Архив офтальмологии Украины Том 14, №1, 2026

Актуальність. У статті наведені дані про вивчення ранніх діагностичних маркерів розвитку та прогресування діабетичної ретинопатії (ДР) у хворих на цукровий діабет (ЦД) 2-го типу з метаболічно-асоційованою стеатотичною хворобою печінки (МАСХП). Підтверджена важливість визначення рівнів інтерлейкіну-6, TNF-α та мелатоніну для більш ранньої діагностики та профілактики як ДР, так і патології печінки. Мета: визначити діагностичну цінність мелатоніну як біомаркера розвитку та прогресування ДР у хворих на ЦД 2-го типу. Матеріали та методи. У дослідженні брали участь хворі на ЦД 2-го типу, що були розподілені на 3 групи. У І групу увійшли хворі з ДР та МАСХП, у ІІ — з ДР, але без патології печінки, а ІІІ становили пацієнти без ДР та МАСХП. Проводилось визначення рівнів мелатоніну, ІL-6 і TNF-α та вивчались наявні кореляції. Результати. У всіх трьох групах виявлено зниження нічного піку мелатоніну. У групах з ДР мелатонін був вірогідно нижчим, особливо у пацієнтів з проліферативною ДР, ніж у ІІІ групі (p < 0,05). Найнижчий рівень мелатоніну виявлено у групі хворих з ДР та МАСХП. Також рівень мелатоніну зворотно корелював з компенсацією ЦД, швидкістю прогресування ДР та ступенем фіброзу печінки. Рівні інтерлейкіну-6 були найвищими у пацієнтів з декомпенсацією ЦД та проліферативною ретинопатією, а показники TNF-α корелювали з індексом фіброзу печінки. Висновки. Отримані результати підкреслюють важливість визначення рівня мелатоніну, а також інтерлейкіну-6 та TNF-α у хворих на ЦД 2-го типу як предикторів розвитку та прогресування ДР.

Background. The article presents data on the early diag­nostic markers for the development and progression of diabetic retinopathy (DR) in patients with type 2 diabetes mellitus and meta­bolic dysfunction-associated steatotic liver disease (MASLD). The importance of determining the levels of interleukin 6 (IL-6), tumor necrosis factor α (TNF-α), and melatonin for earlier diagnosis and prevention of both DR and liver pathology has been proven. The purpose was to determine the diagnostic value of melatonin as a biomarker for the development and progression of DR in patients with type 2 diabetes mellitus. Materials and methods. The study involved type 2 diabetic patients who were divided into 3 groups. The first group included participants with DR and MASLD, the second group consisted of patients with DR but without liver pathology, and the third group included those without DR and MASLD. Mela­tonin, IL-6, and TNF-α levels were determined, and the existing relationships were studied. Results. A decrease in the nighttime peak of melatonin was found in all three groups. In the groups with DR, melatonin was significantly lower, especially in patients with prolife­rative DR, than in the third group (p < 0.05). The lowest melatonin was found in the group with DR and MASLD. Melatonin levels also inversely correlated with diabetes compensation, DR progression rate, and liver fibrosis stage. IL-6 levels were highest in patients with decompensated diabetes and proliferative retinopathy, and TNF-α levels correlated with the liver fibrosis index. Conclusions. The findings emphasize the importance of determining melatonin, IL-6, and TNF-α levels in patients with type 2 diabetes mellitus as predictors for the development and progression of DR.

цукровий діабет 2-го типу; діабетична ретинопатія; метаболічно-асоційована стеатотична хвороба печінки; фіброз печінки; мелатонін; біомаркери

type 2 diabetes mellitus; diabetic retinopathy; metabolic dysfunction-associated steatotic liver disease; liver fibrosis; melatonin; biomarkers

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