Type 2 diabetes mellitus (T2DM) is a significant global health challenge. Recent studies have shown that biomarkers such as microRNAs, especially miRNAs, are altered during the progression of T2DM and its associated complications, reflecting the mechanisms of the disease. This study focused on analyzing the expression of miRNA-224 in Egyptian T2DM patients and investigating its association with diabetic complications. A total of 205 participants were enrolled in this case-control study, of which 100 individuals were diagnosed with T2DM and 105 healthy controls. The study measured various biochemical, anthropometric, and psychometric parameters, alongside miRNA-224 expression via Real-time PCR. The results showed that T2DM patients exhibited significantly increased levels of glycated hemoglobin (HbA1C), fasting blood sugar (FBS), postprandial blood sugar (PPBS), international normalization ratio (INR), creatinine, urea, cholesterol, triglycerides (TG), and low-density lipoproteins (LDL), alongside significantly reduced high-density lipoproteins (HDL) compared to the control group. In addition, the expression of miRNA-224 was significantly upregulated in T2DM patients (P < 0.001) and showed promising diagnostic potential, predicting diabetes risk even in non-diabetic individuals. Diabetic complications such as retinopathy, neuropathy, eye issues, joint pain, and cardiovascular diseases were more common in T2DM patients, with statistically significant differences (P < 0.05). Increased expression of miRNA-224 (> 1.065) was associated with a higher incidence of complications. In conclusion, miRNA-224 emerges as a potential biomarker for diabetes, with elevated levels correlating with both the disease and its complications.
