Sherwin Arokiaraj Anto Ricky, Jayashree Kuppuswami, Senthilkumar Gandhipuram Periyasamy, Thomas Sherin Elizabeth, Babu K Ramesh
Department of Biochemistry, Jawaharlal Institute of Postgraduate Medical Education and Research, Puducherry, India.
Department of Ophthalmology, Jawaharlal Institute of Postgraduate Medical Education and Research, Puducherry, India.
Niger Postgrad Med J. 2025 Jul 1;32(3):240-246. doi: 10.4103/npmj.npmj_127_25. Epub 2025 Aug 1.
Diabetic retinopathy (DR) impairs retinal function and causes significant vision loss. Irisin has been recently implicated in the pathogenesis of DR. Intercellular adhesion molecule-1 (ICAM-1) is a cell surface glycoprotein that primarily facilitates leucocyte recruitment from circulation to inflammation sites.
This cross-sectional study aimed to explore the significance of circulatory irisin and ICAM-1 levels in DR.
This cross-sectional analytical study was conducted at a tertiary care hospital in Puducherry, India. Type 2 diabetes mellitus (T2DM) patients with retinopathy (n = 60) and without retinopathy (n = 60) were recruited. Apart from anthropometric data, blood samples were collected for routine biochemical tests and estimation of serum irisin and ICAM-1 by ELISA. Data were analysed using IBM SPSS version 20.0. The variables were compared using Independent Student's-t-test, Mann-Whitney U-test, one-way analysis of variance, or Chi-square test. Receiver operator curve (ROC) analysis evaluated irisin and ICAM-1 in differentiating proliferative DR (PDR) and non-proliferative DR (NPDR).
Compared to T2DM patients without DR, Serum irisin was higher in those with DR, but no difference was observed in ICAM-1 between the 2 groups. Both irisin and ICAM-1 were decreased in vision-threatening DR (VTDR) compared to non-vision-threatening DR (non-VTDR). Decreased levels of irisin (P = 0.84) and ICAM-1 (P ≤ 0.001) were seen across DR stages. ROC analysis showed irisin differentiated NPDR and PDR (AUC = 0.7, P = 0.01).
Serum irisin and ICAM-1 increased in earlier stages of DR but decreased in later stages. They were decreased in pre-proliferative and proliferative stages of DR, suggesting roles in leucocyte migration and angiogenesis. Clinical management may have contributed, and further research is needed.
糖尿病视网膜病变（DR）损害视网膜功能并导致严重视力丧失。最近发现鸢尾素与DR的发病机制有关。细胞间黏附分子-1（ICAM-1）是一种细胞表面糖蛋白，主要促进白细胞从循环系统募集到炎症部位。
本横断面研究旨在探讨循环鸢尾素和ICAM-1水平在DR中的意义。
本横断面分析研究在印度本地治里的一家三级护理医院进行。招募了患有视网膜病变（n = 60）和未患有视网膜病变（n = 60）的2型糖尿病（T2DM）患者。除人体测量数据外，采集血样进行常规生化检测，并通过酶联免疫吸附测定法（ELISA）测定血清鸢尾素和ICAM-1。使用IBM SPSS 20.0版软件进行数据分析。采用独立样本t检验、曼-惠特尼U检验、单因素方差分析或卡方检验对变量进行比较。采用受试者工作特征曲线（ROC）分析评估鸢尾素和ICAM-1在鉴别增殖性DR（PDR）和非增殖性DR（NPDR）中的作用。
与无DR的T2DM患者相比，有DR的患者血清鸢尾素水平更高，但两组间ICAM-1水平无差异。与无视力威胁性DR（非VTDR）相比，视力威胁性DR（VTDR）患者的鸢尾素和ICAM-1水平均降低。在DR各阶段，鸢尾素（P = 0.84）和ICAM-1（P≤0.001）水平均降低。ROC分析显示，鸢尾素可鉴别NPDR和PDR（曲线下面积[AUC]=0.7，P = 0.01）。
血清鸢尾素和ICAM-1在DR早期升高，但在后期降低。它们在DR的增殖前期和增殖期降低，提示其在白细胞迁移和血管生成中起作用。可能与临床管理有关，需要进一步研究。
