Evaluation of the ATP-binding cassette transporter A1 (ABCA1) in Iraqi individuals with pre-existing and newly diagnosed type 2 diabetes

ATP-binding cassette transporter A1 (ABCA1) is a crucial protein that helps promote cholesterol efflux and HDL synthesis. ABCA1 defects can cause type 2 diabetes, insulin resistance, and difficulties with fat metabolism. The aims of this study were to establish blood ABCA1 levels in Iraqi patients with recent-onset type 2 diabetes and prediabetes and to evaluate their correlations with clinical and metabolic characteristics and smoking status. In this case-control study, serum ABCA1 levels were measured in prediabetes (n= 40), newly diagnosed type 2 diabetes (n = 56), and control groups (n = 40). Samplescollected from January 15, 2024, to November 5, 2024, were used to measure diabetes parameters and lipid profiles. As a result, newly diagnosed type 2 diabetes showed a slight but statistically insignificant reduction in serum ABCA1 levels compared with prediabetes and controls. LDL-C, VLDL-C, total cholesterol, and triglycerides were inversely correlated with ABCA1 in patient groups. ABCA1 correlated positively with HDL in patients with newly diagnosed diabetes mellitus but negatively in those with prediabetes. All groups had significantly lower ABCA1 levels according to smoking status. The negative correlation between HOMA-𝛽 and ABCA1, along with the positive correlations between HOMA-IR and insulin and ABCA1 concentration, reveal the role of these factors in pancreatic function. The main conclusion is that smokers with prediabetes or newly diagnosed diabetes mellitus showed decreased ABCA1 levels, suggesting a complex regulatory system involving genes, metabolism, and environmental factors.