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891, -trend 0.001) was an independent prognostic factor for cognitive decline in these patients with DM during the follow-up period. Our results showed that increased serum cystatin C levels were significantly and independently associated with depressive symptoms and had independent predictive value for depressive symptoms in patients with DM. Serum cystatin C might enable early recognition of depressive symptoms among DM patients. Our results showed that increased serum cystatin C levels were significantly and independently associ