editing. Fei Ma: Conceptualization, Funding acquisition, Resources, Validation, Writing-review & editing. Xiao Huang and Xuan Chen contributed equally and should be considered joint first authors. All authors have read and approved the final version of the manuscript. Each author agrees to be accountable for all aspects of the work, ensuring that any questions regarding the accuracy or integrity of any part of the work are properly investigated and resolved. 6.7 A cknowledgements The authors sincerely thank the nurses, physicians, and all participants for their cooperation and involvement in this study. References Salunkhe VA, Veluthakal R, Kahn SE, et al. 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Modifiable lifestyle, mental health status and diabetic retinopathy in U.S. adults aged 18-64 years with diabetes: a population-based cross-sectional study from NHANES 1999-2018. BMC Public Health 2024;24(1):11. doi:10.1186/s12889-023-17512-8 Simó R, Hernández C. What else can we do to prevent diabetic retinopathy? Diabetologia 2023;66(9):1614-1621. doi:10.1007/s00125-023-05940-5 Zhou YC, Liu JM, Zhao ZP, et al. The national and provincial prevalence and non-fatal burdens of diabetes in China from 2005 to 2023 with projections of prevalence to 2050. Mil Med Res 2025;12(1):28. doi:10.1186/s40779-025-00615-1 Yau JW, Rogers SL, Kawasaki R, et al. Global prevalence and major risk factors of diabetic retinopathy. Diabetes Care 2012;35(3):556-564. doi:10.2337/dc11-1909 Chinese Diabetes Society. Guideline for the prevention and treatment of type 2 diabetes mellitus in China (2020 edition). 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Int J Epidemiol 2020;49(1):113-130. doi:10.1093/ije/dyz078 Van der Heide FCT, Eussen S, Houben A, et al. Alcohol consumption and microvascular dysfunction: a J-shaped association: The Maastricht Study. Cardiovasc Diabetol 2023;22(1):67. doi:10.1186/s12933-023-01783-x Li MY, Luo YY, Zhang P, et al. Interpretation of national clinical practice guideline on obesity management (2024 edition). Zhonghua Yi Xue Za Zhi 2025;105(18):1387-1391. doi:10.3760/cma.j.cn112137-20250221-00414 Ma XF, Li M, Liu HL, et al. Prevalence and related factors of retinopathy in inpatients with type 2 diabetes mellitus in Heilongjiang province. Chin J Diabetes Mellitus 2022;14(12):1396-1403. doi:10.3760/cma.j.cn115791-20221017-00607 Chen SH, Zhang M, Meng QL, et al. Analysis of risk factors for diabetic retinopathy in inpatients with type 2 diabetes mellitus in Dongguan city. Chin J Exp Ophthalmol 2016;34(10):947-951. doi:10.3760/cma.j.issn.2095-0160.2016.10.018 Hasan MA, Islam SMR, Azad MAK. A hospital-based cohort study on risk factors for diabetic retinopathy among patients with type 2 diabetes mellitus. Informatics in Medicine Unlocked 2023;38:101219. doi:10.1016/j.imu.2023.101219 Yin L, Zhang D, Ren Q, et al. Prevalence and risk factors of diabetic retinopathy in diabetic patients: A community based cross-sectional study. Medicine 2020;99(9):e19236. doi:10.1097/MD.0000000000019236 Varma R, Macias GL, Torres M, et al. Biologic risk factors associated with diabetic retinopathy: the Los Angeles Latino Eye Study. Ophthalmology 2007;114(7):1332-1340. doi:10.1016/j.ophtha.2006.10.023 Rasoulinejad SA. Evaluating the risk factors of development and progression of diabetic retinopathy: A review study. Shiraz E-Medical Journal. 2022;23(5):e117171. doi:10.5812/semj.117171 Zhang G, Chen H, Chen W, et al. Prevalence and risk factors for diabetic retinopathy in China: a multi-hospital-based cross-sectional study. Br J Ophthalmol 2017;101(12):1591-1595. doi:10.1136/bjophthalmol-2017-310316 Zhang L, Chen B, Tang L. Metabolic memory: mechanisms and implications for diabetic retinopathy. Diabetes Res Clin Pract 2012;96(3):286-293. doi:10.1016/j.diabres.2011.12.006 Huo X, Zhang J, Guo X, et al. Gender Difference in the Association of Early- vs. Late-Onset Type 2 Diabetes with Non-Fatal Microvascular Disease in China: A Cross-sectional Study. Front Endocrinol (Lausanne) 2018;9:15. doi:10.3389/fendo.2018.00015 Klein R, Klein BE, Moss SE, et al. The Wisconsin epidemiologic study of diabetic retinopathy. II. Prevalence and risk of diabetic retinopathy when age at diagnosis is less than 30 years. Arch Ophthalmol 1984;102(4):520-526. doi:10.1001/archopht.1984.01040030398010 Raman R, Vaitheeswaran K, Vinita K, et al. Is prevalence of retinopathy related to the age of onset of diabetes? Sankara Nethralaya Diabetic Retinopathy Epidemiology and Molecular Genetic Report No. 5. Ophthalmic Res 2011;45(1):36-41. doi:10.1159/000314720 Cree-Green M, Triolo TM, Nadeau KJ. Etiology of insulin resistance in youth with type 2 diabetes. Curr Diab Rep 2013;13(1):81-88. doi:10.1007/s11892-012-0341-0 Engerman RL, Kern TS. Progression of incipient diabetic retinopathy during good glycemic control. Diabetes 1987;36(7):808-812. doi:10.2337/diab.36.7.808 Vinik AI, Maser RE, Mitchell BD, et al. Diabetic autonomic neuropathy. Diabetes Care 2003;26(5):1553-1579. doi:10.2337/diacare.26.5.1553 Additional Declarations No competing interests reported. Cite Share Download PDF Status: Posted Version 1 posted You are reading this latest preprint version Research Square lets you share your work early, gain feedback from the community, and start making changes to your manuscript prior to peer review in a journal. As a division of Research Square Company, we’re committed to making research communication faster, fairer, and more useful. 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Also discoverable on Platform About Our Team In Review Editorial Policies Advisory Board Help Center Resources Author Services Accessibility API Access RSS feed Manage Cookie Preferences © Research Square 2026 | ISSN 2693-5015 (online) Privacy Policy Terms of Service Do Not Sell My Personal Information {"props":{"pageProps":{"initialData":{"identity":"rs-8255216","acceptedTermsAndConditions":true,"allowDirectSubmit":true,"archivedVersions":[],"articleType":"Research Article","associatedPublications":[],"authors":[{"id":572449878,"identity":"4cbaaf2b-003b-45a6-8cfa-fcb516cb3054","order_by":0,"name":"Xiao Huang","email":"","orcid":"","institution":"NHC Key Lab of Hormones and Development and Tianjin Key Lab of Metabolic diseases, Tianjin Medical University Chu Hsien-I Memorial Hospital \u0026 Institute of 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08:11:01","extension":"png","order_by":6,"title":"","display":"","copyAsset":false,"role":"acdc-reference","size":187472,"visible":true,"origin":"","legend":"","description":"","filename":"OnlineFig.2.png","url":"https://assets-eu.researchsquare.com/files/rs-8255216/v1/fcc82cdb1dcbe09de44d6c59.png"},{"id":100023112,"identity":"a63a15e6-416b-41e9-b93b-df234db6f473","added_by":"auto","created_at":"2026-01-12 08:11:02","extension":"png","order_by":7,"title":"","display":"","copyAsset":false,"role":"acdc-reference","size":183686,"visible":true,"origin":"","legend":"","description":"","filename":"OnlineFig.1.png","url":"https://assets-eu.researchsquare.com/files/rs-8255216/v1/6711353f0b50869827160a77.png"},{"id":100363080,"identity":"2da538e5-1eb6-465f-88cd-29f5de967e15","added_by":"auto","created_at":"2026-01-16 07:48:44","extension":"png","order_by":1,"title":"Figure 1","display":"","copyAsset":false,"role":"figure","size":786571,"visible":true,"origin":"","legend":"\u003cp\u003eFlowchart of patients inclusion and exclusion\u003c/p\u003e","description":"","filename":"Fig.1.png","url":"https://assets-eu.researchsquare.com/files/rs-8255216/v1/416a0b613bc93a009f270b11.png"},{"id":100363092,"identity":"7c261522-870f-4243-ab41-943deeb0067b","added_by":"auto","created_at":"2026-01-16 07:48:50","extension":"png","order_by":2,"title":"Figure 2","display":"","copyAsset":false,"role":"figure","size":1113798,"visible":true,"origin":"","legend":"\u003cp\u003eThe proportion of DR and subtypes in T2DM patients\u003c/p\u003e","description":"","filename":"Fig.2.png","url":"https://assets-eu.researchsquare.com/files/rs-8255216/v1/9d010cb94f53b3bb67a2eec8.png"},{"id":109163700,"identity":"976c422d-d2c5-483a-8d6c-094b2a65203d","added_by":"auto","created_at":"2026-05-13 08:00:56","extension":"pdf","order_by":0,"title":"","display":"","copyAsset":false,"role":"manuscript-pdf","size":3076506,"visible":true,"origin":"","legend":"","description":"","filename":"manuscript.pdf","url":"https://assets-eu.researchsquare.com/files/rs-8255216/v1/92e934f0-1264-4859-ad51-18244df9d871.pdf"}],"financialInterests":"No competing interests reported.","formattedTitle":"Full Title: Association Between Blood Glucose-Related Indicators and Diabetic Retinopathy in Type 2 Diabetes: A Cross-Sectional Study","fulltext":[{"header":"1. INTRODUCTION","content":"\u003cp\u003eType 2 diabetes mellitus (T2DM) is a chronic metabolic disorder caused by the interplay of genetic and environmental factors, accounting for over 90% of all diabetes cases\u003csup\u003e1\u003c/sup\u003e.\u0026nbsp;Diabetic retinopathy (DR) represents one of the most frequent and severe microvascular complications associated with T2DM\u003csup\u003e2\u003c/sup\u003e.\u0026nbsp;The growing prevalence of T2DM has led to a continuous rise in DR cases, considerably impairing patients’ quality of life\u003csup\u003e3\u003c/sup\u003e.\u0026nbsp;In developed countries,\u0026nbsp;DR is the primary cause of vision impairment among adults of working age\u003csup\u003e4\u003c/sup\u003e.\u0026nbsp;DR is classified into two major forms: non-proliferative diabetic retinopathy (NPDR) and proliferative diabetic retinopathy (PDR). NPDR, which lacks retinal neovascularization, is further subdivided into mild, moderate, and severe stages. PDR, the most advanced stage, involves the growth of abnormal new blood vessels and, if not treated promptly, can result in vision loss or blindness\u003csup\u003e5\u003c/sup\u003e.\u0026nbsp;\u003c/p\u003e\n\u003cp\u003eAccumulating evidence indicates that clinical indicators related to blood glucose play a crucial role in the pathogenesis of DR. Both fasting blood glucose (FBG) and hemoglobin A1c (HbA1c) reflect glycemic control. Sustained hyperglycemia promotes the excessive formation of advanced glycation end products (AGEs), which bind to receptors on retinal cells, impair endothelial function, trigger inflammatory responses, and ultimately compromise retinal microvascular integrity\u003csup\u003e6-8\u003c/sup\u003e.\u0026nbsp;Additionally, factors such as age at diabetes diagnosis, duration of diabetes, and hypertension are strongly correlated with the development and progression of DR. With increasing age and longer disease duration, the body’s self-repair mechanisms and vascular function progressively decline. Hypertension and other vascular comorbidities often coexist with diabetes, and their synergistic interaction with hyperglycemia promotes vascular endothelial growth factor (VEGF) overexpression and disrupts the blood-retinal barrier, thereby accelerating the progression of DR\u003csup\u003e9,10\u003c/sup\u003e.\u0026nbsp;Various lifestyle factors influence DR progression through distinct pathways: high sugar and low fruit/vegetable intake elevate FBG/HbA1c and\u0026nbsp;body mass index (BMI)\u0026nbsp;to initiate DR, while high salt intake, smoking, excessive alcohol consumption, and poor sleep accelerate it by promoting vascular damage and inflammation; conversely, fish and soy intake\u0026nbsp;preserve\u0026nbsp;retinal microvessels via anti-inflammatory and vascular protective mechanisms\u003csup\u003e11,12\u003c/sup\u003e. Hence, these lifestyle factors were incorporated as confounding variables in the analysis of DR progression.\u003c/p\u003e\n\u003cp\u003eIn China, the vast population of 233 million people with diabetes presents a substantial clinical and socioeconomic burden, particularly due to the potential impact of DR\u003csup\u003e13\u003c/sup\u003e.\u0026nbsp;There is an urgent need to strengthen preventive strategies, early detection, and innovative treatments. Current research on DR has largely focused on regional populations, while hospital-based studies remain relatively limited\u003csup\u003e14\u003c/sup\u003e. Hospital-based cohorts often provide data with high completeness, diagnostic accuracy, and phenotypic uniformity, which are advantageous for improved comparability in terms of disease severity and subtype stratification, thereby supporting more robust risk factor analyses. This cross-sectional study of hospital-based T2DM patients was designed to examine the associations between blood glucose-related indicators and the occurrence of DR. It aimed to determine the prevalence of DR in this population and to elucidate the relationship between key glucose-related indicators and DR. The findings are expected to contribute valuable evidence for early screening and prevention initiatives, assist in identifying high-risk groups, and establish a foundation for targeted clinical interventions.\u003c/p\u003e"},{"header":"2. METHODS","content":"\u003ch2\u003e2.1\u0026nbsp;Study Participants\u003c/h2\u003e\n\u003cp\u003ePatients with T2DM were recruited from the Endocrinology Department of Tianjin 4th Central Hospital between October 2017 and April 2023.