Bushuyeva O. Prognosis and diagnosis optimization of diabetic retinopathy in patients with type 2 diabetes mellitus.

The dissertation is devoted to the theoretical generalization and the decision of an actual scientific task – increase of efficiency of forecasting and diagnostics of diabetic retinopathy on the basis of complex studying of clinical and laboratory data and polymorphic variants rs759853 and rs9640883 of an aldose reductase gene (AKR1B1) in patients with type 2 diabetes. Biochemical and molecular genetic examinations were performed in 409 patients, including: 204 patients with cataracts and type 2 diabetes, 98 patients with cataracts without type 2 diabetes, 107 healthy patients. Scientific data on the influence of oxidative stress and disorders of the enzymatic antioxidant system on the development and progression of diabetic retinopathy in patients with type 2 diabetes have been supplemented: with increasing severity of diabetic retinopathy, the level of diene conjugates in intraocular fluid increased significantly, while catalase activity decreased. The dependence of lipid peroxidation intensity in diabetic retinopathy on AKR1B1 gene polymorphism was proved for the first time. The distribution of genotypes of rs759853 and rs964088 polymorphisms of the AKR1B1 gene was evaluated. It was found that the development of diabetic retinopathy is associated with the presence in the rs759853 polymorphism of the A allele and the A / A genotype, and in the rs9640883 polymorphism - the G allele and the G / G genotype. For the first time, the role in the development of diabetic retinopathy in patients with type 2 diabetes mellitus of the haplotype of both polymorphisms of the AKR1B1 gene has been proven: the haplotype is at risk (A / A rs759853 * G / G rs9640883). The diagnostic role of rs759853 and rs9640883 polymorphisms of the AKR1B1 gene was substantiated for the first time. A model for predicting the development of diabetic retinopathy in patients with type 2 diabetes has been developed.