After adjustment for age, current smoking, current drinking, insurance type, BMI, duration of diabetes, dyslipidemia, SBP, DBP, FBG, HbA1c, UA, and use of RAAS and SGLT2 inhibitors, the risk of DKD decreased with an increasing DHEA concentration; the fully adjusted OR (95% CI) for tertile3 vs tertile1 was 0.37 (0.19-0.70; P = 0.010 for trend). This evidence concerns the gene SLC5A2 and metabolic syndrome.