Furthermore, after adjusting for potential confounding variables, including sex, age, fatty liver, smoking history, TC, TG, LDL-C, HCY, UA, and TNFR-1, both univariate and multivariate logistic regression analyses confirmed that serum ATGL remained a significant protective factor against the development of DKD (Table 4). This evidence concerns the gene PNPLA2 and diabetic kidney disease.