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　　patients with type 2 diabetes to investigate the correlation among proteinuria, blood pressure and renal function (eGFR) under strict control of blood glucose levels (HbA1c of less than 7.0%).19) It is important to maintain HbA1c at less than 7% and blood pressure at less than 130/80 mmHg to inhibit decrease in renal function and occurrence of cardio-vascular or cerebrovascular disease (CVD) in patients with type 2 diabetes. Materials and MethodsPatientsA study was conducted on a cohort of patients with type 2 diabetes who had been treated in Koshigaya Municipal Hospital, Saitama, Japan from January 2012 to August 2017. Sufficient available data from blood and urine samples from 1,053 patients were analyzed in this study. All medical records were reviewed retrospectively. In this study, participants were eligible if their estimated glomerular filtration rate (eGFR), i.e. an index of renal function, was more than 30 ml/min/1.73 m2. (eGFR is 194 x Cr-1.097 x Age-0.287; female x 0.739). After excluding the patients who did not meet this criterion, a remaining 739 patients (mean age: 66.9±12.3 years, mean duration of diabetes: 8.74±6.0 years) were finally evaluated in this study. These patients were divided into three groups according to their HbA1c levels: 1) a lower group (Group L) (n=325; HbA1c less than 7% , mean age : 69.2±10.5 years of age, mean duration of diabetes: 8.55±6.05 years), 2) a middle group (Group M) (n=285; 7%≤HbA1c<8%, mean age : 66.9±12.4 years of age, mean duration of diabetes: 9.0±6.07 years) and 3) a higher group (Group H) (n=129; HbA1c more than 8%, mean age: 61.4±14.8 years of age, mean dura-tion of diabetes: 8.63±5.76 years). All patients had been receiving standard hypoglycemic agents, such as DPP-4 inhibitor, SGLT2 inhibitor, sulpho-nylurea, α-glucosidase inhibitor and insulin in our hospital. The urinary albumin creatinine ratio (uACR) was used for an index of proteinuria. The exacerbation of decline in renal function was defined as a decrease in eGFR levels.Patient follow-upA comparative analysis on the change in protein-uria and renal function was conducted using several parameters including: 1) gender, 2) treatment with or without RAS inhibitors (RASI), 3) treatment with or without statin, 4) blood pressure levels, i.e. well- controlled was defined as systemic blood pressure (sBP) of less than 130 mmHg and 5) HbA1c, for which median value during follow-up period was calculated and patients were divided into groups according to that value (HbA1c < 7% ; Group L, 7%≤ HbA1c < 8 % ; Group M, and 8% ≤ HbA1c; Group H) as described above. LDL-choles-terol (LDL-C), HDL-cholesterol (HDL-C) and triglycerides (TG) were also recorded.The starting point of uACR measurement was defined as the starting time of this study, and the end point was the final measurement of uACR. uACR was periodically measured at intervals of about 6 months. The uACR levels that deviated from mean±2SD were excluded from this study. Amount of change in uACR and eGFR from the starting point to the end point was divided by each follow-up period and the obtained value was defined as annual change. The number of patients with hospitalizations due to cardiovascular or cere-brovascular events were also analyzed.Since this study was not a clinical trial and the data were retrospective in nature and analyzed anonymously, written informed consent for partici-pation was not obtained from the patients. This study was written after the approval was obtained from the ethical committee of our hospital. The ethical committee approval number was 2020-18.Statistical analysesComparisons between groups were performed using the Mann-Whitney U-test. Comparisons between three groups of blood glucose (HbA1c) levels, i.e. Group L, M and H, were performed using the Kruskal-Wallis-U-test. A multiple logistic regression model was used to identify the risk of diabetic nephropathy associated with gender, with or without RASI, with or without Ca channel blocker and β blocker , with or without statin, systolic blood pressure (sBP<130mmHg or sBP ≥130mmHg), and LDL-C (LDL-C classified as 120 mg/dl or more and less than 120 mg/dl), HDL-C (HDL-C classified as 40 mg/dl or more and less than 40 mg/dl), TG (150 mg/dl or more and less than 150 mg/dl). P<0.05 was considered to indicate statistical significance. HAPPY ACTIS version 3.13.3 and 347