Xi'an First Hospital Affiliated to Xi'an Medical University, Xi'an, China
Department of Ophthalmology, Xi'an Ninth Hospital, Medical College of Xi'an Jiaotong University, Xi'an, Shanxi 710054, China.
Postgrad Med J. 2019 Mar;95(1121):162-168. doi: 10.1136/postgradmedj-2018-136102. Epub 2019 May 20.
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.
在糖尿病视网膜病变（DR）患者中，促炎标志物水平升高，与疾病进展和预后相关。细胞间黏附分子-1（ICAM-1）参与炎症反应，并在与慢性眼部炎症相关的病理过程中充当局部增强信号。本系统评价和荟萃分析的目的是研究 ICAM-1 水平与 DR 之间的关系。在线电子数据库中检索了所有在 2017 年 12 月之前发表的相关文章。纳入标准均差（SMD）及其 95%置信区间（CI），并采用随机效应模型进行合并。亚组分析和荟萃回归分析用于探索异质性的来源，并计算发表偏倚以评估汇总研究的质量。这项荟萃分析共纳入了 11 篇文章，包含 428 名 DR 患者和 789 名健康对照者。结果表明，DR 组的 ICAM-1 水平明显高于对照组（SMD：1.20，95%CI 0.83 至 1.57，p<0.001）。亚组分析和荟萃回归分析表明，发表年份、地区、研究方法、糖尿病类型、纽卡斯尔-渥太华量表和样本量不是异质性的潜在来源。本荟萃分析的结果表明，DR 患者的 ICAM-1 水平普遍升高，可能与 DR 的严重程度有关。然而，未来需要进行大规模、高质量的研究来证实这一发现。
