THE ROLE OF E-SELECTIN IN THE DEVELOPMENT OF MACULAR EDEMA IN DIABETIC RETINOPATHY DURING TYPE 2 DIABETES

Abstract

Background. Diabetic retinopathy (DR) and diabetic macular edema (DME) are frequent complications of type 2 diabetes (T2D). Implementation of their effective diagnosis and prognosis by identifying new biomarkers is an important task of modern ophthalmology. Aim: is to establish the role of E-selectin in the development of DME in DR of various degrees in patients with T2D. Materials and methods. The study included 124 patients (124 eyes) with T2D who had mild (29 eyes, group 1), moderate or severe (35 eyes, group 2) non-proliferative DR and proliferative DR (31 eyes, 3rd group); the control group consisted of 29 eyes without diabetes. All patients underwent standard ophthalmological examinations, spectral domain optical coherence tomography (OCT) with determination of central retinal thickness (CRT, μm). The DME set more values of the regulatory database on the ETDRS fields of the spectral-domain OKT software when the CRT is increased. The content of E-selectin in the blood was determined by the immunoenzymatic method (Invitrogen ThermoFisher Scientific, USA). MedStat and MedCalc v.15.1 software packages (MedCalc Software bvba) were used for statistical research. Results. The content of E-selectin in the blood in DR and T2D was significantly increased in all stages of DR (1.2-1.3 times; p<0.01), with a maximum in proliferative DR, which directly correlated with indicators that reflected glycemic control (HbA1c), retinal edema (CRT) and visual acuity deterioration. The content of E-selectin when dividing patients according to the presence of DMN was higher than without it (1.3 times; p<0.001), which was preserved for all stages of DR. The existence of a pathogenetic connection between an increase in the content of E-selectin and the development of DME and the possibility of its use as a biomarker of DME was confirmed in a univariate regression analysis: an increase in the DME risk with an increase in the content of E-selectin was found (OR=1.19; 95% CI 1.12-1.26). The model had satisfactory performance criteria - AUC=0.89 (95% CI 0.83-0.94) with a sensitivity of 89.8% and a specificity of 80.0%. Conclusion. The results of the study confirmed the concept of the significant importance of increasing the content of E-selectin in the blood for the development of DME in DM and T2D.