Relationship Between Serum Soluble Intercellular Adhesion Molecule-1 (sICAM-1) And Type 2 Diabetic Macrovascular Diseases

Objective: Intercellular adhesion molecule-1(ICAM-l),one of immunoglobulin superfamily members,is a single chained transmembrane glycoprotein,containingfive extracellular Ig-like domains. It has at least two ligands of β2 integrins-lymphocyte function-associated antigen-1 (LFA-1) and macrophage-1 (Mac-1) . Through binding with LFA-1 and Mac-1,.ICAM-1 may play an important role in a variety of pathophysiologic and pathologic courses,including development and differentiation of embryos.maintenance of normal tissues strucrure,inflammation and immune responses.repairs of wounds, coagulation, infiltration and metastasis of tumors. Soluble intercellular adhesion molecule-1(sICAM-1) is a shedded cell membrane ligand,which functions also through binding LFA-1 and Mac-1. In recent years,scholars have been paying attention to the role of endothelial dysfunction and subclinical inflammation in the pathogenesis of atherosclerosis and type 2 diabetes,and ICAM-1 that reflects endothelial dysfunction becomes a hot topic in the world. The objective of this study was to to investigate the changes of serum sICAM-1 in type 2 diabetic patients with macrovascular diseases and its clinical significance.Methods: 91 patients with type 2 diabetes were divided into complication-free group(group A,n=22),microangiopathic group(group B,n=13),macroangiopathic group(group C,n=31),and micro- and macroangiopathic group(group D,n=25), and while they were compared with the normal control group(group NC,n=35),all of these groups were matched for age,sex,and body mass index(BMI). Serum sIC AM-1 was measured using ¹²⁵I-sICAM-1 radioimmunoassay. Serum lipids,hypersensitive C-reactive protein(hsCRP) and plasma fibrinogen(FIB) were also measured in these patients. All these clinical data were analysed with software SPSS 11.5. Results: Serum sICAM-1 concentrations in above groups were: group A 188.803±36.923 (groupA) ,group B 190.132 ±37.428,group C 232.343 ±69.347,group D 241.371 ±69.243 and group NC 176.195 ±28.227 ng/ml. Compared with those in group A,group B and group NC,serum sICAM-1 concentrations were significantly increased in group C and group D (/*<().05).But there were no significant difference between group A,group B and group NC, and between group C and group D(P>0.05).Correlation analysis showed that serum sICAM-1 was positively correlated with subclinical inflammatory indexes such as serum hsCRP (rs = 0.282, PO.05) and plasma FIB (rs = 0.391, PO.01) . Serum slCAM-1 was also correlated with triglyceride (rs = 0.292, PO.05) ,total cholesterol (r5 = 0.259, P<0.05 ) and low-density lipoprotein (rs = 0.235, P<0.05) .There were no significant correlations between serum sICAM-1 and age,blood pressure,diabetes-related indexes(including diabeticduration,HbAlc,FPG,P2HPG and HOMA-IR index). Logistic regression analysis showed that systolic blood pressure ,hsCRP and sICAM-1 were independently and significantly associated with diabetic macrovascular disease. Conclusions : (1) Serum sICAM-1 was significantly elevated in diabetic macrovasculopathic group,indicating that endothelium of patients with diabetic macrovasculopathy was seriously injured,and that serum sICAM-1 may be used as a index for diagnosing diabetic macrovasculopathy. (2) The significant correlation between serum sICAM-1 and classical subclinical inflammatory indexes indicated the important role of subclinical inflammation in type 2 diabetes and its macrovascular complications. (3) The significant correlation between serum sICAM-1 and serum lipids indicated the relations between ICAM-1 and lipids in atherosclerosis. (4) Logistic regression analysis showed that systolic blood pressure ^hypersensitive C-reaction protein and sICAM-1 were the most significant risk factors for type 2 diabetic macrovascular disease,indicating that strict control of blood pressure and related anti-inflammatory therapy might...