\u003c/p\u003e\n\u003ch2\u003e2.1.1\u0026nbsp;Inclusion criteria:\u0026nbsp;\u003c/h2\u003e\n\u003cp\u003e1)\u0026nbsp;Met the diagnostic criteria for T2DM. 2)\u0026nbsp;Underwent DR examination and satisfied the diagnostic criteria for DR. 3) Age \u0026ge; 18 years.\u0026nbsp;\u003c/p\u003e\n\u003ch2\u003e2.1.2\u0026nbsp;Exclusion criteria:\u0026nbsp;\u003c/h2\u003e\n\u003cp\u003e1)\u0026nbsp;Active tuberculosis or other infectious diseases.\u0026nbsp;2)\u0026nbsp;Coexisting ocular pathologies.\u0026nbsp;3)\u0026nbsp;History of congenital or traumatic fundus disorders.\u0026nbsp;4)\u0026nbsp;Refractive media opacities preventing clear fundus visualization.\u0026nbsp;5)\u0026nbsp;Severe chronic conditions, including hepatobiliary, hematological, cardiopulmonary diseases, or malignancies.\u0026nbsp;6)\u0026nbsp;Major trauma or perioperative stress.\u003c/p\u003e\n\u003ch3\u003e2.1.3\u0026nbsp;T2DM diagnostic criteria\u003c/h3\u003e\n\u003cp\u003eT2DM was diagnosed according to the Guideline for the Prevention and Treatment of Type 2 Diabetes Mellitus in China (2020 edition)\u003csup\u003e15\u003c/sup\u003e,\u0026nbsp;using FBG, 2-hour oral glucose tolerance test (OGTT), and HbA1c as key biomarkers. Patients with classic diabetes symptoms (polyuria, polydipsia, polyphagia, unexplained weight loss) and FBG\u0026ge;7.0 mmol/L, OGTT 2-h glucose\u0026ge;11.1 mmol/L, HbA1c\u0026ge;6.5%, or random glucose\u0026ge;11.1 mmol/L were diagnosed. For asymptomatic individuals, confirmation required repeat testing on a separate day. Type 1 diabetes, latent autoimmune diabetes in adults (LADA), and other specific types were excluded based on age of onset, body habitus, treatment response, islet function, and autoimmune antibodies (e.g., anti-GAD antibodies)\u003csup\u003e16,17\u003c/sup\u003e.\u003c/p\u003e\n\u003ch2\u003e2.1.4\u0026nbsp;DR\u0026nbsp;diagnostic criteria\u003c/h2\u003e\n\u003cp\u003eDR was diagnosed and graded according to the International Clinical Diabetic Retinopathy Disease Severity Scale (2019)\u003csup\u003e18\u003c/sup\u003e.\u0026nbsp;Dilated fundus examination was performed to evaluate four retinal quadrants (superotemporal, inferotemporal, superonasal, inferonasal) surrounding the optic disc. Cases were classified as: NDR, NPDR (mild: microaneurysms only; moderate: additional non-proliferative features; severe: \u0026ge;20 intraretinal hemorrhages in all quadrants, venous beading in \u0026ge;2 quadrants, or prominent intraretinal microvascular abnormalities in \u0026ge;1 quadrant), or PDR (neovascularization, vitreous/preretinal hemorrhage).\u003c/p\u003e\n\u003cp\u003eAfter T2DM confirmation, participants underwent DR screening using non-mydriatic fundus cameras, with at least two images captured per eye focusing on the macular and optic disc regions.\u0026nbsp;Images were uploaded to a dedicated ophthalmologist platform for quality control and evaluated by three independent physicians. Discrepancies were resolved by a panel of five senior specialists.\u003c/p\u003e\n\u003ch2\u003e2.1.5\u0026nbsp;Sample size estimation\u003c/h2\u003e\n\u003cp\u003eBased on a reported DR prevalence of 22.4% in the Chinese diabetic population\u003csup\u003e19\u003c/sup\u003e,\u0026nbsp;the sample size was calculated using the formula:\u0026nbsp;\u0026nbsp;\u003cimg src=\"data:image/png;base64,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\"\u003e. With a two-sided \u0026alpha; = 0.05 ( =1.96), margin of error d = 2.5%, and P = 0.224, a minimum of 4,352 participants was required. Accounting for potential invalid responses, the sample size was increased by 10%, yielding a final requirement of at least 5,223 participants. \u003c/p\u003e\n\u003ch2\u003e2.2\u0026nbsp;Questionnaires\u0026nbsp;in\u0026nbsp;Study\u0026nbsp;\u003c/h2\u003e\n\u003cp\u003eA self-designed questionnaire, titled Questionnaire on Blood Glucose-Related Indicators in Patients with Type 2 Diabetes Mellitus in Tianjin, was administered to collect demographic and lifestyle factors. Items included: 1) Basic Information: age, sex, age at T2DM diagnosis, disease duration, history of hypertension/coronary heart disease, family history of T2DM. 2) Smoking History\u003csup\u003e20\u003c/sup\u003e: defined per criteria\u0026nbsp;as\u0026nbsp;none,\u0026nbsp;small amount (\u0026lt;20 cigarettes/day),\u0026nbsp;or substantial amount (\u0026ge;20 cigarettes/day);\u0026nbsp;individuals smoking \u0026ge;1 cigarette daily for \u0026ge;1 year were considered smokers.\u0026nbsp;3) Alcohol consumption\u003csup\u003e21\u003c/sup\u003e:\u0026nbsp;classified as\u0026nbsp;none,\u0026nbsp;small amount (\u0026le;20 g/day for men,\u0026nbsp;\u0026le;10 g/day for\u0026nbsp;women)\u0026nbsp;or\u0026nbsp;substantial amount (\u0026gt;20 g/day for men\u0026nbsp;or \u0026gt;10 g/day for\u0026nbsp;women).\u0026nbsp;4) Dietary Patterns: daily vegetables/\u0026nbsp;fruit\u0026nbsp;consumption\u0026nbsp;(\u0026lt;200 g, 200-400 g, 400-600 g, \u0026ge;600 g); daily soy-products\u0026nbsp;consumption\u0026nbsp;(\u0026lt;100 g, 100-250 g, 250-400 g, 400-500 g, \u0026ge;500 g); daily\u0026nbsp;salt intake (\u0026lt;4g, 4-6g, 6-8g, \u0026ge;8g);\u0026nbsp;weekly fish consumption\u0026nbsp;(\u0026le;1 time/week, \u0026ge;2 times/week with \u0026lt;100g/serving, \u0026ge;2 times/week with \u0026ge;100g/serving);\u0026nbsp;weekly sugar-sweetened beverage intake\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003cstrong\u003e(none, \u0026lt;250 ml, 250\u003c/strong\u003e\u003cstrong\u003e-1000 ml,\u003c/strong\u003e\u003cstrong\u003e\u0026nbsp;\u0026ge;1000 ml\u003c/strong\u003e\u003cstrong\u003e).\u003c/strong\u003e 5) Sleep and Rest:\u0026nbsp;sleep quality\u0026nbsp;(medication-dependent, poor, optimal); siesta habits, and nighttime bedtime (early sleeper or late sleeper if\u0026nbsp;\u0026ge;23:30). Medical histories were cross-verified using self-reports and hospital records to ensure accuracy.\u003c/p\u003e\n\u003ch2\u003e\u003cstrong\u003e2.3\u0026nbsp;\u003c/strong\u003e\u003cstrong\u003ePhysical\u0026nbsp;\u003c/strong\u003e\u003cstrong\u003eE\u003c/strong\u003e\u003cstrong\u003examination\u003c/strong\u003e\u003c/h2\u003e\n\u003cp\u003eThe following assessments were performed: 1) Blood pressure:\u0026nbsp;measured using an Omron HBP-1300 sphygmomanometer by trained nurses. Three measurements were taken from each arm at 5-minute intervals in a resting state, and the average value was recorded. 2) Heart rate:\u0026nbsp;assessed by stethoscope for 1 minute at rest; repeated three times, with the mean value used.\u0026nbsp;3)\u0026nbsp;BMI:\u0026nbsp;calculated as weight (kg)/height\u0026sup2; (m\u0026sup2;).\u0026nbsp;Categories followed Chinese criteria: \u0026lt;18.5 (underweight), 18.5-24.0 (normal), 24.0-28.0 (overweight),\u0026nbsp;\u0026ge;28.0 (obese)\u003csup\u003e22\u003c/sup\u003e.\u003c/p\u003e\n\u003ch3\u003e2.4 Laboratory Examinations\u003c/h3\u003e\n\u003cp\u003eStandardized protocols were employed: 1)\u0026nbsp;FBG:\u0026nbsp;Measured using the glucose oxidase method. Venous blood samples were collected after\u0026nbsp;\u0026ge;8 hours of fasting and analyzed within 24 hours.\u0026nbsp;2)\u0026nbsp;\u003cstrong\u003eHbA1c\u003c/strong\u003e\u003cstrong\u003e:\u0026nbsp;\u003c/strong\u003eQuantified via high-performance liquid chromatography (HPLC). All assays were performed in an accredited clinical laboratory under strict quality control.\u003c/p\u003e\n\u003ch2\u003e2.5\u0026nbsp;Statistical\u0026nbsp;Methods\u0026nbsp;\u003c/h2\u003e\n\u003cp\u003eData were analyzed using SPSS version 27.0.\u0026nbsp;Continuous variables are presented as\u0026nbsp;mean \u0026plusmn; SD\u0026nbsp;(\u0026nbsp;\u0026plusmn;s)\u0026nbsp;if normally distributed;\u0026nbsp;categorical variables are reported as frequencies (n,\u0026nbsp;%).\u0026nbsp;Group comparisons utilized independent t-tests or \u0026chi;\u0026sup2; tests, as appropriate. Multicollinearity was assessed using tolerance and variance inflation factor (VIF). Multivariable logistic regression was used to analyze associations between blood glucose-related indicators and DR risk\u003cem\u003e. A two-sided P\u0026lt;0.05 was considered statistically significant.\u003c/em\u003e\u003c/p\u003e"},{"header":"3. RESULTS","content":"\u003ch2\u003e3.1 Basic\u0026nbsp;Information of DR in\u0026nbsp;T2DM\u003c/h2\u003e\n\u003cp\u003eA total of 6,855 patients with T2DM initially underwent fundus examination for DR screening and provided informed consent. After applying inclusion and exclusion criteria, 5,498 participants were included in the final analysis\u0026nbsp;(Insert Fig.\u0026nbsp;1 about here). Based on standardized grading criteria, DR was identified in 1,144 patients (20.81%), among whom 1,108 (20.15%) were classified as NPDR and 36 (0.65%) as PDR\u0026nbsp;(Insert Fig.\u0026nbsp;2\u0026nbsp;about here).\u003c/p\u003e\n\u003cp\u003e\u0026nbsp;The study population had a mean age of 55.67 \u0026plusmn; 10.75 years, comprising 3,256 males (59.22%) and 2,242 females (40.78%). Univariate analysis revealed that several lifestyle factors were significantly associated with the presence of DR. Specifically, smoking history, daily fruit consumption, and daily soy-products consumption showed statistically significant correlations with DR (P\u0026lt;0.05). No statistically significant differences were observed in age, sex, alcohol consumption, daily vegetables consumption, daily salt intake, weekly fish consumption, weekly sugar-sweetened beverage intake, sleep quality, siesta habits, or nighttime bedtime between the DR and NDR groups (P\u0026gt;0.05) (Table 2).\u0026nbsp;\u003c/p\u003e\n\u003cp\u003eTable 2 Demographic distribution characteristics of DR in T2DM\u003cem\u003e\u0026nbsp;patients\u003c/em\u003e\u003c/p\u003e\n\u003ctable border=\"0\" cellspacing=\"0\" cellpadding=\"0\" width=\"100%\"\u003e\n \u003ctbody\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 34px;\"\u003e\n \u003cp\u003eVariables\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"3\" valign=\"top\" style=\"width: 19px;\"\u003e\n \u003cp\u003eTotal population\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 13px;\"\u003e\n \u003cp\u003eDR\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 13px;\"\u003e\n \u003cp\u003eNDR\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 10px;\"\u003e\n \u003cp\u003e\u003cem\u003e\u0026chi;\u0026sup2;\u003c/em\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 9px;\"\u003e\n \u003cp\u003e\u003cem\u003ep-\u003c/em\u003evalue\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 34px;\"\u003e\n \u003cp\u003eAge(years)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"3\" valign=\"top\" style=\"width: 19px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 13px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 13px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 10px;\"\u003e\n \u003cp\u003e1.774\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 9px;\"\u003e\n \u003cp\u003e0.183\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 34px;\"\u003e\n \u003cp\u003e＜40\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"3\" valign=\"top\" style=\"width: 19px;\"\u003e\n \u003cp\u003e\u0026nbsp;580(10.54)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 13px;\"\u003e\n \u003cp\u003e\u0026nbsp;133(11.63)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 13px;\"\u003e\n \u003cp\u003e\u0026nbsp;447(10.27)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 10px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 9px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 34px;\"\u003e\n \u003cp\u003e\u0026ge;40\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"3\" valign=\"top\" style=\"width: 19px;\"\u003e\n \u003cp\u003e4918(89.46)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 13px;\"\u003e\n \u003cp\u003e1011(88.37)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 13px;\"\u003e\n \u003cp\u003e3907(89.73)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 10px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 9px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 34px;\"\u003e\n \u003cp\u003eSex\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"3\" valign=\"top\" style=\"width: 19px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 13px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 13px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 10px;\"\u003e\n \u003cp\u003e1.739\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 9px;\"\u003e\n \u003cp\u003e0.187\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 34px;\"\u003e\n \u003cp\u003efemale\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"3\" valign=\"top\" style=\"width: 19px;\"\u003e\n \u003cp\u003e2242(40.78)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 13px;\"\u003e\n \u003cp\u003e447(39.07)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 13px;\"\u003e\n \u003cp\u003e1795(41.23)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 10px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 9px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 34px;\"\u003e\n \u003cp\u003emale\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"3\" valign=\"top\" style=\"width: 