{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,11,7]],"date-time":"2026-11-07T05:55:45Z","timestamp":1794030945041,"version":"4.8.0"},"reference-count":24,"publisher":"SAGE Publications","issue":"4","license":[{"start":{"date-parts":[[2026,4,1]],"date-time":"2026-04-01T00:00:00Z","timestamp":1775001600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"},{"start":{"date-parts":[[2026,4,1]],"date-time":"2026-04-01T00:00:00Z","timestamp":1775001600000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"funder":[{"DOI":"10.13039\/501100018543","name":"Natural Science Foundation of Tibet Autonomous Region","doi-asserted-by":"publisher","award":["XZ202401ZR0063"],"award-info":[{"award-number":["XZ202401ZR0063"]}],"id":[{"id":"10.13039\/501100018543","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["J Int Med Res"],"published-print":{"date-parts":[[2026,4]]},"abstract":"<jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>To estimate the prevalence, severity, awareness, and clinical correlates of diabetic retinopathy among adults with type 2 diabetes living at very high altitude in Tibet.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>This cross-sectional, community-based subanalysis used prospectively collected data from the China National Diabetic Chronic Complications Study data. Adults with physician-diagnosed type 2 diabetes from three Tibet sites (3650\u20134300\u2009m) with \u22651 gradable nonmydriatic fundus photograph were included (N\u2009=\u2009320). Diabetic retinopathy was centrally graded using the International Clinical scale. Vision-threatening diabetic retinopathy was defined as severe nonproliferative or proliferative diabetic retinopathy. Kidney indices included the urinary albumin-to-creatinine ratio and estimated glomerular filtration rate. Parsimonious multivariable logistic regression (complete-case n\u2009=\u2009318) was used to evaluate correlates of any diabetic retinopathy.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      The prevalence of any diabetic retinopathy was 16.6% (95% confidence interval: 12.9\u201321.0), whereas vision-threatening diabetic retinopathy was observed in 4.4% of participants (95% confidence interval: 2.6\u20137.2). Diabetic retinopathy was predominantly nonproliferative, and proliferative diabetic retinopathy was rare (0.3%). Only 36.5% of participants with diabetic retinopathy reported prior awareness. Higher urinary albumin-to-creatinine ratio and estimated glomerular filtration rate &lt;60\u2009mL\/min\/1.73\u2009m\n                      <jats:sup>2<\/jats:sup>\n                      were independently associated with diabetic retinopathy, whereas glycated hemoglobin was not significant after adjustment.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>In community-dwelling Tibetans with type 2 diabetes living at very high altitude, diabetic retinopathy is common, awareness is low, and markers of kidney damage are strongly associated with diabetic retinopathy, supporting integrated retinal\u2013renal screening.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/03000605261437612","type":"journal-article","created":{"date-parts":[[2026,4,9]],"date-time":"2026-04-09T11:03:50Z","timestamp":1775732630000},"update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":3,"title":["Diabetic retinopathy and kidney involvement in adults with type 2 diabetes in high-altitude Tibet: A cross-sectional subanalysis of the China National Diabetic Chronic Complications Study"],"prefix":"10.1177","volume":"54","author":[{"given":"Lihui","family":"Yang","sequence":"first","affiliation":[{"name":"Department of Science and Education, People\u2019s Hospital of Xizang Autonomous Region, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4550-9380","authenticated-orcid":false,"given":"Zexin","family":"Zhang","sequence":"additional","affiliation":[{"name":"Kyoto University"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2026,4,9]]},"reference":[{"key":"e_1_3_8_2_2","doi-asserted-by":"publisher","DOI":"10.1016\/S2213-8587(25)00299-2"},{"key":"e_1_3_8_3_2","doi-asserted-by":"publisher","DOI":"10.1016\/S2214-109X(20)30489-7"},{"key":"e_1_3_8_4_2","doi-asserted-by":"publisher","DOI":"10.2337\/dc25-S012"},{"key":"e_1_3_8_5_2","doi-asserted-by":"publisher","DOI":"10.1001\/jama.2021.22208"},{"key":"e_1_3_8_6_2","doi-asserted-by":"publisher","DOI":"10.1038\/s41467-023-39864-w"},{"key":"e_1_3_8_7_2","doi-asserted-by":"publisher","DOI":"10.1073\/pnas.2102463118"},{"key":"e_1_3_8_8_2","doi-asserted-by":"publisher","DOI":"10.1136\/bmjopen-2023-072854"},{"key":"e_1_3_8_9_2","doi-asserted-by":"publisher","DOI":"10.1136\/heartjnl-2014-307158"},{"key":"e_1_3_8_10_2","doi-asserted-by":"publisher","DOI":"10.2174\/13894501113149990015"},{"key":"e_1_3_8_11_2","doi-asserted-by":"publisher","DOI":"10.3389\/fphar.2020.01063"},{"key":"e_1_3_8_12_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.phrs.2022.106292"},{"key":"e_1_3_8_13_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijbiomac.2026.150272"},{"key":"e_1_3_8_14_2","first-page":"633","article-title":"Data resource profile: a protocol of china national diabetic chronic complications study","volume":"35","author":"Hou XH","year":"2022","unstructured":"Hou XH, Wang LM, Chen SY, et\u00a0al. Data resource profile: a protocol of china national diabetic chronic complications study. 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