Abstract
BACKGROUND: Diabetes Mellitus (DM) is a complex metabolic disorder characterized by hyperglycemia, primarily arising from insufficient insulin secretion or the development of insulin resistance. Estrogen plays a significant role in regulating the occurrence and progression of DM. This study aims to investigate the role of estrogen-related genes in diabetes, focusing on identifying potential biomarkers and therapeutic targets for the disease. METHODS: We initially obtained gene expression datasets related to type 2 diabetes mellitus (T2DM) from the GEO database. A systematic and coherent series of methodologies was then implemented in a structured manner. First, Principal Component Analysis (PCA) was employed for preliminary data exploration and dimensionality reduction. Next, we identified Differentially Expressed Genes (DEGs). Subsequently, we conducted Weighted Gene Co-expression Network Analysis (WGCNA) to uncover gene modules associated with DM. This was followed by Gene Ontology (GO) and Kyoto Encyclopedia of Genes and Genomes (KEGG) enrichment analyses to explore the biological functions and pathways associated with the identified genes. To enhance the precision of biomarker identification, we applied three distinct machine learning algorithms, including Least Absolute Shrinkage and Selection Operator (LASSO), Support Vector Machine-Recursive Feature Elimination (SVM-RFE), and Random Forest (RF), for further refined selection. This comprehensive approach ultimately identified the estrogen-related gene IER3 as a promising biomarker for DM. Furthermore, correlation analyses focusing on immune cell infiltration were conducted to clarify the immunological role of IER3 in DM. RESULTS: Our findings revealed a significant downregulation of IER3 in DM patients, accompanied by an AUC value of 0.723 in the diagnostic curve ROC, indicating its considerable diagnostic and prognostic potential for DM. Furthermore, the expression levels of IER3 exhibited a strong correlation with variations in the proportions of diverse immune cell types, suggesting that it may play a pivotal role in the immunoregulatory mechanisms underlying DM. CONCLUSION: In conclusion, our findings reveal that the estrogen-related gene IER3 is significantly downregulated in patients with DM, highlighting its potential as a diagnostic and prognostic marker for the disease. Therefore, IER3 may serve as a promising biomarker and therapeutic target for DM.