19px;\"\u003e\n \u003cp\u003e3256(59.22)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 13px;\"\u003e\n \u003cp\u003e697(60.93)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 13px;\"\u003e\n \u003cp\u003e2559(58.77)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 10px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 9px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 34px;\"\u003e\n \u003cp\u003eSmoking history\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"3\" valign=\"top\" style=\"width: 19px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 13px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 13px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 10px;\"\u003e\n \u003cp\u003e9.113\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 9px;\"\u003e\n \u003cp\u003e0.010\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 34px;\"\u003e\n \u003cp\u003enone\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"3\" valign=\"top\" style=\"width: 19px;\"\u003e\n \u003cp\u003e2948(53.62)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 13px;\"\u003e\n \u003cp\u003e576(50.35)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 13px;\"\u003e\n \u003cp\u003e2372(54.48)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 10px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 9px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 34px;\"\u003e\n \u003cp\u003esmall amount\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"3\" valign=\"top\" style=\"width: 19px;\"\u003e\n \u003cp\u003e258(4.69)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 13px;\"\u003e\n \u003cp\u003e68(5.94)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 13px;\"\u003e\n \u003cp\u003e190(4.36)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 10px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 9px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 34px;\"\u003e\n \u003cp\u003esubstantial amount\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"3\" valign=\"top\" style=\"width: 19px;\"\u003e\n \u003cp\u003e2292(41.69)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 13px;\"\u003e\n \u003cp\u003e500(43.71)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 13px;\"\u003e\n \u003cp\u003e1792(41.16)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 10px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 9px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 34px;\"\u003e\n \u003cp\u003eAlcohol consumption\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"3\" valign=\"top\" style=\"width: 19px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 13px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 13px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 10px;\"\u003e\n \u003cp\u003e4.974\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 9px;\"\u003e\n \u003cp\u003e0.083\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 34px;\"\u003e\n \u003cp\u003enone\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"3\" valign=\"top\" style=\"width: 19px;\"\u003e\n \u003cp\u003e3114(56.64)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 13px;\"\u003e\n \u003cp\u003e615(53.76)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 13px;\"\u003e\n \u003cp\u003e2499(57.40)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 10px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 9px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 34px;\"\u003e\n \u003cp\u003esmall amount\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"3\" valign=\"top\" style=\"width: 19px;\"\u003e\n \u003cp\u003e1487(27.05)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 13px;\"\u003e\n \u003cp\u003e327(28.58)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 13px;\"\u003e\n \u003cp\u003e1160(26.64)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 10px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 9px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 34px;\"\u003e\n \u003cp\u003esubstantial amount\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"3\" valign=\"top\" style=\"width: 19px;\"\u003e\n \u003cp\u003e897(16.31)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 13px;\"\u003e\n \u003cp\u003e202(17.66)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 13px;\"\u003e\n \u003cp\u003e695(15.96)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 10px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 9px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 34px;\"\u003e\n \u003cp\u003eDaily vegetables consumption (g)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"3\" valign=\"top\" style=\"width: 19px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 13px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 13px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 10px;\"\u003e\n \u003cp\u003e1.839\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 9px;\"\u003e\n \u003cp\u003e0.606\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 34px;\"\u003e\n \u003cp\u003e\u0026lt;200\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"3\" valign=\"top\" style=\"width: 19px;\"\u003e\n \u003cp\u003e359(6.53)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 13px;\"\u003e\n \u003cp\u003e75(6.56)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 13px;\"\u003e\n \u003cp\u003e284(6.52)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 10px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 9px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 34px;\"\u003e\n \u003cp\u003e200-400\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"3\" valign=\"top\" style=\"width: 19px;\"\u003e\n \u003cp\u003e2942(53.51)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 13px;\"\u003e\n \u003cp\u003e628(54.90)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 13px;\"\u003e\n \u003cp\u003e2314(53.15)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 10px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 9px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 34px;\"\u003e\n \u003cp\u003e400-600\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"3\" valign=\"top\" style=\"width: 19px;\"\u003e\n \u003cp\u003e2097(38.14)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 13px;\"\u003e\n \u003cp\u003e424(37.06)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 13px;\"\u003e\n \u003cp\u003e1673(38.42)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 10px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 9px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 34px;\"\u003e\n \u003cp\u003e\u0026ge;600\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"3\" valign=\"top\" style=\"width: 19px;\"\u003e\n \u003cp\u003e100(1.82)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 13px;\"\u003e\n \u003cp\u003e17(1.48)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 13px;\"\u003e\n \u003cp\u003e83(1.91)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 10px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 9px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 34px;\"\u003e\n \u003cp\u003eDaily fruit consumption (g)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"3\" valign=\"top\" style=\"width: 19px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 13px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 13px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 10px;\"\u003e\n \u003cp\u003e16.457\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 9px;\"\u003e\n \u003cp\u003e\u0026lt;0.001\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 34px;\"\u003e\n \u003cp\u003e\u0026lt;200\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"3\" valign=\"top\" style=\"width: 19px;\"\u003e\n \u003cp\u003e4397(79.66)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 13px;\"\u003e\n \u003cp\u003e956(83.57)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 13px;\"\u003e\n \u003cp\u003e3423(78.62)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 10px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 9px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 34px;\"\u003e\n \u003cp\u003e200-400\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"3\" valign=\"top\" style=\"width: 19px;\"\u003e\n \u003cp\u003e942(17.13)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 13px;\"\u003e\n \u003cp\u003e166(14.51)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 13px;\"\u003e\n \u003cp\u003e776(17.82)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 10px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 9px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 34px;\"\u003e\n \u003cp\u003e400-600\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"3\" valign=\"top\" style=\"width: 19px;\"\u003e\n \u003cp\u003e162(2.94)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 13px;\"\u003e\n \u003cp\u003e21(1.84)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 13px;\"\u003e\n \u003cp\u003e141(3.23)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 10px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 9px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 34px;\"\u003e\n \u003cp\u003e\u0026ge;600\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"3\" valign=\"top\" style=\"width: 19px;\"\u003e\n \u003cp\u003e15(0.27)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 13px;\"\u003e\n \u003cp\u003e1(0.08)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 13px;\"\u003e\n \u003cp\u003e14(0.33)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 10px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 9px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 34px;\"\u003e\n \u003cp\u003eDaily soy-products consumption (g)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"3\" valign=\"top\" style=\"width: 19px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 13px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 13px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 10px;\"\u003e\n \u003cp\u003e10.839\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 9px;\"\u003e\n \u003cp\u003e0.028\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 34px;\"\u003e\n \u003cp\u003e\u0026lt;100\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"3\" valign=\"top\" style=\"width: 19px;\"\u003e\n \u003cp\u003e2451(44.58)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 13px;\"\u003e\n \u003cp\u003e557(48.69)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 13px;\"\u003e\n \u003cp\u003e1894(43.50)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 10px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 9px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 34px;\"\u003e\n \u003cp\u003e100-250\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"3\" valign=\"top\" style=\"width: 19px;\"\u003e\n \u003cp\u003e1625(29.56)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 13px;\"\u003e\n \u003cp\u003e324(28.32)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 13px;\"\u003e\n \u003cp\u003e1301(29.88)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 10px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 9px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 34px;\"\u003e\n \u003cp\u003e250-400\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"3\" valign=\"top\" style=\"width: 19px;\"\u003e\n \u003cp\u003e1214(22.08)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 13px;\"\u003e\n \u003cp\u003e225(19.67)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 13px;\"\u003e\n \u003cp\u003e989(22.71)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 10px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 9px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 34px;\"\u003e\n \u003cp\u003e400-500\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"3\" valign=\"top\" style=\"width: 19px;\"\u003e\n \u003cp\u003e181(3.29)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 13px;\"\u003e\n \u003cp\u003e33(2.88)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 13px;\"\u003e\n \u003cp\u003e148(3.40)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 10px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 9px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 34px;\"\u003e\n \u003cp\u003e\u0026ge;500\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"3\" valign=\"top\" style=\"width: 19px;\"\u003e\n \u003cp\u003e27(0.49)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 13px;\"\u003e\n \u003cp\u003e5(0.44)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 13px;\"\u003e\n \u003cp\u003e22(0.51)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 10px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 9px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 34px;\"\u003e\n \u003cp\u003eDaily salt intake (g)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"3\" valign=\"top\" style=\"width: 19px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 13px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 13px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 10px;\"\u003e\n \u003cp\u003e5.872\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 9px;\"\u003e\n \u003cp\u003e0.118\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 34px;\"\u003e\n \u003cp\u003e\u0026lt;4\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"3\" valign=\"top\" style=\"width: 19px;\"\u003e\n \u003cp\u003e83(1.51)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 13px;\"\u003e\n \u003cp\u003e19(1.66)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 13px;\"\u003e\n \u003cp\u003e64(1.47)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 10px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 9px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 34px;\"\u003e\n \u003cp\u003e4-6\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"3\" valign=\"top\" style=\"width: 19px;\"\u003e\n \u003cp\u003e755(13.73)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 13px;\"\u003e\n \u003cp\u003e181(15.82)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 13px;\"\u003e\n \u003cp\u003e574(13.18)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 10px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 9px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 34px;\"\u003e\n \u003cp\u003e6-8\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"3\" valign=\"top\" style=\"width: 19px;\"\u003e\n \u003cp\u003e2435(44.29)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 13px;\"\u003e\n \u003cp\u003e487(42.57)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 13px;\"\u003e\n \u003cp\u003e1948(44.74)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 10px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 9px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 34px;\"\u003e\n \u003cp\u003e\u0026ge;8\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"3\" valign=\"top\" style=\"width: 19px;\"\u003e\n \u003cp\u003e2225(40.47)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 13px;\"\u003e\n \u003cp\u003e457(39.95)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 13px;\"\u003e\n \u003cp\u003e1768(40.61)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 10px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 9px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 34px;\"\u003e\n \u003cp\u003eWeekly fish consumption\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"3\" valign=\"top\" style=\"width: 19px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 13px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 13px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 10px;\"\u003e\n \u003cp\u003e0.109\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 9px;\"\u003e\n \u003cp\u003e0.947\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 34px;\"\u003e\n \u003cp\u003e\u0026le;1 times\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"3\" valign=\"top\" style=\"width: 19px;\"\u003e\n \u003cp\u003e4384(79.74)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 13px;\"\u003e\n \u003cp\u003e914(79.90)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 13px;\"\u003e\n \u003cp\u003e3470(79.70)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 10px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 9px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"2\" valign=\"top\" style=\"width: 35px;\"\u003e\n \u003cp\u003e\u0026ge;2 times/week with \u0026lt;100g/serving\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" valign=\"top\" style=\"width: 17px;\"\u003e\n \u003cp\u003e211(3.84)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 13px;\"\u003e\n \u003cp\u003e42(3.67)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 13px;\"\u003e\n \u003cp\u003e169(3.88)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 10px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 9px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"3\" valign=\"top\" style=\"width: 39px;\"\u003e\n \u003cp\u003e\u0026ge;2 times/week with \u0026ge;100g/serving\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 13px;\"\u003e\n \u003cp\u003e903(16.42)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 13px;\"\u003e\n \u003cp\u003e188(16.43)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 13px;\"\u003e\n \u003cp\u003e715(16.42)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 10px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 9px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"3\" valign=\"top\" style=\"width: 39px;\"\u003e\n \u003cp\u003eWeekly sugar-sweetened beverage intake\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 13px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 13px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 13px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 10px;\"\u003e\n \u003cp\u003e1.361\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 9px;\"\u003e\n \u003cp\u003e0.715\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"3\" valign=\"top\" style=\"width: 39px;\"\u003e\n \u003cp\u003enone\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 13px;\"\u003e\n \u003cp\u003e4841(88.05)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 13px;\"\u003e\n \u003cp\u003e1018(88.99)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 13px;\"\u003e\n \u003cp\u003e3823(87.80)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 10px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 9px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"3\" valign=\"top\" style=\"width: 39px;\"\u003e\n \u003cp\u003e\u0026lt;250 ml\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 13px;\"\u003e\n \u003cp\u003e300(5.46)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 13px;\"\u003e\n \u003cp\u003e58(5.07)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 13px;\"\u003e\n \u003cp\u003e242(5.56)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 10px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 9px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 34px;\"\u003e\n \u003cp\u003eContinue table 2\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"3\" valign=\"top\" style=\"width: 19px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 13px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 13px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 10px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 9px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 34px;\"\u003e\n \u003cp\u003e250-1000 ml\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"3\" valign=\"top\" style=\"width: 19px;\"\u003e\n \u003cp\u003e155(2.82)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 13px;\"\u003e\n \u003cp\u003e31(2.71)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 13px;\"\u003e\n \u003cp\u003e124(2.85)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 10px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 9px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 34px;\"\u003e\n \u003cp\u003e\u0026ge;1000 ml\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"3\" valign=\"top\" style=\"width: 19px;\"\u003e\n \u003cp\u003e202(3.67)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 13px;\"\u003e\n \u003cp\u003e37(3.23)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 13px;\"\u003e\n \u003cp\u003e165(3.79)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 10px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 9px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 34px;\"\u003e\n \u003cp\u003eSleep quality\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"3\" valign=\"top\" style=\"width: 19px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 13px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 13px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 10px;\"\u003e\n \u003cp\u003e1.375\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 9px;\"\u003e\n \u003cp\u003e0.503\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 34px;\"\u003e\n \u003cp\u003emedication-dependent\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"3\" valign=\"top\" style=\"width: 19px;\"\u003e\n \u003cp\u003e306(5.57)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 13px;\"\u003e\n \u003cp\u003e62(5.42)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 13px;\"\u003e\n \u003cp\u003e244(5.60)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 10px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 9px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 34px;\"\u003e\n \u003cp\u003epoor\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"3\" valign=\"top\" style=\"width: 19px;\"\u003e\n \u003cp\u003e1312(23.86)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 13px;\"\u003e\n \u003cp\u003e288(25.17)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 13px;\"\u003e\n \u003cp\u003e1024(23.52)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 10px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 9px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 34px;\"\u003e\n \u003cp\u003eoptimal\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"3\" valign=\"top\" style=\"width: 19px;\"\u003e\n \u003cp\u003e3880(70.57)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 13px;\"\u003e\n \u003cp\u003e794(69.41)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 13px;\"\u003e\n \u003cp\u003e3086(70.88)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 10px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 9px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 34px;\"\u003e\n \u003cp\u003eSiesta habits\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"3\" valign=\"top\" style=\"width: 19px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 13px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 13px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 10px;\"\u003e\n \u003cp\u003e0.268\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 9px;\"\u003e\n \u003cp\u003e0.605\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 34px;\"\u003e\n \u003cp\u003eno\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"3\" valign=\"top\" style=\"width: 19px;\"\u003e\n \u003cp\u003e3183(57.89)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 13px;\"\u003e\n \u003cp\u003e670(58.57)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 13px;\"\u003e\n \u003cp\u003e2513(57.72)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 10px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 9px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 34px;\"\u003e\n \u003cp\u003eyes\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"3\" valign=\"top\" style=\"width: 19px;\"\u003e\n \u003cp\u003e2315(42.11)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 13px;\"\u003e\n \u003cp\u003e474(41.43)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 13px;\"\u003e\n \u003cp\u003e1841(42.28)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 10px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 9px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 34px;\"\u003e\n \u003cp\u003eNighttime bedtime\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"3\" valign=\"top\" style=\"width: 19px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 13px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 13px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 10px;\"\u003e\n \u003cp\u003e0.507\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 9px;\"\u003e\n \u003cp\u003e0.476\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 34px;\"\u003e\n \u003cp\u003eearly sleeper\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"3\" valign=\"top\" style=\"width: 19px;\"\u003e\n \u003cp\u003e4127(75.06)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 13px;\"\u003e\n \u003cp\u003e868(75.87)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 13px;\"\u003e\n \u003cp\u003e3259(74.85)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 10px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 9px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 34px;\"\u003e\n \u003cp\u003elate sleeper\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"3\" valign=\"top\" style=\"width: 19px;\"\u003e\n \u003cp\u003e1371(24.94)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 13px;\"\u003e\n \u003cp\u003e276(24.13)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 13px;\"\u003e\n \u003cp\u003e1095(25.15)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 10px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 9px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 84px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd style=\"width: 0px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd style=\"width: 0px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd style=\"width: 119px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd style=\"width: 119px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd style=\"width: 119px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd style=\"width: 105px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd style=\"width: 105px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003c/tr\u003e\n \u003c/tbody\u003e\n\u003c/table\u003e\n\u003cp\u003eAbbreviations: DR, Diabetic retinopathy; T2DM, Type 2 diabetes mellitus; NDR, Non-diabetic retinopathy.\u0026nbsp;\u003c/p\u003e\n\u003cp\u003eNote: Categorical variables are presented as n (%).