Purpose To study the prevalence and associations of dry eye symptoms in adult Chinese. Methods The Beijing Eye Study is a population-based study in northern China, which included 4439 of 5324 subjects invited to participate with an age of 40 þ years (response rate: 83.4%). For the present study, a random sample was taken consisting of 1957(44.1%) subjects (1112 women; 56.9%). Dry eye symptoms were evaluated with (1) an interviewer-assisted questionnaire; (2) measurement of the tear-film break-up time; (3) assessment of the fluorescein staining of the cornea; (4) slit-lamp-based examination of a meibomian gland dysfunction; and (5) Schirmer's test. Results Symptoms of a dry eye felt 'often' or 'at all times' were present in 411 subjects (21.0%). In a multivariate analysis, dry eye symptoms were significantly associated with age (Po0.001), female gender (Po0.001; odds ratio (OR): 1.56; 95% confidence intervals (CI): 1.23, 1.98), urban region (Po0.001;OR: 1.89; 95% CI: 1.46, 2.48), low degree of nuclear cataract (P ¼ 0.02), and undercorrection of refractive error (P ¼ 0.005; OR: 1.42; 95% CI: 1.11, 1.82). All tests for dry eye did not vary significantly between the dry eye group and the normal group. Conclusions The dry eye symptoms as evaluated subjectively in a questionnaire occurred in about 21% of the adult population in China, with associations to age, female gender, urban region, and undercorrection of a refractive error. Measurement of the tear-film break-up time, assessment of the corneal fluorescein staining, slit-lamp-based examination of a meibomian gland dysfunction, and Schirmer's test were not significantly associated with dry eye symptoms.

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Statistics.No statistical method was used to predetermine the sample size. The values are presented as mean ± SEM. Statistical differences between the experimental and control groups were determined by 2-tailed t test (either unpaired or paired) using Microsoft Excel and GraphPad Prism 6 (GraphPad Software, Inc.). P values less than 0.05 were considered statistically significant. Box-and-whisker plots were drawn using GraphPad Prism 6.Study approval. Approval of the animal-based studies was obtained from the Institutional Animal Care and Use Committees at the USC. Deidentified human cornea rims were obtained after the excision of the cornea for transplantation under the approval of the Institutional Review Board of the USC.

Apolipoprotein E (ApoE) gene polymorphism has been implicated in predisposition to diabetes and dementia in old population, but the results from the different studies were inconclusive. A cross-sectional study was carried out to explore the relationship among ApoE gene polymorphism, diabetes and cognition in non-demented aging Chinese adults. A total number of 1000 community dwellers aged 55 years and above were randomly recruited. Demographic information of the participants was collected using well designed self-administered questionnaires. The Montreal Cognitive Assessment (MoCA) test was employed to evaluate the cognitive status of the participants. Semi-quantitative food frequency questionnaire was used to obtain the dietary intake information. Fasting venous blood samples were taken for ApoE genotyping and serum lipid measurements. 238 participants were type 2 diabetes mellitus (T2DM) patients and 145 participants were ApoE4 carriers. ApoE 4-T2DM subjects had higher serum triglyceride (TG) concentration than E2 and E3 carriers (P < 0.05). T2DM subjects carrying ApoE4 had lower cognition than subjects with E2 or E3 carriers (P < 0.05). Comparing to non-type 2 diabetic mild cognitive impaired (nT2DM-MCI) subjects, the type 2 diabetic mild cognitive impaired (T2DM-MCI) subjects have higher serum glucose (Glu) level and lower high-density lipoprotein (HDL-C) level (P < 0.05). The T2DM-MCI subjects carrying ApoE4 have lower cognition than E2 and E3 carriers (P <0.05); and the interaction of ApoE genotype with T2DM was detected (P < 0.05). Our results indicated the association among ApoE gene polymorphism, T2DM and cognitive performance in non-demented aging population. The carrying of ApoE4 predisposed the T2DM subjects and the T2DM-MCI subjects to have poor cognitive performance. Additional experimental studies are required to explore the mechanism that ApoE genotype modifies the risk for cognitive impairment in aging subjects with T2DM.