Background: Diabetes mellitus type 2 (T2DM) is a chronic condition characterized by insulin resistance, affecting approximately 530 million adults globally, with a prevalence of 10.5% among individuals aged 20 to 79. In Iraq, the prevalence is significantly higher at 13.9%. Objectives: This study examines the relationship between long noncoding RNA HOX transcript antisense RNA (HOTAIR) polymorphisms and T2DM risk, investigating HOTAIR's potential as a diagnostic marker. Methods: Blood samples were collected from 28 T2DM patients and 20 healthy controls, with physiological parameters measured. HOTAIR plasma levels were assessed using quantitative real-time (qRT)-PCR, and single-nucleotide polymorphisms rs12826786 and rs1899663 were analyzed through amplification refractory mutation system (ARMS)-PCR. Results: HOX transcript antisense RNA expression was found to be 6.6 times higher in T2DM patients compared to controls, suggesting its involvement in T2DM pathophysiology. Genotype distributions adhered to Hardy-Weinberg equilibrium, with the rs12826786 C allele appearing protective against T2DM, while rs1899663 showed no significant association. Statistical analysis identified a significant relationship between the rs12826786 genotype and body mass index (BMI), though other diabetes-related metrics did not show significant results. Conclusions: The findings suggest that elevated HOTAIR expression may play a role in T2DM, highlighting the need for further investigation into these associations and their potential implications for diagnosis and risk assessment