\u0026nbsp;\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n\u003ch2\u003e3.2\u0026nbsp;Univariate\u0026nbsp;Analysis of\u0026nbsp;Blood\u0026nbsp;Glucose-related\u0026nbsp;Indicators\u0026nbsp;Associated with DR in T2DM\u0026nbsp;Patients\u003c/h2\u003e\n\u003cp\u003eSignificant differences were observed between the DR and NDR groups regarding clinical characteristics: age at diagnosis of T2DM, duration of T2DM, HbA1c levels, and heart rate were all significantly associated with DR (P\u0026lt;0.05). Conversely, no statistically significant associations were found for the following variables: history of hypertension, history of coronary heart disease, family history of T2DM, FBG, and BMI (P\u0026gt;0.05) (Table 3).\u003c/p\u003e\n\u003cp\u003eTable 3 Associations of blood glucose-related indicators with DR in T2DM\u003cem\u003e\u0026nbsp;patients\u003c/em\u003e\u003c/p\u003e\n\u003ctable border=\"0\" cellspacing=\"0\" cellpadding=\"0\" width=\"566\"\u003e\n \u003ctbody\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 179px;\"\u003e\n \u003cp\u003eVariables\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 113px;\"\u003e\n \u003cp\u003e\u0026nbsp; \u0026nbsp;Total population\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 76px;\"\u003e\n \u003cp\u003e\u0026nbsp; \u0026nbsp; DR\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 85px;\"\u003e\n \u003cp\u003e\u0026nbsp; \u0026nbsp; NDR\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 57px;\"\u003e\n \u003cp\u003e\u0026nbsp; \u0026nbsp; \u0026chi;\u0026sup2;/t\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 57px;\"\u003e\n \u003cp\u003ep-value\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 179px;\"\u003e\n \u003cp\u003eDiagnosis age of T2DM (years)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 113px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 76px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 85px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 57px;\"\u003e\n \u003cp\u003e55.580\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 57px;\"\u003e\n \u003cp\u003e\u0026lt;0.001\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 179px;\"\u003e\n \u003cp\u003e\u0026lt;40\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 113px;\"\u003e\n \u003cp\u003e846(15.39)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 76px;\"\u003e\n \u003cp\u003e257(22.47)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 85px;\"\u003e\n \u003cp\u003e589(13.52)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 57px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 57px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 179px;\"\u003e\n \u003cp\u003e\u0026ge;40\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 113px;\"\u003e\n \u003cp\u003e4652(84.61)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 76px;\"\u003e\n \u003cp\u003e887(77.53)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 85px;\"\u003e\n \u003cp\u003e3765(86.48)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 57px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 57px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 179px;\"\u003e\n \u003cp\u003eDuration of T2DM (years)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 113px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 76px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 85px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 57px;\"\u003e\n \u003cp\u003e312.299\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 57px;\"\u003e\n \u003cp\u003e\u0026lt;0.001\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 179px;\"\u003e\n \u003cp\u003e\u0026lt;1\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 113px;\"\u003e\n \u003cp\u003e3708(67.44)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 76px;\"\u003e\n \u003cp\u003e566(49.48)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 85px;\"\u003e\n \u003cp\u003e3142(72.12)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 57px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 57px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 179px;\"\u003e\n \u003cp\u003e1-5\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 113px;\"\u003e\n \u003cp\u003e813(14.79)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 76px;\"\u003e\n \u003cp\u003e193(16.87)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 85px;\"\u003e\n \u003cp\u003e620(14.24)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 57px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 57px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 179px;\"\u003e\n \u003cp\u003e5-10\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 113px;\"\u003e\n \u003cp\u003e464(8.44)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 76px;\"\u003e\n \u003cp\u003e146(12.76)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 85px;\"\u003e\n \u003cp\u003e318(7.30)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 57px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 57px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 179px;\"\u003e\n \u003cp\u003eContinue table 3\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 113px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 76px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 85px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 57px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 57px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 179px;\"\u003e\n \u003cp\u003e\u0026ge;10\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 113px;\"\u003e\n \u003cp\u003e513(9.33)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 76px;\"\u003e\n \u003cp\u003e239(20.89)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 85px;\"\u003e\n \u003cp\u003e274(6.34)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 57px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 57px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 179px;\"\u003e\n \u003cp\u003eHistory of hypertension\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 113px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 76px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 85px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 57px;\"\u003e\n \u003cp\u003e0.035\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 57px;\"\u003e\n \u003cp\u003e0.851\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 179px;\"\u003e\n \u003cp\u003eno\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 113px;\"\u003e\n \u003cp\u003e2548(46.34)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 76px;\"\u003e\n \u003cp\u003e533(46.59)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 85px;\"\u003e\n \u003cp\u003e2015(46.28)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 57px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 57px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 179px;\"\u003e\n \u003cp\u003eyes\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 113px;\"\u003e\n \u003cp\u003e2950(53.66)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 76px;\"\u003e\n \u003cp\u003e611(53.41)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 85px;\"\u003e\n \u003cp\u003e2339(53.72)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 57px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 57px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 179px;\"\u003e\n \u003cp\u003eHistory of coronary heart disease\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 113px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 76px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 85px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 57px;\"\u003e\n \u003cp\u003e1.474\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 57px;\"\u003e\n \u003cp\u003e0.225\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 179px;\"\u003e\n \u003cp\u003eno\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 113px;\"\u003e\n \u003cp\u003e4583(83.36)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 76px;\"\u003e\n \u003cp\u003e940(82.17)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 85px;\"\u003e\n \u003cp\u003e3643(83.67)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 57px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 57px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 179px;\"\u003e\n \u003cp\u003eyes\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 113px;\"\u003e\n \u003cp\u003e915(16.64)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 76px;\"\u003e\n \u003cp\u003e204(17.83)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 85px;\"\u003e\n \u003cp\u003e711(16.33)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 57px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 57px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 179px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eF\u003c/strong\u003e\u003cstrong\u003eamily history of T2DM\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 113px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 76px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 85px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 57px;\"\u003e\n \u003cp\u003e1.106\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 57px;\"\u003e\n \u003cp\u003e0.293\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 179px;\"\u003e\n \u003cp\u003eno\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 113px;\"\u003e\n \u003cp\u003e2416(43.94)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 76px;\"\u003e\n \u003cp\u003e487(42.57)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 85px;\"\u003e\n \u003cp\u003e1929(44.30)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 57px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 57px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 179px;\"\u003e\n \u003cp\u003eyes\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 113px;\"\u003e\n \u003cp\u003e3082(56.06)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 76px;\"\u003e\n \u003cp\u003e657(57.43)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 85px;\"\u003e\n \u003cp\u003e2425(55.70)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 57px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 57px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 179px;\"\u003e\n \u003cp\u003eFBG (mmol/L)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 113px;\"\u003e\n \u003cp\u003e9.13\u0026plusmn;2.68\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 76px;\"\u003e\n \u003cp\u003e9.15\u0026plusmn;2.81\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 85px;\"\u003e\n \u003cp\u003e9.12\u0026plusmn;2.64\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 57px;\"\u003e\n \u003cp\u003e-0.324\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 57px;\"\u003e\n \u003cp\u003e0.746\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 179px;\"\u003e\n \u003cp\u003eHbA1c (%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 113px;\"\u003e\n \u003cp\u003e8.94\u0026plusmn;1.88\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 76px;\"\u003e\n \u003cp\u003e9.10\u0026plusmn;1.84\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 85px;\"\u003e\n \u003cp\u003e8.90\u0026plusmn;1.89\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 57px;\"\u003e\n \u003cp\u003e-3.246\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 57px;\"\u003e\n \u003cp\u003e0.001\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 179px;\"\u003e\n \u003cp\u003eBMI (kg/m\u003csup\u003e2\u003c/sup\u003e)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 113px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 76px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 85px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 57px;\"\u003e\n \u003cp\u003e5.448\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 57px;\"\u003e\n \u003cp\u003e0.142\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 179px;\"\u003e\n \u003cp\u003e\u0026lt;18.5\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 113px;\"\u003e\n \u003cp\u003e17(0.31)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 76px;\"\u003e\n \u003cp\u003e4(0.35)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 85px;\"\u003e\n \u003cp\u003e13(0.30)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 57px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 57px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 179px;\"\u003e\n \u003cp\u003e18.5-24.0\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 113px;\"\u003e\n \u003cp\u003e976(17.75)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 76px;\"\u003e\n \u003cp\u003e229(20.02)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 85px;\"\u003e\n \u003cp\u003e747(17.16)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 57px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 57px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 179px;\"\u003e\n \u003cp\u003e24.0-28.0\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 113px;\"\u003e\n \u003cp\u003e2389(43.45)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 76px;\"\u003e\n \u003cp\u003e490(42.83)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 85px;\"\u003e\n \u003cp\u003e1899(43.62)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 57px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 57px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 179px;\"\u003e\n \u003cp\u003e\u0026ge;28\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 113px;\"\u003e\n \u003cp\u003e2116(38.49)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 76px;\"\u003e\n \u003cp\u003e421(36.80)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 85px;\"\u003e\n \u003cp\u003e1695(38.92)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 57px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 57px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 179px;\"\u003e\n \u003cp\u003eHeart rate (beats per minute)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 113px;\"\u003e\n \u003cp\u003e83.40\u0026plusmn;12.15\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 76px;\"\u003e\n \u003cp\u003e84.23\u0026plusmn;12.32\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 85px;\"\u003e\n \u003cp\u003e83.19\u0026plusmn;12.10\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 57px;\"\u003e\n \u003cp\u003e-2.577\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 57px;\"\u003e\n \u003cp\u003e0.010\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003c/tbody\u003e\n\u003c/table\u003e\n\u003cp\u003eAbbreviations: DR, Diabetic retinopathy; T2DM, Type 2 diabetes mellitus; NDR, Non-diabetic retinopathy; FBG, Fasting blood glucose; HbA1c, Hemoglobin A1c; BMI, Body mass index.