ITGAM and diabetes mellitus: Experimental validation confirmed that genes such as ITGAM, CCL5, CXCL10, STAT1, and STAT2 were significantly upregulated in obese individuals compared to lean controls, underscoring a potential immunometabolic axis in PDAC pathophysiology.<h4>Conclusion</h4>Our findings highlight a strong association between the upregulation of PDAC recurrence genes and the activation of metabolic pathways linked to obesity, diabetes, and inflammation.