A recent study reconfirmed that levothyroxine treatment reduced urinary albumin excretion in patients with early DKD with mildly elevated TSH levels and positive serum TPOAB (46) In addition, our study identified a risk association between FT3/FT4 and FT4 and ACR, and although this result was not statistically significant in DKD events and eGFR, the effect values showed a reliable and consistent trend. This evidence concerns the gene ALB and diabetic kidney disease.