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Association between ICAM-1 level and diabetic retinopathy: a review and meta-analysis
  1. Yang Yao1,
  2. Junhui Du2,
  3. Rong Li1,
  4. Lei Zhao3,
  5. Na Luo1,
  6. Jing Ya Zhai2,
  7. Lihui Long1
  1. 1 Xi'an First Hospital Affiliated to Xi'an Medical University, Xi'an, China
  2. 2 Department of Ophthalmology, Xi'an Ninth Hospital, Medical College of Xi'an Jiaotong University, Xi'an, Shanxi 710054, China
  3. 3 Department of Ophthalmology, The First Affiliated Hospital, Xi'an Medical University, Xi’an, Shaanxi 710077, China
  1. Correspondence to Dr Yang Yao, Xi'an First Hospital Affiliated to Xi'an Medical University, Xi'an, Shaanxi, China; yaoyang1220{at}


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.

  • intercellular adhesion molecule-1
  • diabetic retinopathy
  • meta-analysis
  • inflammation
  • celladhesion molecules
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  • Contributors RL and NL collected the date. YY and JD assessed the quality of the included studies.NL and YY performed the statistical analysis. RL drafted the manuscript. LL and LZ conceived and designed the study.LZ reviewed and revised the manuscript. All authors have read and approved the final manuscript.

  • Funding This work was supported by the National Natural Science Foundation of China (No.81500726), the Medical Research Project of Xi’an Science Technology Bureau [No.201805097YX5SF31(4)] and the Health Research Foundation of Shaanxi Province (No. 2018D074).

  • Competing interests None declared.

  • Patient consent for publication Not required.

  • Provenance and peer review Not commissioned; externally peer reviewed.

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