The amount and activity of dipeptidyl peptidase IV (DPPIV/CD26) in urinary MV coming from proximal tubule cells was shown to positively correlate with progression of DN in type 2 diabetic patients (76) suggesting an early tubular impairment, which may be considered an early marker of renal damage even before the onset of albuminuria. This evidence concerns the gene DPP4 and liver dysplastic nodule.