Діабетична ретинопатія та секс-стероїд-зв’язувальний глобулін: гіпотеза чи реальний взаємозв’язок?

Materials and methods. We investigated the SSBG level in the blood serum of 76 patients with type 2 diabetes mellitus (T2DM), obesity and diabetic retinopathy (DR) of different stages (men and women, mean age 59.98±4.17 years, the average length of diabetes 10.01±2.81 years, the average level of glycated hemoglobin (HbA1C) 10.94±2.08%) and in 23 patients with obesity without T2DM (men and women, mean age 57.03±4.91 years), which constituted the control group. Results. An ANOVA analysis has shown that the initial stage of DR (minimal and mild non-proliferative DR) is characterized by a significant increase of serum SHBG level in patients with T2DM compared with the control group (89.0±8.6 nmol/l; 95% CI 76.9-101.2 vs 59.9±11.2 nmol/l; 95% CI 44.1-75.7). It was found that a statistically significant increase of SHBG serum level is observed in a moderate and severe non-proliferative stage of DR compared with obesity without T2DM (103.8±17.9 nmol/l; 95% CI 78.6-129.0 vs 59.9±11.2 nmol/l; 95% CI 44.1-75.7). A moderate increase of SHBG serum level was observed in the proliferative stage of DR in patients of all risk groups. It was shown that in comparison with obesity group the reference values of serum SHBG level were excessed predominantly in females (40.0±15.59% in women vs 23.1±11.67% in men, p Conclusion. On the proliferative stage of DR the protective effect of SHBG on the eyes vascular membrane decreases in connection with decreasing of its content in the blood, caused by insulin therapy and fatty liver dystrophy, i.e. nonalcoholic fatty liver dystrophy has, perhaps, a paradoxical positive effect on the course of DR, which can be regarded as the phenomenon first described by the authors in this article.