Abstract: Objective:To investigate the predictive value of the neutrophil to lymphocyte ratio(NLR) and cystatin C(CysC) in early renal damage of type 2 diabetes patients.Methods:One hundred and eighty-two type 2 diabetes patients were divided into the simple diabetes groupalbumin to creatinine(ACR)<3.4 mg/mmol and early diabetic nephropathy group(3.4 ≤ ACR<33.9 mg/mmol) according to the urinary ACR ratio.The levels of gender,age,duration of diabetes,whole blood NLR,serum urea(UREA),creatinine(CREA),uric acid(UA) and CysC between two groups were compared,and analyzed using the receiver operating curve(ROC) and logistic regression.Results:The differences of the gender,duration of diabetes,and serum levels of UREA,CREA and UA between two groups were not statistically significant(P>0.05),but the age,whole blood NLR and serum level of CysC in early diabetic nephropathy group were higher than those in simple diabetic group(P< 0.05 to P<0.01).The diagnostic value of serum CysC in early diabetic nephropathy was higher than that of age and whole blood NLR.The area under ROC curve of CysC,age and whole blood NLR were 0.831,0.678 and 0.638,respectively,the sensitivities of CysC,age and whole blood NLR were 70.59%,92.86% and 92.86%,respectively,the specificities of CysC,age and whole blood NLR were 90.00%,41.27% and 36.51%,respectively,the negative predictive values of CysC,age and whole blood NLR were 84.36%,92.85% and 91.99%,respectively,and the positive predictive values of CysC,age and whole blood NLR were 80.02%,41.31% and 39.43%,respectively.Serum CysC was a risk factor in early diabetic nephropathy,and the odds ratio of which was 266.080.Conclusions:Age and whole blood NLR can be set as a screening index for early diabetic nephropathy.The serum CysC has highly predictive value,which is an independent risk factor in early diabetic nephropathy.