\u0026nbsp;\u003c/p\u003e\n\u003cp\u003eNote: Categorical variables are presented as n (%); Continuous variables are presented as mean \u0026plusmn; SD (X̅ \u0026nbsp;\u0026plusmn; S).\u0026nbsp;\u003c/p\u003e\n\u003ch2\u003e3.3 \u003cstrong\u003eMultivariable\u0026nbsp;\u003c/strong\u003eLogistic\u0026nbsp;Regression\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003cstrong\u003eA\u003c/strong\u003e\u003cstrong\u003enalysis of the\u0026nbsp;\u003c/strong\u003e\u003cstrong\u003eA\u003c/strong\u003e\u003cstrong\u003essociation\u0026nbsp;\u003c/strong\u003e\u003cstrong\u003eB\u003c/strong\u003e\u003cstrong\u003eetween\u0026nbsp;\u003c/strong\u003e\u003cstrong\u003eBlood G\u003c/strong\u003e\u003cstrong\u003elucose-related\u0026nbsp;\u003c/strong\u003e\u003cstrong\u003eI\u003c/strong\u003e\u003cstrong\u003endicators and DR in T2DM patients\u003c/strong\u003e\u003c/h2\u003e\n\u003cp\u003eMultivariable logistic regression was performed to evaluate the association between blood glucose-related indicators and DR, after including relevant variables in the model. Tolerance values ranged from 0.343 to 0.988, and VIF\u0026nbsp;values ranged from 1.047 to 2.917, indicating the absence of significant multicollinearity among the included risk factors.\u003c/p\u003e\n\u003cp\u003eAfter adjusting for age, sex, and lifestyle factors, the results showed that the diagnosis age of \u0026nbsp;T2DM (OR: 0.543, 95%CI: 0.414-0.731), duration of T2DM (1-5 years: OR: 1.713, 95%CI: 1.416-2.073; 5-10 years: OR: 2.516, 95%CI: 2.012-3.145; \u0026ge; 10 years: OR: 4.659, 95%CI: 3.748-5.790), HbA1c (OR: 1.111, 95%CI: 1.069-1.154) and heart rate (OR: 1.008, 95%CI: 1.003-1.014) were significantly associated with the occurrence of DR in T2DM (P\u0026lt;0.05) (Table 4).\u003c/p\u003e\n\u003cp\u003eTable 4 \u003cstrong\u003eMultivariable analysis of the association between blood glucose-related indicators and DR in T2DM patients\u003c/strong\u003e\u003c/p\u003e\n\u003ctable border=\"1\" cellspacing=\"0\" cellpadding=\"0\" width=\"101%\"\u003e\n \u003ctbody\u003e\n \u003ctr\u003e\n \u003ctd rowspan=\"2\" style=\"width: 17px;\"\u003e\n \u003cp\u003eVariables\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"3\" valign=\"top\" style=\"width: 28px;\"\u003eModel 1\u003cbr\u003e\u003c/td\u003e\n \u003ctd colspan=\"3\" valign=\"top\" style=\"width: 27px;\"\u003eModel 2\u003cbr\u003e\u003c/td\u003e\n \u003ctd colspan=\"3\" valign=\"top\" style=\"width: 26px;\"\u003eModel 2\u003cbr\u003e\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 7px;\"\u003e\n \u003cp\u003eOR\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 9.7848%;\"\u003e\n \u003cp\u003e95%CI\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 9.7847%;\"\u003e\n \u003cp\u003ep-value\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 7px;\"\u003e\n \u003cp\u003eOR\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 11px;\"\u003e\n \u003cp\u003e95%CI\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 9px;\"\u003e\n \u003cp\u003ep-value\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 7px;\"\u003e\n \u003cp\u003eOR\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 11px;\"\u003e\n \u003cp\u003e95%CI\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 8px;\"\u003e\n \u003cp\u003ep-value\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 17px;\"\u003e\n \u003cp\u003eFBG (mmol/L)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 7px;\"\u003e\n \u003cp\u003e1.000\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 9.7848%;\"\u003e\n \u003cp\u003e0.975-1.025\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 9.7847%;\"\u003e\n \u003cp\u003e0.977\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 7px;\"\u003e\n \u003cp\u003e0.999\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 11px;\"\u003e\n \u003cp\u003e0.974-1.024\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 9px;\"\u003e\n \u003cp\u003e0.922\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 7px;\"\u003e\n \u003cp\u003e0.997\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 11px;\"\u003e\n \u003cp\u003e0.972-1.023\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 8px;\"\u003e\n \u003cp\u003e0.840\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 17px;\"\u003e\n \u003cp\u003eDiagnosis age of T2DM (years)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 7px;\"\u003e\n \u003cp\u003e0.619\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 9.7848%;\"\u003e\n \u003cp\u003e0.576-0.828\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 9.7847%;\"\u003e\n \u003cp\u003e\u0026lt;0.001\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 7px;\"\u003e\n \u003cp\u003e0.550\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 11px;\"\u003e\n \u003cp\u003e0.421-0.720\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 9px;\"\u003e\n \u003cp\u003e\u0026lt;0.001\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 7px;\"\u003e\n \u003cp\u003e0.543\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 11px;\"\u003e\n \u003cp\u003e0.414-0.713\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 8px;\"\u003e\n \u003cp\u003e\u0026lt;0.001\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 17px;\"\u003e\n \u003cp\u003eDuration of T2DM (years)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 7px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 9.7848%;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 9.7847%;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 7px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 11px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 9px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 7px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 11px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 8px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 17px;\"\u003e\n \u003cp\u003e\u0026lt;1\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 7px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 9.7848%;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 9.7847%;\"\u003e\n \u003cp\u003e\u0026lt;0.001\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 7px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 11px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 9px;\"\u003e\n \u003cp\u003e\u0026lt;0.001\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 7px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 11px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 8px;\"\u003e\n \u003cp\u003e\u0026lt;0.001\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 17px;\"\u003e\n \u003cp\u003e1-5\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 7px;\"\u003e\n \u003cp\u003e1.787\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 9.7848%;\"\u003e\n \u003cp\u003e1.480-2.157\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 9.7847%;\"\u003e\n \u003cp\u003e\u0026lt;0.001\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 7px;\"\u003e\n \u003cp\u003e1.777\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 11px;\"\u003e\n \u003cp\u003e1.471-2.145\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 9px;\"\u003e\n \u003cp\u003e\u0026lt;0.001\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 7px;\"\u003e\n \u003cp\u003e1.713\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 11px;\"\u003e\n \u003cp\u003e1.416-2.073\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 8px;\"\u003e\n \u003cp\u003e\u0026lt;0.001\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 17px;\"\u003e\n \u003cp\u003e5-10\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 7px;\"\u003e\n \u003cp\u003e2.616\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 9.7848%;\"\u003e\n \u003cp\u003e2.101-3.256\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 9.7847%;\"\u003e\n \u003cp\u003e\u0026lt;0.001\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 7px;\"\u003e\n \u003cp\u003e2.535\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 11px;\"\u003e\n \u003cp\u003e2.032-3.163\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 9px;\"\u003e\n \u003cp\u003e\u0026lt;0.001\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 7px;\"\u003e\n \u003cp\u003e2.516\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 11px;\"\u003e\n \u003cp\u003e2.012-3.145\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 8px;\"\u003e\n \u003cp\u003e\u0026lt;0.001\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 17px;\"\u003e\n \u003cp\u003e\u0026ge;10\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 7px;\"\u003e\n \u003cp\u003e5.071\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 9.7848%;\"\u003e\n \u003cp\u003e4.118-6.245\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 9.7847%;\"\u003e\n \u003cp\u003e\u0026lt;0.001\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 7px;\"\u003e\n \u003cp\u003e4.771\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 11px;\"\u003e\n \u003cp\u003e3.847-5.917\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 9px;\"\u003e\n \u003cp\u003e\u0026lt;0.001\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 7px;\"\u003e\n \u003cp\u003e4.659\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 11px;\"\u003e\n \u003cp\u003e3.748-5.790\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 8px;\"\u003e\n \u003cp\u003e\u0026lt;0.001\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 17px;\"\u003e\n \u003cp\u003eHistory of hypertension\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 7px;\"\u003e\n \u003cp\u003e1.042\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 9.7848%;\"\u003e\n \u003cp\u003e0.904-1.202\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 9.7847%;\"\u003e\n \u003cp\u003e0.567\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 7px;\"\u003e\n \u003cp\u003e1.031\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 11px;\"\u003e\n \u003cp\u003e0.894-1.189\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 9px;\"\u003e\n \u003cp\u003e0.672\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 7px;\"\u003e\n \u003cp\u003e1.029\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 11px;\"\u003e\n \u003cp\u003e0.891-1.188\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 8px;\"\u003e\n \u003cp\u003e0.696\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 17px;\"\u003e\n \u003cp\u003eHistory of coronary heart disease\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 7px;\"\u003e\n \u003cp\u003e1.022\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 9.7848%;\"\u003e\n \u003cp\u003e0.848-1.232\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 9.7847%;\"\u003e\n \u003cp\u003e0.818\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 7px;\"\u003e\n \u003cp\u003e1.017\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 11px;\"\u003e\n \u003cp\u003e0.843-1.225\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 9px;\"\u003e\n \u003cp\u003e0.863\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 7px;\"\u003e\n \u003cp\u003e1.004\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 11px;\"\u003e\n \u003cp\u003e0.831-1.213\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 8px;\"\u003e\n \u003cp\u003e0.966\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 17px;\"\u003e\n \u003cp\u003eFamily history of T2DM\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 7px;\"\u003e\n \u003cp\u003e0.998\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 9.7848%;\"\u003e\n \u003cp\u003e0.871-1.145\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 9.7847%;\"\u003e\n \u003cp\u003e0.982\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 