Association between ICAM-1 level and diabetic retinopathy: a review and meta-analysis

• Published in: Postgraduate medical journal Vol. 95; no. 1121; pp. 162 - 168
• Main Authors: Yao, Yang, Du, Junhui, Li, Rong, Zhao, Lei, Luo, Na, Zhai, Jing Ya, Long, Lihui
• Format: Journal Article
• Language: English
• Published: England Oxford University Press 01.03.2019
• Subjects: Cell adhesion & migration; Diabetes; Diabetic neuropathy; Diabetic retinopathy; Meta-analysis; Pathogenesis; Quality; Retina; Systematic review; meta-analysis; celladhesion molecules; diabetic retinopathy; inflammation; intercellular adhesion molecule-1
• ISSN: 0032-5473; 1469-0756
• DOI: 10.1136/postgradmedj-2018-136102

Elevated levels of proinflammatory markers are evident in patients with diabetic retinopathy (DR) and are associated with disease progression and prognosis. Intercellular adhesion molecule-1 (ICAM-1) is involved in inflammation and acts as a local intensifying signal in the pathological processes associated with chronic eye inflammation. The aim of this systematic review and meta-analysis was to investigate the relationship between ICAM-1 level and DR. Online electronic databases were searched to retrieve all relevant articles published before December 2017. The standard mean difference (SMD) and their 95% CI were included and then pooled with a random effects model. Subgroup analysis and metaregression analysis were applied to explore the sources of heterogeneity, and publication bias was calculated to assess the quality of pooled studies. A total of 11 articles, containing 428 patients with DR and 789 healthy controls, were included in this meta-analysis. The results indicated a significant increase in ICAM-1 level in the DR group compared with the control group (SMD: 1.20, 95%CI 0.83 to 1.57, p<0.001). Subgroup analyses and metaregression analysis indicated that publication year, region, study method, diabetes mellitus type, Newcastle-Ottawa Scale and sample size were not the potential sources of heterogeneity. The results of this current meta-analysis indicated that the increased level of ICAM-1 generally exists in the patients with DR and it may associated with the severity of DR. However, large-scale and high-quality studies are required to confirm this finding in the future.