Relationship between soluble intercellular adhesion molecule 1 and clinically manifest cardiovascular disease in diabetic chronic hemodialysis patients

Background: The relationship between soluble intercellular adhesion molecule-1 (sICAM-1) and the presence of cardiovascular disease in diabetic chronic dialysis patients has been studied to a lesser extent. Aims: to evaluate the relationship between the serum level of sICAM-1 and clinically manifest cardiovascular disease in diabetic chronic hemodialysis patients. Methods: Twenty-six diabetic chronic hemodialysis patients treated in the Alba-Iulia Dialysis Center were included in a crossectional study. The serum sICAM-1 levels were measured, the routine laboratory evaluation was performed and the presence of clinically manifest cardiovascular disease (CVD), defined as coronary artery disease (CAD), peripheral arterial disease (PAD) or cerebrovascular disease(CRD) as well as the current treatment scheme were assessed. Results: sICAM-1 level was positively correlated with the glycated hemoglobin (r=0.59; IC95% 0.22-0.81; p=0.004). Nineteen of the 26 patients had clinically manifest CVD. The sICAM-1 level was significantly higher in CVD patients vs. non-CVD patients: 290 ng/ml (262.5-367) vs. 238 ng/ml (208-283); p=0.03. sICAM-1>260 ng/ml was significantly associated with CAD: OR=5.33; IC95% 1.02-29.4; p=0.04 and with overall clinically manifest CVD: OR=1.33; IC95% 1.25-78.3; p=0.007. sICAM-1 was significantly lower in angiotensin-converting enzyme inhibitor (ACEI)-treated patients: 258 ng/ml (220-289) vs 292 ng/ml (263-348) in the untreated group, p=0.03. The ACEI treatment was significantly associated with sICAM-1 below 260 ng/ml (p=0.002). Conclusion: Clinically apparent CVD in diabetic hemodialysis-treated patients was associated with high sICAM-1 levels. The ACEI treatment and better glycemic control were associated with lower levels of sICAM-1.