Abstract

Background: Obesity and Type 2 diabetes mellitus (T2DM) are growing public health concerns in Southeast Asia, including Indonesia. Obesity promotes insulin resistance and metabolic irregularities, increasing the risk for T2DM. CTLA-4, an immune checkpoint receptor, plays a role in immune regulation, but its involvement in obesity, dyslipidemia, and T2DM remains unclear. Objective: The aim of this study was to evaluate the association between CTLA-4 levels and obesity, dyslipidemia, and T2DM. Methods: A cross-sectional study was conducted at Universitas Sumatera Utara Hospital and affiliated hospitals, including 100 adult participants from the endocrine clinic. Participants with coronary heart disease, kidney issues, heart problems, and cancers were excluded. Fasting blood glucose, A1C levels, LDL cholesterol, triglycerides, and CTLA-4 expression were measured. BMI was calculated from age, gender, height, and weight data. Statistical analysis was performed using SPSS 26.0, applying the Mann-Whitney U-test and Spearman correlation for variable relationships. Statistical significance was set at p < 0.05. Result: Among 100 participants, 36% were obese, 42% had dyslipidemia, and 31% had T2DM. The median CTLA-4 serum level was 93.3 pg/mL (range 36–264). CTLA-4 levels were significantly lower in obese individuals (67.2 pg/mL) compared to non-obese individuals (106.8 pg/mL, p = 0.019). No significant differences in CTLA-4 levels were found for dyslipidemia (p = 0.839) or T2DM (p = 0.351). A significant negative correlation was found between CTLA-4 levels and BMI (r = -0.329, p = 0.001). Conclusion: CTLA-4 levels negatively correlate with BMI, indicating its potential involvement in obesity-related metabolic changes. No significant link was found with dyslipidemia or T2DM, warranting further research.

Key words: CTLA-4, T2DM, obesity, metabolic