In the multivariate logistic analyses, adjusting for, age, gender, BMI, FPG, smoking, TG, TC, duration of diabetes, SBP, diabetic retinopathy, eGFR, high sensitivity C-reactive protein, angiotensin receptor blocker/ACE inhibitor usage, with the increase in one SD of serum cfDNA levels, the risk of DKD progression increased by 2.4 times (OR, 2.46; 95% CI 1.84 to 4.89) (table 3). The gene discussed is ACE; the disease is diabetic retinopathy.