EC has been shown to induce epigenetic changes by regulating the levels of histone acetyltransferases (HATs) and histone deacetylase 4 (HDAC4), decreasing H3K9 acetylation and H3K4 dimethylation and increasing H3K9 dimethylation triggered by high glucose (37), thereby indirectly downregulating the TGF-β1 pathway to reduce the deposition of extracellular matrix (38), which play an important role in DKD treatment. This evidence concerns the gene HDAC4 and diabetic kidney disease.