Abstract: Objective To analyze the values of serum CERP, SF, α-Klotho and FGF-23 in predicting the progression of albuminuria in patients with type 2 diabetes (T2D). Methods A totalof 120 patients with T2D repeatedly admitted to the Department of Endocrinology of Shuyang Hospital for blood glucose control from June 2020 to May 2022 were selected for the retrospective cohort study. The hospitalization data during the index hospitalization and the readmission were used as the baseline data and follow-up data respectively. Patients were divided into 3 groups: non-albuminuria group, micro-albuminuria group, macro-albuminuria group, according to the albuminuria level of baseline data. The levels of CERP, SF α-Klotho and FGF-23 in patient of different groups were compared. The progression of albuminuria was evaluated according to the follow-up data, and the baseline clinical data and levels of CERP, SF, α-Klotho, FGF-23 between patients with and with out albuminuria were compared. The influencing factors of albuminuria progression were analyzed by logistic regression, and the predictive indicators of albuminuria progression were analyzed by ROCcurve. Results The levels of CERP, SF and FGF-23 were increased and the level of α-Klotho wasdecreased with the increase of the albuminuria level in T2D patients (P< 0. 05). The duration of diabetes in the T2D patients with albuminuria progression was longer than that in the T2D patients without albuminuria progression. The proportions of using metformin and SGLT2 inhibitor (SGLT2i) and the level of α-Klotho in the T2D patients with albuminuria progression were lower than those in the T2D patients without albuminuria progression, and the proportion of hypertension, the levels of FBG, UA, CERP, SF and FGF-23 in the T2D patients with albuminuria progression were higherthan those in the T2D patients without albuminuria progression (P< 0. 05). Logistic regression analysis showed that the elevated levels of CERP, SF and FGF-23 were risk factors for the progression of albuminuria, the use of metformin and SGLT2i and the increase of α-Klotho level were protective factors for the progression of albuminuria. ROC curve analysis showed that the levels of serum CERP, SF, α-Klotho and FGF-23 had predictive values for the development of albuminuria, the sensitivity and specificity by using the combined index in predicting the progression of albuminuriawere both higher than those by using single indexes. Conclusion Increased levels of serum CERP,SF, FGF-23 and decreased level of α-Klotho are related with the development of albuminuria in T2D patients. Those four serum indicators have predictive values for the progression of albuminuria.

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