Abstract
Background. Diabetes mellitus (DM) is a chronic metabolic disorder characterized by chronic hyperglycemia due to insulin resistance and/or impaired insulin secretion. Diabetic retinopathy (DR) is the most common neurovascular complication of DM, the most frequent cause of new cases of blindness among adults aged 20–74 years. A critical step in the pathogenesis of DR is the adhesion of leukocytes to endothelial cells, which is mediated by specific adhesion molecules. Among the key participants in this process is the cluster of differentiation chemokine CD54. There are tight connections between the state of the hematoretinal barrier and CD54 expression. Studying the relationship between CD54 and the course of DR is an actual issue of modern ophthalmology. Aim: was to make a model for assessing the prognostic significance of serum CD54 in the development and progression of DR in patients with type 2 diabetes. Materials and methods. An open observational study was conducted among adult patients with T2D and DR. The inclusion of patients in groups with DR was occurred in accordance with the ETDRS (2019) protocol. Research methods: ophthalmological (visometry, Humphrey perimetry, refractometry, tonometry, biomicroscopy, gonioscopy, ophthalmoscopy, optical coherence tomography, including in Angio mode, photography of the fundus with a fundus camera). The study was conducted in 82 patients with DR (148 eyes) (28 men and 54 women, average age 64.41±1.18 years, average duration of diabetes 15.54±0.83 years old, average HbA1c level 9.17±0.22%. The concentration of CD54 in blood serum was determined by enzyme immunoassay. Statistical analysis included discriminant analysis. Differences were considered statistically significant at p<0.05. Results. It is shown that the blood serum CD54 concentration, HbA1c content (diabetes compensation state) and visual acuity play a leading role among the main clusters of the formation of DR stage I, while insulin therapy and the duration of diabetes play a major role in the course of DR stage III. The formation of the DR stage II is characterized by a balanced contribution of variables (clusters) (blood serum CD54 concentration, HbA1c, visual acuity, age of patients, standing of diabetes, type of antidiabetic therapy). Conclusion. Models for assessing the risk of progression of diabetic retinopathy in patients with type 2 diabetes are adequate, with a statistically significant value of 65.8% (p=0.0001) or 76.8% (p=0.003), depending on the type of chosen model