Diabetic retinopathy (DR) is a leading cause of visual impairment among patients with type 2 diabetes mellitus (T2DM). Evidence regarding the association between lower extremity physical performance and DR remains limited; therefore, this study aimed to investigate this relationship among patients with T2DM in China. A cross-sectional study was conducted among adult patients with diagnosed T2DM attending community health centers in Shaoguan. Lower extremity physical performance was assessed using the balance status, chair stand time, and gait speed. DR was determined through retinal photography. Multivariable logistic regression models were used to assess the association between lower extremity physical performance and the presence of DR. Among 3079 participants with type 2 diabetes, 999 (32.3%) were diagnosed with DR. Compared to non-DR individuals, participants with DR had lower BMI, poorer balance, longer diabetes duration, and higher HbA1c levels. Multivariable logistic regression showed that better balance was associated with lower odds of DR odds ratio (OR) = 0.66, 95% confidence interval (CI): 0.45–0.96, while longer chair stand times were associated with higher odds of DR (OR = 1.04, 95% CI: 1.02–1.06). Gait speed was not significantly associated with DR (OR = 1.03, 95% CI: 0.96–1.09). In exploratory ROC analysis, the fully adjusted model showed modest discrimination for DR, with an AUC of 0.682 (95% CI: 0.660–0.704). In this community-based sample of Chinese patients with T2DM, poorer lower extremity physical performance was associated with the presence of DR. These findings suggest that physical function assessment may provide complementary information on overall health status, but its role in DR risk assessment requires prospective validation.
Zhou et al. (2026) studied this question.