Immune Involvement in Diabetes Mellitus: Analysis of TLR4 and ICE Serum Levels in Patients from Basrah

Background: Diabetes mellitus (DM) is a prevalent chronic metabolic condition that is linked to increasing rates of illness and death globally. Recent findings suggest a role for innate immunity, particularly Toll-like receptor 4 (TLR4), in the development of DM. Objective: This research seeks to explore the involvement of Toll-like receptor 4 (TLR4) and pancreatic islet cells in the onset and advancement of diabetes mellitus. Methodology: A case-control study was undertaken at FDEMC, Basrah, Iraq between May 2022 and August 2022, including a total of 169 participants (98 diabetic patients and 71 age and sex-matched healthy controls). The levels of TLR4 and ICE in serum were analyzed by ELISA. Statistical analysis was conducted using SPSS v26, with significance set at p < 0.05. Results: No notable differences were observed in the age or sex distribution of the two groups. The duration of T2DM was longer in comparison to T1DM (8.61±6.14 vs. 5.57±4.02 years). T1DM patients were predominantly underweight (51%) and T2DM patients were predominantly obese (63.3%) with a difference in BMI being significant (p=0.011). The levels of TLR4 and ICE were found to be significantly elevated in individuals with diabetes compared to those in the control group (p<0.0001), especially among participants aged 21 to 30 and in females. Conclusion: The higher TLR4 and ICE levels in diabetic patients, particularly in younger age group and females, substantiate their participation in immune-mediated connections tied to the onset and advancement of diabetes. This connection underscores the intricate role these markers play in the disease's landscape.