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

Abstract Purpose: To investigate the pterygium prevalence and evaluate risk factors of pterygium in rural community-based type 2 diabetic (D2M) patients aged 50 years and above in Funing Country, Jiangsu Province, China. Methods A cross-sectional ophthalmic survey was conducted in type 2 diabetes mellitus (D2M) patients aged ≥50 years in Funing county, Jiangsu Province, China, which was named Jiangsu Diabetic Eye Disease Study (JDEDS). All participants underwent a comprehensive questionnaire and ocular examination. Pterygium was diagnosed by slit lamp examination. The risk factors associated with pterygium were evaluated with logistic regression models.Results The prevalence of pterygium was 22.37% (n= 427) and 95% confidence interval (CI): (20.50-24.24%) in D2M patients aged 50 years and above in JDEDS. The prevalence of pterygium was 18.32% (95% CI: 15.33~21.32%) in men and 24.43% (95% CI: 22.06~26.80%) in women. Women had a higher prevalence than men (p= 0.001). Multivariate analysis showed, for male participants with D2M, pterygium was independently associated with increasing age [ 70-79yrs: OR and 95% CI: 2.49(1.20~5.18), p=0.014; ≥80yrs: 4.84(2.04~11.47), p<0.001], while cigarette smoking was the protective factors, especially in current smoker [OR and 95% CI: 0.79(0.67~0.92); p=0.003]. For female participants with D2M, age [ 60-69yrs OR and 95% CI: 1.68(1.07~2.62), p=0.023; 70-79yrs: 2.62(1.69~4.06), p<0.001; ≥80yrs:3.24(1.70~5.90), p<0.001], hypertension [OR and 95%CI: 1.40(1.05~1.87), p=0.024], BMI 24-27.9 [OR and 95%CI: 1.20(1.00~1.44), p=0.047], higher HbA1c [ (5.6-7.9) % OR and 95%CI: 1.42(1.10~1.82), p=0.006; (8.0-9.9) %: 1.32(1.10~1.58), p=0.003] were risk factors. Conclusions D2M patients aged over 50 years has a high prevalence of pterygium in JDEDS. The pterygium prevalence is higher in female D2M participants. Diabetes and related factors may be risk factors of pterygium in female D2M patients. Further studies are needed to explore the gender difference in the pathogenesis of pterygium in D2M subjects.