Abstract:Objective To explore the changes and predictive value of serum kidney injury molecule-1（KIM-1），urinary microalbumin-to-creatinine ratio（UACR），and lipid metabolism in patients with diabetes and early kidney injury，and to provide new ideas for the prediction of early kidney injury in diabetic patients. Methods From June 2022 to June 2024，160 patients with diabetes admitted to the 982nd Hospital of the Joint Logistics Support Force and the Second Hospital of Shijiazhuang were selected as study subjects，and assigned to the kidney injury group（n=80）and the simple diabetes group（n=80）according to whether they had kidney injury. KIM-1，UACR and lipid metabolism indicators were compared between the two groups. The influencing factors were screened by multivariate logistic regression analysis. The receiver operating characteristic（ROC）curves were plotted to analyze the predictive efficacy of KIM-1，UACR，and lipid metabolism indicators for early kidney injury in diabetes. Results The levels of KIM-1，UACR and triglyceride（TG），as well as the proportion of hypertension and the duration of diabetes in the kidney injury group were higher than those in the simple diabetes group（P<0.05）. Multivariate logistic regression analysis showed that KIM-1（OR=3.647，95%CI：1.239-10.740），UACR（OR=2.726，95%CI：1.109-6.704），and TG（OR=3.043，95%CI：1.085-8.533）were influencing factors of early kidney injury in diabetes（P<0.05）. ROC curve analysis results showed that the areas under the curve（AUC）of KIM-1，ACR，and TG to predict early kidney injury in diabetes were 0.896，0.838，and 0.702，respectively. Among them，KIM-1 had the highest AUC，with a sensitivity of 81.25% and a specificity of 92.50%. Conclusion KIM-1，UACR，and TG are influencing factors of early kidney injury in diabetes. All three indicators have good predictive efficacy for early kidney injury in diabetes，and KIM-1 shows the best predictive performance.