7px;\"\u003e\n \u003cp\u003e1.001\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 11px;\"\u003e\n \u003cp\u003e0.871-1.149\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 9px;\"\u003e\n \u003cp\u003e0.985\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 7px;\"\u003e\n \u003cp\u003e1.006\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 11px;\"\u003e\n \u003cp\u003e0.876-1.154\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 8px;\"\u003e\n \u003cp\u003e0.937\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 17px;\"\u003e\n \u003cp\u003eHbA1c (%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 7px;\"\u003e\n \u003cp\u003e1.100\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 9.7848%;\"\u003e\n \u003cp\u003e1.060-1.142\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 9.7847%;\"\u003e\n \u003cp\u003e\u0026lt;0.001\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 7px;\"\u003e\n \u003cp\u003e1.103\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 11px;\"\u003e\n \u003cp\u003e1.062-1.145\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 9px;\"\u003e\n \u003cp\u003e\u0026lt;0.001\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 7px;\"\u003e\n \u003cp\u003e1.111\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 11px;\"\u003e\n \u003cp\u003e1.069-1.154\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 8px;\"\u003e\n \u003cp\u003e\u0026lt;0.001\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 17px;\"\u003e\n \u003cp\u003eBMI (kg/m\u003csup\u003e2\u003c/sup\u003e)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 7px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 9.7848%;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 9.7847%;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 7px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 11px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 9px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 7px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 11px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 8px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 17px;\"\u003e\n \u003cp\u003e\u0026lt;18.5\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 7px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 9.7848%;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 9.7847%;\"\u003e\n \u003cp\u003e0.942\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 7px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 11px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 9px;\"\u003e\n \u003cp\u003e0.949\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 7px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 11px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 8px;\"\u003e\n \u003cp\u003e0.962\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 17px;\"\u003e\n \u003cp\u003e18.5-24.0\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 7px;\"\u003e\n \u003cp\u003e1.103\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 9.7848%;\"\u003e\n \u003cp\u003e0.344-3.540\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 9.7847%;\"\u003e\n \u003cp\u003e0.869\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 7px;\"\u003e\n \u003cp\u003e1.107\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 11px;\"\u003e\n \u003cp\u003e0.346-3.543\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 9px;\"\u003e\n \u003cp\u003e0.864\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 7px;\"\u003e\n \u003cp\u003e1.067\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 11px;\"\u003e\n \u003cp\u003e0.332-3.428\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 8px;\"\u003e\n \u003cp\u003e0.913\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 17px;\"\u003e\n \u003cp\u003e24.0-28.0\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 7px;\"\u003e\n \u003cp\u003e1.045\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 9.7848%;\"\u003e\n \u003cp\u003e0.327-3.339\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 9.7847%;\"\u003e\n \u003cp\u003e0.941\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 7px;\"\u003e\n \u003cp\u003e1.046\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 11px;\"\u003e\n \u003cp\u003e0.328-3.336\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 9px;\"\u003e\n \u003cp\u003e0.939\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 7px;\"\u003e\n \u003cp\u003e1.019\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 11px;\"\u003e\n \u003cp\u003e0.319-3.261\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 8px;\"\u003e\n \u003cp\u003e0.975\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 17px;\"\u003e\n \u003cp\u003e\u0026ge;28.0\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 7px;\"\u003e\n \u003cp\u003e1.042\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 9.7848%;\"\u003e\n \u003cp\u003e0.325-3.337\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 9.7847%;\"\u003e\n \u003cp\u003e0.945\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 7px;\"\u003e\n \u003cp\u003e1.058\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 11px;\"\u003e\n \u003cp\u003e0.331-3.380\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 9px;\"\u003e\n \u003cp\u003e0.925\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 7px;\"\u003e\n \u003cp\u003e1.051\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 11px;\"\u003e\n \u003cp\u003e0.328-3.372\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 8px;\"\u003e\n \u003cp\u003e0.933\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 17px;\"\u003e\n \u003cp\u003eHeart rate (beats per minute)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 7px;\"\u003e\n \u003cp\u003e1.008\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 9.7848%;\"\u003e\n \u003cp\u003e1.002-1.014\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 9.7847%;\"\u003e\n \u003cp\u003e0.005\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 7px;\"\u003e\n \u003cp\u003e1.009\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 11px;\"\u003e\n \u003cp\u003e1.003-1.014\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 9px;\"\u003e\n \u003cp\u003e0.003\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 7px;\"\u003e\n \u003cp\u003e1.008\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 11px;\"\u003e\n \u003cp\u003e1.003-1.014\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 8px;\"\u003e\n \u003cp\u003e0.004\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003c/tbody\u003e\n\u003c/table\u003e\n\u003cp\u003eAbbreviations: OR, Odds ratio; T2DM, Type 2 diabetes mellitus; FBG, Fasting blood glucose; HbA1c, Hemoglobin A1c; BMI, Body mass index.\u0026nbsp;\u003c/p\u003e\n\u003cp\u003eNote: Model 1 variables were unadjusted. Model 2 was adjusted for sex and age. Model 3 further adjusted for lifestyle factors based on Model 2.\u0026nbsp;\u003c/p\u003e"},{"header":"4. DISCUSSION","content":"\u003cp\u003eThis study revealed an overall DR\u0026nbsp;prevalence of 20.81% among patients with\u0026nbsp;T2DM. Furthermore, significant associations were identified between the occurrence of DR and elevated HbA1c, younger age at diagnosis\u0026nbsp;of T2DM, longer duration of T2DM, and increased heart rate.\u003c/p\u003e\n\u003ch2\u003e4.1\u0026nbsp;\u003cstrong\u003eDR\u0026nbsp;\u003c/strong\u003e\u003cstrong\u003eP\u003c/strong\u003e\u003cstrong\u003erevalence in T2DM:\u0026nbsp;\u003c/strong\u003e\u003cstrong\u003eR\u003c/strong\u003e\u003cstrong\u003eegional and\u0026nbsp;\u003c/strong\u003e\u003cstrong\u003eH\u003c/strong\u003e\u003cstrong\u003eospital-based\u0026nbsp;\u003c/strong\u003e\u003cstrong\u003eComparison\u003c/strong\u003e\u003c/h2\u003e\n\u003cp\u003eThe prevalence of DR among hospital-based T2DM patients in Tianjin was 20.81%, which is lower than the pooled prevalence of 22.4% (95%CI: 18.8%-26.1%) reported in a meta-analysis of Chinese diabetic populations by Deng et al.\u003csup\u003e19\u003c/sup\u003e.\u0026nbsp;This rate is also notably lower than those reported in single-center studies from regions such as Heilongjiang (34.5%)\u003csup\u003e23\u003c/sup\u003e and Dongguan (28.3%)\u003csup\u003e24\u003c/sup\u003e.\u0026nbsp;The relatively lower prevalence in Tianjin may be attributable to more effective diabetes management strategies, including sustained glycemic control and systematic complication monitoring. Although the overall DR prevalence in northern China was reported as 27.7%\u003csup\u003e19\u003c/sup\u003e,\u0026nbsp;the rate in Tianjin was 6.89 percentage points lower. Of particular note, the substantial discrepancy between community-based populations (1.7%)\u003csup\u003e19\u003c/sup\u003e and hospital-based patients (20.81%) underscores that hospitalized T2DM patients represent a higher-risk group, necessitating targeted DR screening efforts.\u003c/p\u003e\n\u003ch2\u003e4.2\u0026nbsp;\u003cstrong\u003eAssociation of\u0026nbsp;\u003c/strong\u003eElevated\u003cstrong\u003e\u0026nbsp;HbA1c and\u0026nbsp;\u003c/strong\u003eLonger\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003cstrong\u003eD\u003c/strong\u003e\u003cstrong\u003euratio\u003c/strong\u003e\u003cstrong\u003en\u003c/strong\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003cstrong\u003eof DM\u0026nbsp;\u003c/strong\u003e\u003cstrong\u003ein\u003c/strong\u003e\u003cstrong\u003e\u0026nbsp;T2DM\u003c/strong\u003e\u003c/h2\u003e\n\u003cp\u003eThis study found that elevated HbA1c\u0026nbsp;(OR: 1.111, 95%CI: 1.069-1.154, P\u0026lt;0.001) and longer duration of T2DM (\u0026ge;10 years: OR: 4.659, 95%CI: 3.748-5.790, P\u0026lt;0.001)\u0026nbsp;were significant risk factors for DR,\u0026nbsp;consistent with other cross-sectional studies\u003csup\u003e25,26\u003c/sup\u003e.\u0026nbsp;Chronic hyperglycemia is a well-established major contributor to the development and progression of DR. Previous evidence indicates that each 1% reduction in HbA1c is associated with a 22% decrease in the risk of DR\u003csup\u003e27\u003c/sup\u003e,\u0026nbsp;highlighting the crucial importance of glycemic control in DR prevention and management.\u003c/p\u003e\n\u003cp\u003eAdditionally, 67.44% of the participants in this study had a disease duration of less than one year. Generally, a longer duration of diabetes is associated with a higher prevalence of DR. Studies have reported that the prevalence of DR among patients with long-standing diabetes is twice that of newly diagnosed cases\u003csup\u003e28\u003c/sup\u003e.\u0026nbsp;Zhang et al. demonstrated that each additional year of diabetes duration increases the risk of retinopathy by approximately\u0026nbsp;9%\u003csup\u003e29\u003c/sup\u003e, attributable to cumulative retinal vascular damage and neovascularization\u003csup\u003e30\u003c/sup\u003e.\u0026nbsp;Similarly, Yin et al. confirmed a significant association between longer diabetes duration and DR\u003csup\u003e26\u003c/sup\u003e.\u0026nbsp;Prolonged exposure to hyperglycemia, hypertension, and dyslipidemia over the disease course exacerbates microvascular damage, facilitating the onset and progression of DR. These findings reinforce the recommendation for annual fundus screening in patients with diagnosed diabetes. Individuals with persistently elevated HbA1c should be promptly referred to ophthalmologists.\u003c/p\u003e\n\u003ch2\u003e4.3\u0026nbsp;Association\u0026nbsp;Between\u0026nbsp;Age at\u0026nbsp;Diagnosis of T2DM and DR\u003c/h2\u003e\n\u003cp\u003eAfter adjusting for sex and lifestyle factors, this study demonstrated a significant inverse association between age at diabetes diagnosis and the risk of DR\u0026nbsp;(OR:0.543, 95%CI: 0.414-0.713, P\u0026lt;0.001),\u0026nbsp;indicating that later diagnosis may serve as a protective factor against DR in T2DM. Patients with early-onset T2DM face a higher risk of developing DR compared to those with late-onset T2DM, a finding consistent with multiple cohort studies. For\u0026nbsp;example,\u0026nbsp;Huo et al.\u003csup\u003e31\u003c/sup\u003e reported that early-onset T2DM patients (diagnosed before age 40) had a 2.3-fold higher risk of microvascular complications than late-onset patients.\u0026nbsp;Klein et al.\u003csup\u003e32\u003c/sup\u003e and Raman et al.\u003csup\u003e33\u003c/sup\u003e also\u0026nbsp;observed a significantly higher prevalence of DR among early-onset diabetes patients.\u003c/p\u003e\n\u003cp\u003e\u0026nbsp;The elevated DR risk in early-onset diabetes may be explained by the cumulative burden of prolonged disease duration. Younger patients often exhibit more severe insulin resistance and \u0026beta;-cell dysfunction, leading to greater glycemic variability\u003csup\u003e34\u003c/sup\u003e.\u0026nbsp;Animal studies suggest that early uncontrolled hyperglycemia may induce a \u0026quot;metabolic memory\u0026quot; effect through epigenetic modifications in retinal cells, resulting in sustained suppression of protective gene expression and accelerated microvascular damage, even after subsequent glycemic control\u003csup\u003e35\u003c/sup\u003e.