Differential effect of ramadan fasting on intercellular adhesion molecule-1 (ICAM-1) in diabetes mellitus and non-diabetes mellitus patients

BACKGROUND: The month of Ramadan is a holy month for Muslims. During this month, Muslims do not eat, drink, or smoke from sunrise to sunset. Patients with type 2 diabetes mellitus (T2DM) will also fast from dawn to dusk, creating a unique opportunity to study the effects of dietary changes during fasting period. One of the interesting results of Ramadan fasting is its effect on endothelial dysfunction, measured using Intercellular Adhesion Molecule-1 (ICAM-1) as a biological marker of endothelial function. AIM: To determine the changes ICAM-1 levels in T2DM and non-DM patients during Ramadan fasting. METHODS: A retrospective cohort study was performed on 26 T2DM patients and 21 non-DM, age-matched patients (aged 19–60 years). Measurement of metabolic parameters (systolic and diastolic blood pressure, total calorie intake, and intensity of physical activity), anthropometry (body weight, body mass index (BMI) and abdominal circumference), total dietary intake, and laboratory analysis (blood glucose fasting, HbA1c, lipid profile, ICAM-1) were done at 4 weeks before (T0) and 14 days after Ramadan fasting (T1). RESULT: The median ICAM-1 level in T2DM patients at T0 was 340.9 (193–505) ng/mL and at T1 was 312.3 (158–581) ng/mL, while the ICAM-1 level in non-DM patients at T0 was 482 (305–653) and at T1 was 398.4 (202–526) ng/mL. There was no significant difference of ICAM-1 level between study groups at both T0 and T1 (p > 0.05). Both T2DM and non-DM patients had lower ICAM-1 level following Ramadan fasting. However, only non-DM patients had significantly lower post Ramadan ICAM-1 (p = 0.008) CONCLUSION: There was a significant decrease in ICAM-1 level in both T2DM and non-DM patients after Ramadan fasting.