{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,16]],"date-time":"2026-09-16T17:12:40Z","timestamp":1789578760977,"version":"build-2803163510"},"reference-count":72,"publisher":"MDPI AG","issue":"8","license":[{"start":{"date-parts":[[2025,4,17]],"date-time":"2025-04-17T00:00:00Z","timestamp":1744848000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"Trakia University","award":["10\/2022"],"award-info":[{"award-number":["10\/2022"]}]},{"name":"Trakia University","award":["14\/2023"],"award-info":[{"award-number":["14\/2023"]}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["IJMS"],"abstract":"<jats:p>This study investigates the association between diabetic retinopathy (DR) and its complication, diabetic macular edema (DME), and compared it with biomarkers of oxidative stress. This study aimed to compare the main indicators of the development of diabetic retinopathy measured as parameters of oxidative stress and compared to lipid oxidation, DNA damage, and cytokine levels and to monitor their quantitative manifestation in DME. This study evaluated 134 patients (62 males and 72 females; aged 62.10 \u00b1 11.22 years) and divided them into two groups: type 2 diabetes mellitus with DR and type 2 diabetes mellitus with DME. All results were compared with healthy volunteers (n = 94) and showed that patients with DME had significantly higher levels of ROS, cytokine production, lipid oxidation, and DNA damage. In addition, patients with DME had decreased levels of nitric oxide (NO) and an impaired NO synthase (NOS) system (p &lt; 0.05). These findings suggest that patients with DR and DME are unable to compensate for high levels of oxidative stress. Reduced NO levels in patients with DME may be due to impaired NO availability. This study highlights compromised oxidative status as a contributing factor to DME in patients with decompensated type 2 diabetes mellitus. An assessment of oxidative stress levels and inflammatory biomarkers may aid in the early detection and prediction of diabetic complications.<\/jats:p>","DOI":"10.3390\/ijms26083810","type":"journal-article","created":{"date-parts":[[2025,4,17]],"date-time":"2025-04-17T20:50:46Z","timestamp":1744923046000},"page":"3810","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":11,"title":["Systematic Inflammation and Oxidative Stress Elevation in Diabetic Retinopathy and Diabetic Patients with Macular Edema"],"prefix":"10.3390","volume":"26","author":[{"given":"Kamelia","family":"Petkova-Parlapanska","sequence":"first","affiliation":[{"name":"Medical Chemistry and Biochemistry Department, Medical Faculty, Trakia University, 11 Armeiska Str., 6000 Stara Zagora, Bulgaria"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Valeria","family":"Draganova","sequence":"additional","affiliation":[{"name":"Department of Otorhinolaryngology and Ophthalmology, Medical Faculty, Trakia University, 6000 Stara Zagora, Bulgaria"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0552-6266","authenticated-orcid":false,"given":"Ekaterina","family":"Georgieva","sequence":"additional","affiliation":[{"name":"Department of General and Clinical Pathology, Forensic Medicine, Deontology and Dermatovenerology, Medical Faculty, Trakia University, 11 Armeiska Str., 6000 Stara Zagora, Bulgaria"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Petya","family":"Goycheva","sequence":"additional","affiliation":[{"name":"Propaedeutic of Internal Diseases Department, Medical Faculty, Trakia University Hospital, 6000 Stara Zagora, Bulgaria"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Galina","family":"Nikolova","sequence":"additional","affiliation":[{"name":"Medical Chemistry and Biochemistry Department, Medical Faculty, Trakia University, 11 Armeiska Str., 6000 Stara Zagora, Bulgaria"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yanka","family":"Karamalakova","sequence":"additional","affiliation":[{"name":"Medical Chemistry and Biochemistry Department, Medical Faculty, Trakia University, 11 Armeiska Str., 6000 Stara Zagora, Bulgaria"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2025,4,17]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"147","DOI":"10.1016\/j.survophthal.2022.11.008","article-title":"Persistent diabetic macular edema: Definition, incidence, biomarkers, and treatment methods","volume":"68","author":"Sorour","year":"2023","journal-title":"Surv. 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