Background. Diabetic retinopathy (DR) is one of the main complications of diabetes mellitus, the main cause of irreversible blindness in patients of working age in industrialized countries, has a high incidence rates and refers to neovascular eye diseases. At the present time, additional factors that affect the sensitivity to chronic hyperglycemia, the formation of microvascular complications, in particular, DR, include obesity and obesity-associated hormones of adipose tissue (adipokines: leptin, adiponectin, resistin, etc.). Purpose. To investigate the serum adiponectin levels in patients at different stages of DR in type 2 diabetes mellitus (T2DM) and obesity. Material and Methods. Study involved 99 patients, divided into 2 groups. The 1-st group (control group) consisted of 23 persons with obesity without T2DM (both male and female subjects; mean age, 57.03 ± 4.91 years), the 2-nd group consisted of 76 patients with T2DM, obesity and DR (both male and female subjects; mean age, 59.98 ± 4.17 years; mean duration of diabetes, 10.01 ± 2.81 years; mean glycated hemoglobin (HbA1C) level, 10.94 ± 2.08%), subdivided into 3 subgroups: with minimal and mild non-proliferative DR, with moderate to severe non-proliferative DR, with proliferative DR. The concentration of serum adiponectin was determined by ELISA kit. Statistical analysis included one-and two-factor analysis of variance. Results. Patients with mild non-proliferative DR had somewhat lower (worst) adiponectin levels among patients aged 60 and below with DM subcompensation. The lowest serum adiponectin levels were common for moderate to severe nonproliferative DR among T2DM patients aged above 60 with duration of diabetes of 10 years or less and with T2DM compensation. Among T2DM patients with proliferative DR, the worst serum adiponectin levels were common for T2DM patients aged 60 and below with duration of diabetes of less than 10 years and with T2DM compensation. Considering statistic values of serum adiponectin levels for this stage, it should be noted that, for conditionally combined proliferative DR with severe and moderate DR, statistically significant changes (р=0.007) consisted in the decreased serum adiponectin levels in T2DM compensation. Conclusions. Minimal and mild non-proliferative DR is characterized by a significant lower serum adiponectin level compared with the subsequent stages in subcompensation of T2DM.

AimTo assess the severity of dry eye disease (DED) in humans, its impact on quality of life (QoL) and to grade the damage incurred by the anterior ocular surface in patients diagnosed with type 2 diabetes mellitus (T2DM).Patients and methodsForty-six patients (mean age ± SD = 63.8 ± 6.7 years) diagnosed with T2DM were enrolled in the experimental group and 26 healthy individuals constituted the control group (67.9 ± 8.9 years). The diagnosis and gradation of DED were conducted in accordance with the International Task Force severity grading scheme. Disease-specific questionnaires were used to obtain the Ocular Surface Disease Index (OSDI) and assess the negative effects of the disease on the patient’s QoL. The severity of conjunctival redness and corneal/conjunctival staining was assessed by Efron and Oxford scales, respectively.ResultsAccording to OSDI scores, the entire experimental group presented symptoms of DED: 54.4% were diagnosed with mild DED and 46.6% with moderately severe DED. No cases of severe DED were diagnosed in either the experimental or control group. In the control group, 57.7% of individuals did not have the disease. A significant difference between the experimental and control groups was recorded for both OSDI scores (p  < 0.01) and health-related QoL (p < 0.01). It was observed that keratopathy influenced the mean OSDI values of patients. The mean OSDI value was 25.14 ± 3 in the experimental group diagnosed with keratopathy, 19.3 ± 3.5 in the subgroup with no indications of corneal injury (p = 0.000002), and 13.0 ± 3.0 in the control group (p  <  0.000002). Based on the DEWS scheme, a grade I severity level was observed in 46% of control subjects and 33% of patients diagnosed with T2DM (p = 0.4915); grades II and III were detected in the bulk of the experimental group (p = 0.0051; p = 0.1707). None of the subjects in the control or experimental groups manifested grade IV severity of DED.ConclusionIn comparison to healthy adults, DED adversely impacts the QoL of type 2 DM patients, regardless of the disease’s association with keratopathy.

Актуальність. Діабетична ретинопатія (ДР) є провідною причиною втрати зору у всьому світі. Мета дослідження: вивчити рівень глікемії та інсулінорезистентності у хворих на ДР на тлі цукрового діабету 2-го типу (СД2) і ожиріння. Матеріали та методи. Дослідження проведені в 137 пацієнтів (234 ока), розподілених на дві групи. Результати. Подано результати дослідження за допомогою двофакторного дисперсійного аналізу ступеня інсулінорезистентності як головного кластера метаболічного синдрому на різних стадіях ДР, а також показників вуглеводного обміну як одного з провідних чинників ризику прогресування ретинопатії при СД2 з урахуванням обтяжливих факторів перебігу СД2 (вік хворих, тривалість діабету, ступінь його компенсації) і виду цукрознижувальної терапії. Показано, що всі пацієнти з ДР, незалежно від досліджуваної групи, перебувають у стані хронічної гіперглікемії при декомпенсації СД2. Висновки. Показники вуглеводного обміну розпочинають поліпшуватися тільки в проліферативній стадії ДР, однак це трапляється на тлі тяжких гіпоглікемій. У проліферативній стадії ДР перебуває найбільша кількість хворих із несприятливими індексами інсулінорезистентності за індексом HOMA-IR і зниженою чутливістю до інсуліну за індексом QUICKI.

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