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Vascular cell adhesion molecule-1, but not intercellular adhesion molecule-1, is associated with diabetic kidney
Jian-Jun Liu1, Lee Ying Yeoh2, Chee Fang Sum3
1Clinical Research Unit, Khoo Teck Puat Hospital, 768828 Singapore.
Insights
Vascular cell adhesion molecule-1 (VCAM-1) is linked to diabetic kidney disease (DKD) in Asians with type 2 diabetes. Intercellular adhesion molecule-1 (ICAM-1) may indicate systemic inflammation and incipient DKD risk.
Area of Science:
- Nephrology
- Endocrinology
- Immunology
Background:
- Cardiovascular disease associations of ICAM-1 and VCAM-1 are established.
- Their specific roles in diabetic kidney disease (DKD) remain unclear.
- Understanding these roles is crucial for managing DKD in type 2 diabetes.
Purpose of the Study:
- To investigate the association of plasma ICAM-1 and VCAM-1 with DKD.
- To analyze these associations in an Asian population with type 2 diabetes mellitus (T2DM).
Main Methods:
- Cross-sectional study of 1950 Asian individuals with T2DM.
- Plasma levels of ICAM-1 and VCAM-1 measured via immunoassays.
- Assessment of estimated glomerular filtration rate (eGFR) and urinary albumin-to-creatinine ratio (ACR).
Main Results:
- Progressive decline in eGFR and increase in ACR correlated with higher plasma VCAM-1.
- No significant association found between ICAM-1 levels and eGFR or ACR.
- VCAM-1, but not ICAM-1, independently associated with eGFR and albuminuria in multivariable analysis.
Conclusions:
- Plasma VCAM-1 is independently linked to prevalent DKD in Asian T2DM patients.
- Elevated ICAM-1 may signal systemic inflammation and increased risk of early DKD.
- VCAM-1 is a more significant biomarker for DKD than ICAM-1 in this population.
Background And Aims:
The association of adhesion molecules ICAM-1 and VCAM-1 with cardiovascular diseases has been well-studied. However, their roles in diabetic kidney disease (DKD) are incompletely understood. We aim to study the association of plasma ICAM-1 and VCAM-1 with DKD in Asians with type 2 diabetes (T2DM).
Subjects And Methods:
A total of 1950 Asians with T2DM were included in this cross-sectional study. Plasma ICAM-1 and VCAM-1 were measured by immunoassays.
Results:
Renal filtration function (eGFR) declined and urinary albumin-to-creatinine ratio (ACR) levels increased progressively with the increase in plasma VCAM-1 levels. In contrast, no significant changes in eGFR and ACR were observed in subjects across different plasma ICAM-1 levels. Both ICAM-1 and VCAM-1 were correlated with ACR (rho = 0.153, p < 0.001 for VCAM-1 and ACR; rho = 0.053, p = 0.020 for ICAM-1 and ACR) in bivariate correlation analysis. However, only VCAM-1 was correlated with eGFR (rho = -0.228, p < 0.001). Multivariable linear regression models revealed that VCAM-1, but not ICAM-1, was independently associated with eGFR and albuminuria. Backward linear regression suggested that plasma VCAM-1 variability was mainly determined by eGFR whereas plasma ICAM-1 level was mainly determined by C-reactive protein in patients with T2DM.
Conclusions:
Plasma VCAM-1 level, but not ICAM-1 level, was independently associated with prevalent DKD in Asians with T2DM. High level of ICAM-1 may be indicative of systemic inflammation and portends increase risk of incipient DKD.
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