【Abstract】Objective To analyze the expression and correlation of serum 25hydroxyvitamin D (25 (OH) D), blood lipids and serum fetuin A (AHSG) in patients with diabetic nephropathy (DN). Methods 112 patients with DN treated in our hospital from April 2017 to June 2019 were retrospectively analyzed. According to the urinary protein/creatinine value (ACR), they were divided into normal urinary protein group (42 cases), microurinary protein group (36 cases) and large urinary protein group (34 cases). Another 36 healthy patients underwent physical examination in our hospital in the same time were selected as the healthy group. 36 patients were selected as simple diabetes group. The expression relationships between 25 (OH) D, AHSG, and lipids in different people and patients with different levels of proteinuria DN were compared. The correlation between 25 (OH) D, AHSG, blood lipids and diabetic nephropathy was analyzed. Results As the disease progressed, the levels of 25 (OH) D and AHSG gradually decreased, and the lipid indicators (TC, TG, LDLC) gradually increased (P＜005), and 25 (OH) D was positively correlated with AHSG and ACR, and negatively correlated with TC, TG, and LDLC (P＜005). TC, TG and LDLC were negatively correlated with AHSG, and positively correlated with ACR (P＜005). Further Logistic research results showed that the deficiency of 25 (OH) D, the decreasing of AHSG, the increasing of LDLC, and the increasing of ACR were independent influencing factors affecting the occurrence of DN (P＜005). Conclusion 25 (OH) D, AHSG, and blood lipids are related to the development of DN in patients. 〖JP〗In the early stage of diabetes, 25 (OH) D, AHSG, and blood lipid levels can be detected, 〖JP2〗blood glucose control, and timely supplementation of vitamin D can delay the occurrence and development of DN.