Evaluation of PADI4 (Human Peptidyl Arginine Deiminase Type 4) levels in patients with type 2 diabetes mellitus with/without complications

Purpose: Human peptidyl arginine deiminase 4 (PADI4) transforms arginine residues on histone tails to citrulline. Recently, researchers have studied PADI4 in inflammation, infection, cancer, and autoimmune disorders. PADI4 also modulates the release of neutrophil extracellular traps (NETs) through a process known as NETosis, which is linked to dysglycemia. PADI4's role in type 2 diabetic mellitus (DM) is not well understood. The goal of this study is to compare PADI4 levels in type 2 DM patients who have not yet experienced diabetic complications, those who have, and a healthy control group. Materials and methods: This research included three groups of volunteers aged 30-65 years old: a healthy control group, a type 2 diabetic with no diabetic complications, and those with diabetic complications. Serum samples from control and type 2 DM patients were analyzed for complete blood count, biochemistry, and PADI4 (ng/ml). Results: The control, complicated, and uncomplicated type 2 DM groups did not differ significantly in their serum PADI4 levels (4.94±5.09 ng/ml (med: 2.62, IQR: 2.34-3.87), 5.06±6.58 ng/ml (med: 2.59, IQR: 2.19-2.99), and 4.51±4.76 (med: 2.74, IQR: 2.1- 3.71). Vitamin B12 levels were significantly higher in the complicated type 2 DM group than in the control group (647.83±461.37 vs. 357.32±136.15; p=0.03). The correlation analysis found no significant relationship between nephropathy, retinopathy, or neuropathy and serum PADI4 in the complicated type 2 DM group. There was a statistically significant, negative, and slight correlation with metformin use in the uncomplicated DM group (r=-0.325, p=0.05). Conclusion: Finally, there was no significant difference in serum PADI4 levels between the type 2 DM groups with complications, those without complications, and the healthy control group. PADI4 is seen as a viable target for illness treatment and surveillance. Prospective studies involving larger patient populations on this subject are needed.