Objective To discuss the relevance of serum visfatin(VF), lipoprotein-a(LP-a) and homocysteine(HCY) in diabetic nephropathy (DN). Methods 168 patients with diabetes were selected from October 2011 to July 2015 in our Hospital.According to whether associated with kidney disease were divided into without nephropathy group (82 cases) and nephropathy group (86 cases),on the basis of urinary albumin excretion rate (UAER), nephropathy group were divided into low volume nephropathy group (UAER≤300 mg/24 h, 58 cases) and high volume nephropathy group(UAER>300 mg/24 h, 48cases),at the same time,a medical health personnel 30 cases were chosen as normal group, enzyme-linked immunosorbent method was used to detect the serum VF, LP-a, HCY levels, Pearson correlation analysis was used to analyse the relationship between UAER and serum VF, LP-a, HCY levels.Results The serum LP-a in nephropathy group was significantly higher than that of without nephropathy group and normal group, the serum LP-a, HCY in high volume nephropathy group was significantly higher than the low volume nephropathy group, the difference was statistically significant (P<0.05);the serum VF level in high volume nephropathy group>low volume nephropathy group>without nephropathy group>normal group ( P<0.05 );Pearson correlation analysis showed that, UAER were positively correlated with LP-a(r=5.013,P<0.05),VF(r=5.864,P<0.05),HCY(r=7.246,P<0.05) levels in serum.Conclusion The serum VF, LP-a, HCY levels is associated with the development of DN, and it is associated to patients with renal function changes.It is helpful to the physician monitoring disease progression in patients with DN via detecting the levels of VF, LP-a and HCY.