Background

Diabetic Foot is a major cause of morbidity in patients with Diabetes Mellitus, characterized by chronic inflammation and impaired wound healing. Adenosine Deaminase, an enzyme involved in cellular immunity, has been proposed as a potential biomarker of inflammatory and immunological activity. This study aimed to estimate serum ADA levels and evaluate their role in risk assessment and immunomodulation in diabetic foot patients.

Methods

This hospital-based observational study included 106 participants (53 cases with diabetic foot and 53 controls with diabetes without foot complications). Clinical, biochemical, and inflammatory parameters were assessed. Serum ADA levels were measured using a standard colorimetric method. Statistical analysis included group comparisons, ANOVA for severity grading, and ROC curve analysis to determine diagnostic performance.

Results

Patients with diabetic foot had significantly higher serum ADA levels compared to controls (34.6 ± 9.2 vs 23.8 ± 6.5 U/L; p<0.001). ADA levels increased progressively with Wagner grade (p<0.001) and were significantly higher in patients with infection and longer ulcer duration. ROC analysis demonstrated good diagnostic accuracy (AUC 0.84), with a cut-off ≥32.5 U/L yielding 78.3% sensitivity and 79.2% specificity.

Conclusion

Serum ADA is a promising biomarker reflecting disease severity and immune activation in diabetic foot, with potential utility in risk stratification and clinical management.