BEHAVIORAL AND GENETICALLY DETERMINED DIFFERENCES IN PATIENTS WITH TYPE 2 DIABETES MELLITUS COMPLICATED BY RETINOPATHY WITH DIFFERENT PPARG-DEPENDENT PHENOTYPE

Abstract

Relevance. The problem of treatment and prevention of microvascular complications against the background of hyperglycemia is much broader than adherence to an appropriate diet. It is necessary to take into account both the behavioral characteristics of a person and the genetically determined mechanisms of metabolic regulation.
 Objective to study the behavioral and genetically determined differences in patients with type 2 diabetes mellitus complicated by retinopathy with different PPARG-dependent phenotype.
 Materials and methods. The study included 101 patients with type 2 diabetes mellitus (T2DM), who, according to the results of an ophthalmological examination, revealed various stages of diabetic retinopathy (DR) according to the ETDRS scale. The control group (CG) included 40 people without diabetes, comparable to patients by gender, age, and body mass index. Gene polymorphism was determined using real-time PCR on an automatic amplifier Gene Amp® PCR System 7500, the fatty acid spectrum (FA) was determined using gas-liquid chromatography, and behavioral and nutritional habits were analyze according to the results of a questionnaire.
 Results. In patients with type 2 diabetes, the most effective way to correct hyperglycemia at all stages of development of complications was the use of insulin in tablet forms. Carriers of the PPARG gene polymorphism had greater stability in achieving the target blood glucose level. The carriers of the wild genotype Pro12Pro did not differ from the CG in the rationality of nutrition and lifestyle. Carriers of the 12Ala allele were characterized by a neglect of food recommendations at the beginning of the disease, but with the progression of the degree of microvascular complications, the awareness of the need for proper nutrition doubled (P <0.05). Their lifestyle was initially less rational than that of carriers of the wild genotype Pro12Pro, but the course of T2DM and the development of complications in the form of DR by 2–3 times (P <0.05) reduced the desire for a healthy lifestyle.