Are elevated circulating intercellular adhesion molecule 1 levels more strongly predictive of diabetes than vascular risk? Outcome of a prospective study in the elderly.
OBJECTIVE
The aim of this prospective study was to determine whether circulating intercellular adhesion molecule (ICAM) 1, as a potential surrogate of 'endothelial activation', is more strongly associated with risk of vascular events than with incident diabetes.


METHODS
We related baseline ICAM-1 levels to vascular events (866 CHD and stroke events in 5,685 participants) and incident diabetes (292 in 4,945 without baseline diabetes) in the elderly over 3.2 years of follow-up.


RESULTS
ICAM-1 levels correlated positively with triacylglycerol but negatively with LDL- and HDL-cholesterol. ICAM-1 levels were higher in those who developed diabetes (388.6 +/- 1.42 vs 369.4 +/- 1.39 ng/ml [mean+/-SD], p = 0.011) and remained independently associated with new-onset diabetes (HR 1.84, 95% CI 1.26-2.69, p = 0.0015 per unit increase in log[ICAM-1] after adjusting for classical risk factors and C-reactive protein). By contrast, ICAM-1 levels were not significantly (p = 0.40) elevated in those who had an incident vascular event compared with those who remained event-free, and corresponding adjusted risk associations were null (HR 0.98, 95% CI 0.80-1.22, p = 0.89) in analyses adjusted for other risk factors.


CONCLUSIONS
We show that elevated ICAM-1 levels are associated with risk of incident diabetes in the elderly at risk, despite no association with incident cardiovascular disease risk. We suggest that perturbations in circulating ICAM-1 levels are aligned more towards diabetes risk.
Sattar
N
N
Faculty of Medicine, BHF Glasgow Cardiovascular Research Centre, University of Glasgow, University Place, Glasgow G12 8TA, UK. nsattar@clinmed.gla.ac.uk
Murray
H M
HM
Welsh
P
P
Blauw
G J
GJ
Buckley
B M
BM
de Craen
A J
AJ
Ford
I
I
Forouhi
N G
NG
Freeman
D J
DJ
Jukema
J W
JW
Macfarlane
P W
PW
Murphy
M B
MB
Packard
C J
CJ
Stott
D J
DJ
Westendorp
R G J
RG
Shepherd
J
J
D000368:Aged; D000369:Aged, 80 and over; D001794:Blood Pressure; D002784:Cholesterol / Q000097:blood; D008076:Cholesterol, HDL / Q000097:blood; D008078:Cholesterol, LDL / Q000097:blood; D003920:Diabetes Mellitus / Q000097:blood / Q000453:epidemiology*; D004730:Endothelium, Vascular / Q000502:physiology*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors / Q000627:therapeutic use; D015994:Incidence; D018799:Intercellular Adhesion Molecule-1 / Q000097:blood*; D008297:Male; D009203:Myocardial Infarction / Q000097:blood / Q000453:epidemiology* / Q000401:mortality; D017035:Pravastatin / Q000627:therapeutic use; D011237:Predictive Value of Tests; D011446:Prospective Studies; D012307:Risk Factors; D020521:Stroke / Q000097:blood / Q000453:epidemiology* / Q000401:mortality; D013997:Time Factors
D008076:Cholesterol, HDL; D008078:Cholesterol, LDL; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors; D018799:Intercellular Adhesion Molecule-1; D002784:Cholesterol; D017035:Pravastatin