\u0026nbsp;Therefore, clinicians should implement intensive glycemic management for patients diagnosed with diabetes before age 40, aiming for an HbA1c target below 7% (or \u0026le;6.5% in those without hypoglycemia risk). Quarterly HbA1c testing combined with continuous glucose monitoring is recommended to evaluate glycemic variability. Additionally, these patients should undergo\u0026nbsp;a\u0026nbsp;comprehensive dilated fundus examination with optical coherence tomography (OCT) at initial diagnosis, followed by personalized screening schedules based on retinopathy severity.\u003c/p\u003e\n\u003ch2\u003e4.4\u0026nbsp;Association of\u0026nbsp;Increased Heart Rate\u0026nbsp;with DR in\u0026nbsp;T2DM\u003c/h2\u003e\n\u003cp\u003eI\u003cstrong\u003encreased\u003c/strong\u003e heart rate was significantly associated with DR in T2DM (OR:1.008, 95%CI: 1.003-1.014, P=0.004).\u0026nbsp;Diabetes often involves autonomic dysfunction\u003csup\u003e36\u003c/sup\u003e, characterized by sympathetic overactivity and impaired parasympathetic function. This imbalance can lead to increased heart rate, microcirculatory hypoperfusion, vascular endothelial dysfunction, and elevated inflammatory and oxidative stress levels,\u0026nbsp;all of which may contribute to retinal microvascular injury and DR progression. Clinically, resting heart rate should be incorporated as a routine monitoring parameter in T2DM management. For patients with diabetes duration exceeding five years, annual heart rate variability (HRV) assessment is recommended.\u003c/p\u003e\n\u003ch2\u003e4.5\u0026nbsp;Limitations of Study:\u003c/h2\u003e\n\u003cp\u003eAs a single-center study, the sample may not be fully representative of the broader hospital-based population, limiting the generalizability of the results. Moreover, the cross-sectional design precludes causal inference. Future multicenter longitudinal studies are needed to validate the observed associations and elucidate the underlying mechanisms linking these factors to DR incidence in T2DM. Finally, the assessment of lifestyle factors (e.g., diet, smoking) relied on self-report, which is subject to recall and social desirability bias.\u003c/p\u003e\n\u003cp\u003e\u003cbr\u003e\u003c/p\u003e"},{"header":"5. CONCLUSIONS","content":"\u003cp\u003eA total of 5498 patients with T2DM were enrolled in this study, and the overall prevalence of T2DM complicated with DR was found to be approximately 20.81%. Multivariate analysis indicated that poor glycemic control, prolonged disease duration, early-onset diabetes mellitus, and elevated heart rate were all significantly associated with an increased risk of DR in T2DM patients.\u0026nbsp;\u003c/p\u003e\n\u003cp\u003e\u003cbr\u003e\u003c/p\u003e"},{"header":"Abbreviations","content":"\u003cp\u003eTable 1 List of abbreviations\u003c/p\u003e\n\u003ctable border=\"0\" cellspacing=\"0\" cellpadding=\"0\"\u003e\n \u003ctbody\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 277px;\"\u003e\n \u003cp\u003eFull spelling\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 277px;\"\u003e\n \u003cp\u003eAbbreviation\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 277px;\"\u003e\n \u003cp\u003eDiabetic retinopathy\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 277px;\"\u003e\n \u003cp\u003eDR\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 277px;\"\u003e\n \u003cp\u003eNon-diabetic retinopathy\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 277px;\"\u003e\n \u003cp\u003eNDR\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 277px;\"\u003e\n \u003cp\u003eType 2 diabetes mellitus\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 277px;\"\u003e\n \u003cp\u003eT2DM\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 277px;\"\u003e\n \u003cp\u003eFasting blood glucose\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 277px;\"\u003e\n \u003cp\u003eFBG\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 277px;\"\u003e\n \u003cp\u003eHemoglobin A1c\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 277px;\"\u003e\n \u003cp\u003eHbA1c\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 277px;\"\u003e\n \u003cp\u003eBody mass index.\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 277px;\"\u003e\n \u003cp\u003eBMI\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 277px;\"\u003e\n \u003cp\u003eOdds ratio\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 277px;\"\u003e\n \u003cp\u003eOR\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003c/tbody\u003e\n\u003c/table\u003e\n\u003cp\u003e\u0026nbsp;\u003c/p\u003e"},{"header":"Declarations","content":"\u003ch2\u003e\u003cstrong\u003e6.1\u0026nbsp;\u003c/strong\u003eEthics Approval and Consent to Participate\u003c/h2\u003e\n\u003cp\u003eThis study was conducted in accordance with the principles of the Declaration of Helsinki and was approved by the Tianjin Fourth Central Hospital Ethics Committee (Approval No. 2017-SZXLL020). All participants provided written informed consent.\u003c/p\u003e\n\u003ch2\u003e\u003cstrong\u003e6.2\u0026nbsp;\u003c/strong\u003e\u003cstrong\u003eConsent for\u0026nbsp;\u003c/strong\u003e\u003cstrong\u003eP\u003c/strong\u003e\u003cstrong\u003eublication\u003c/strong\u003e\u003c/h2\u003e\n\u003cp\u003eNot applicable.\u003c/p\u003e\n\u003ch2\u003e\u003cstrong\u003e6.3 Availability of Data and Materials\u003c/strong\u003e\u003c/h2\u003e\n\u003cp\u003eThe datasets used and analyzed during the current study are available from the corresponding author on reasonable request.\u003c/p\u003e\n\u003ch2\u003e\u003cstrong\u003e6.4 Competing Interests\u003c/strong\u003e\u003c/h2\u003e\n\u003cp\u003eThe authors declare that they have no competing interests relevant to the content of this article.\u003c/p\u003e\n\u003ch2\u003e6.5 Funding\u003c/h2\u003e\n\u003cp\u003eThis work was supported by the General Program of the National Natural Science Foundation of China [grant numbers\u0026nbsp;82373573]; Tianjin Municipal Science and Technology Program [project\u0026nbsp;numbers\u0026nbsp;24KPHDRC00330]; Tianjin Health Research Project [project\u0026nbsp;numbers\u0026nbsp;TJWJ2023MS019]; Tianjin Key Medical Discipline Construction Project [project\u0026nbsp;numbers\u0026nbsp;TJYXZDXK-3-007B].\u003c/p\u003e\n\u003ch2\u003e6.6\u0026nbsp;Authors' Contributions\u003c/h2\u003e\n\u003cp\u003eXiao Huang: Data curation, Formal analysis, Methodology, Validation, Writing-original draft, Writing - review \u0026amp; editing.\u003cbr\u003e\u0026nbsp;Xuan Chen: Data curation, Formal analysis, Visualization, Writing-original draft, Writing - review \u0026amp; editing.\u003c/p\u003e\n\u003cp\u003eXiaomin Wu: Data curation, Formal analysis, Validation.\u003cbr\u003e\u0026nbsp;Zhaohu Hao: Methodology, Resources.\u003cbr\u003e\u0026nbsp;Hailin Shao: Funding acquisition, Resources, Project administration, Writing - review \u0026amp; editing.\u003cbr\u003e\u0026nbsp;Fei Ma: Conceptualization, Funding acquisition, Resources, Validation, Writing-review \u0026amp; editing.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eXiao Huang and Xuan Chen contributed equally\u003c/strong\u003e\u003cstrong\u003e\u0026nbsp;and\u0026nbsp;\u003c/strong\u003eshould be considered joint first authors.\u003c/p\u003e\n\u003cp\u003eAll authors have read and approved the final version of the manuscript. Each author agrees to be accountable for all aspects of the work, ensuring that any questions regarding the accuracy or integrity of any part of the work are properly investigated and resolved.\u003c/p\u003e\n\u003ch2\u003e\u003cstrong\u003e6.7\u0026nbsp;\u003c/strong\u003e\u003cstrong\u003eA\u003c/strong\u003e\u003cstrong\u003ecknowledgements\u003c/strong\u003e\u003c/h2\u003e\n\u003cp\u003eThe authors sincerely thank the nurses, physicians, and all participants for their cooperation and involvement in this study.\u003c/p\u003e"},{"header":"References","content":"\u003col\u003e\n\u003cli\u003eSalunkhe VA, Veluthakal R, Kahn SE,\u0026nbsp;et al. Novel approaches to restore beta cell function in prediabetes and type 2 diabetes. Diabetologia\u0026nbsp;2018;61(9):1895-1901. doi:10.1007/s00125-018-4658-3\u003c/li\u003e\n\u003cli\u003eMiller DJ, Cascio MA, Rosca MG. Diabetic Retinopathy: The Role of Mitochondria in the Neural Retina and Microvascular Disease. 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Diabetes Care 2003;26(5):1553-1579. doi:10.2337/diacare.26.5.1553\u003c/li\u003e\n\u003c/ol\u003e"}],"fulltextSource":"","fullText":"","funders":[],"hasAdminPriorityOnWorkflow":false,"hasManuscriptDocX":true,"hasOptedInToPreprint":true,"hasPassedJournalQc":"","hasAnyPriority":false,"hideJournal":true,"highlight":"","institution":"","isAcceptedByJournal":false,"isAuthorSuppliedPdf":false,"isDeskRejected":"","isHiddenFromSearch":false,"isInQc":false,"isInWorkflow":false,"isPdf":false,"isPdfUpToDate":true,"isWithdrawnOrRetracted":false,"journal":{"display":true,"email":"[email protected]","identity":"researchsquare","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":true,"externalIdentity":"","sideBox":"","snPcode":"","submissionUrl":"/submission","title":"Research Square","twitterHandle":"researchsquare","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"","reportingPortfolio":"","inReviewEnabled":false,"inReviewRevisionsEnabled":true},"keywords":"Diabetic retinopathy, Risk factors, Glycemic control, Cross-sectional study","lastPublishedDoi":"10.21203/rs.3.rs-8255216/v1","lastPublishedDoiUrl":"https://doi.org/10.21203/rs.3.rs-8255216/v1","license":{"name":"CC BY 4.0","url":"https://creativecommons.org/licenses/by/4.0/"},"manuscriptAbstract":"\u003cp\u003e\u003cstrong\u003eObjectives:\u003c/strong\u003e To investigate the prevalence of diabetic retinopathy (DR) in patients with type 2 diabetes mellitus (T2DM) and to analyze the association between blood glucose-related indicators and the occurrence of DR.\u0026nbsp;\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eMethods:\u003c/strong\u003e \u0026nbsp;A cross-sectional study was conducted among hospital-based patients with T2DM. Participants were categorized into DR and non-diabetic retinopathy (NDR) groups based on fundus photography examinations. Data on demographic characteristics, lifestyle factors, and blood glucose-related indicators were collected. Univariate and multivariable logistic regression analyses were employed to examine the associations between these factors and DR in T2DM patients.\u0026nbsp;\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eResults: \u003c/strong\u003e\u0026nbsp;Among 5,498 patients with T2DM, 1,144 (20.81%) were diagnosed with DR. Univariate analysis revealed significant associations between DR and diagnosis age of T2DM, duration of T2DM, HbA1c, heart rate, smoking history, daily fruit consumption, and daily soy-products consumption (P\u0026lt;0.05). After adjusting for age, sex, and lifestyle factors, multivariable logistic regression demonstrated independent associations with DR for the following factors: diagnosis age of T2DM (OR: 0.543, 95%CI: 0.414-0.731), duration of T2DM (1-5 years: OR: 1.713, 95%CI: 1.416-2.073; 5-10 years: OR: 2.516, 95%CI: 2.012-3.145; ≥10 years: OR: 4.659, 95%CI: 3.748-5.790), HbA1c (OR: 1.111, 95%CI: 1.069-1.154), and heart rate (OR: 1.008, 95%CI: 1.003-1.014) (P\u0026lt;0.05).\u0026nbsp;\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eConclusions:\u003c/strong\u003e The prevalence of DR among T2DM patients was 20.81%, with non-proliferative diabetic retinopathy (NPDR) being the predominant type, accounting for 96.85% of cases. Elevated HbA1c levels, longer duration of T2DM, younger age at diagnosis of T2DM, and increased heart rate were identified as independent risk factors for DR.\u003c/p\u003e","manuscriptTitle":"Full Title: Association Between Blood Glucose-Related Indicators and Diabetic Retinopathy in Type 2 Diabetes: A Cross-Sectional Study","msid":"","msnumber":"","nonDraftVersions":[{"code":1,"date":"2026-01-12 08:10:54","doi":"10.21203/rs.3.rs-8255216/v1","editorialEvents":[{"type":"communityComments","content":0}],"status":"published","journal":{"display":true,"email":"[email protected]","identity":"researchsquare","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":true,"externalIdentity":"","sideBox":"","snPcode":"","submissionUrl":"/submission","title":"Research Square","twitterHandle":"researchsquare","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"","reportingPortfolio":"","inReviewEnabled":false,"inReviewRevisionsEnabled":true}}],"origin":"","ownerIdentity":"d79d1182-8c30-442b-a161-87cf4331eb57","owner":[],"postedDate":"January 12th, 2026","published":true,"recentEditorialEvents":[{"type":"decision","content":"Withdrawn","date":"2026-05-13T07:37:45+00:00","index":"","fulltext":""}],"rejectedJournal":[],"revision":"","amendment":"","status":"posted","subjectAreas":[],"tags":[],"updatedAt":"2026-05-13T07:56:06+00:00","versionOfRecord":[],"versionCreatedAt":"2026-01-12 08:10:54","video":"","vorDoi":"","vorDoiUrl":"","workflowStages":[]},"version":"v1","identity":"rs-8255216","journalConfig":"researchsquare"},"__N_SSP":true},"page":"/article/[identity]/[[...version]]","query":{"redirect":"/article/rs-8255216","identity":"rs-8255216","version":["v1"]},"buildId":"XKTyCvWXoU3ODBz1xrDgd","isFallback":false,"isExperimentalCompile":false,"dynamicIds":[84888],"gssp":true,"scriptLoader":[]}