diaendoСахарный диабетDiabetes mellitus2072-03512072-0378Endocrinology research centre10.14341/DM12798diaendo-12798Research ArticleОбзорыReviewДисфункция мейбомиевых желез у пациентов с сахарным диабетомDysfunction of the meibomian glands in patients with diabetes mellitushttps://orcid.org/0000-0002-4601-0904СафоноваТ. Н.SafonovaT. N.

Сафонова Татьяна Николаевна, кандидат медицинских наук

Москва

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Tat`yana N. Safonova, MD, PhD

Moscow

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safotat@mail.ruhttps://orcid.org/0000-0001-8466-8566МедведеваЕ. С.MedvedevaE. S.

Медведева Екатерина Сергеевна 

119571, Москва, ул. ­26-ти Бакинских комиссаров, д. 7, к. 4

Researcher ID: AAW-4247-2021;

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Ekaterina S. Medvedeva, MD

7 26-ti Bakinskih komissarov street, 119571, Moscow

Researcher ID: AAW-4247-2021;

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arena0109@mail.ruНаучно-исследовательский институт глазных болезнейResearch Institute of Eye Diseases202225032022252186191Copyright © Сафонова Т.Н., Медведева Е.С., 20222022Сафонова Т.Н., Медведева Е.С.Safonova T.N., Medvedeva E.S.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://www.dia-endojournals.ru/jour/article/view/12798

Распространенность сахарного диабета (СД) за последние десятилетия значительно возросла. Наиболее частыми офтальмологическими проявлениями СД являются ретинопатия, эпителиопатии, эрозии роговицы и синдром сухого глаза, симптомы которого выражены в большей степени, чем у людей, не страдающих диабетом. Мейбомиевы железы, являясь основным источником различных липидов, участвуют в формировании липидного слоя слезной пленки, препятствующей испарению водно-муциновой фазы и обеспечивающей сохранность гомеостаза глазной поверхности. Мейбум — богатый липидами секрет, вырабатываемый полностью дифференцированными мейбоцитами. Нарушение секреции инсулина, инсулинорезистентность, абсолютный дефицит инсулина, а также гипергликемия потенцируют развитие оксидативного стресса и каскада метаболических изменений, приводящих к изменению анатомо-функционального состояния мейбомиевых желез, что сказывается на качественном и количественном составе секрета. Посредством метода лазерной сканирующей микроскопии были установлены цитологические аномалии, а также изменения структуры выводных протоков мейбомиевых желез у пациентов с длительным течением СД. С помощью метода масс-спектрометрии возможно определить закономерности изменений химического состава мейбума у пациентов, страдающих СД. Полученные данные могут стать одним из критериев прогноза течения, отражать степень компенсации и/или прогрессирования СД.

The prevalence of diabetes mellitus has increased in recent decades. The most common ophthalmic manifestations of diabetes mellitus are retinopathy, epitheliopathies, corneal erosion and dry eye syndrome, the symptoms of which are more pronounced than in people without diabetes. The meibomian glands, which are the producer of various lipids, participate in the formation of the lipid layer of the tear film, which prevents the evaporation of the water-mucin phase and ensures the preservation of homeostasis of the ocular surface. Meibum is a lipid-rich secret produced by fully differentiated meibocytes. Impaired insulin secretion, insulin resistance, absolute insulin deficiency, as well as hyperglycemia, potentiate the development of oxidative stress and a cascade of metabolic changes, leading to a change in the anatomical and functional state of the meibomian glands, which affects the qualitative and quantitative secretion. Cytological abnormalities, as well as the structure of the excretory ducts of the meibomian glands in patients with long-term diabetes mellitus, were established using the method of laser scanning microscopy. Using the method of mass spectrometry, it is possible to determine the patterns of changes in the chemical composition of meibum in patients with diabetes mellitus. The data obtained can become one of the criteria for predicting the course, reflect the degree of compensation and / or progression of diabetes mellitus.

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The authors declare that there are no conflicts of interest present.