Abstract:Objective: To analyze the related risk factors of osteoporosis in patients with diabetic kidney disease. Methods: 243 patients with DKD treated in the hospital between September 2018 and September 2021 were selected. According to the examination results of the X-ray bone mineral density meter, the patients were divided into the osteoporosis group (OP group, 119 cases) and the non-osteoporosis group (NOP group, 124 cases). The general data of the two groups of patients were compared, and multivariate Logistic analysis was used to analyze the related factors affecting the occurrence of OP in patients with DKD. ROC curve was plotted to analyze the diagnostic value of Klotho and FGF-23 on the occurrence of OP in patients with DKD. Results: There were statistically significant differences between the OP group and the NOP group in terms of gender, GFR, BMI, Klotho, and FGF-23 (P<0.05). Multivariate Logistic analysis showed that gender and FGF-23 were risk factors that affected the occurrence of OP in patients with DKD, and Klotho was a protective factor affecting the occurrence of OP in patients with DKD (P<0.05). ROC curve analysis results showed that when the cut-off values of Klotho and FGF-23 were 333.33ng/L and 347.46ng/L, the areas under the curves of Klotho and FGF-23 in diagnosing OP in patients with DKD were 0.700 (95% CI: 0.635~0.765), 0.659 (95% CI: 0.591~0.728), and the sensitivities and specificities were 59.7% and 71.8%, 56.3% and 72.6% respectively. Conclusion: Female and high FGF-23 levels are risk factors to promote OP in patients with DKD, and a high Klotho level is a protective factor to inhibit OP in patients with DKD. Klotho and FGF-23 have good diagnostic value on OP in patients with DKD.