OPG is a secreted cytokine receptor originally identified as an inhibitor of bone resorption and acts a decoy receptor for receptor activator of nuclear factor kB ligand (RANKL) and tumour necrosis factor (TNF)- related apoptosis-inducing ligand. OPG has been implicated to play a causal role in the pathogenesis of T2DM. OPG has been shown to be associated with CVD onset and progression. OPG levels are in fact positively correlated with markers of vascular damage with the presence of coronary artery disease (CAD).presence of coronary artery disease (CAD). Participants and methods: The study includes 45 patients with diabetes. Patients were subdivided into 3 groups each group was 15 patients, Group 1 included 15 type 2 diabetic patient with normal to mildly increased albuminuria. Group 2 included 15 type 2 diabetic patients with moderately increased albuminuria. Group 3 included 15 diabetic patients with severely increased albuminuria. For all participants, the following were performed: assessment of history, clinical examination including BMI, systolic blood pressure, and diastolic blood pressure, ophthalmoscopy , kidney ultrasound and assessment of fasting blood glucose, glycated hemoglobin, lipid profile, serum creatinine and urea, urinary ACR , serum OPG. Results Our study showed statistically positive correlation between osteoprotegerin and degree of albuminuria in type 2 diabetic patients. Conclusion OPG may be a useful biomarker for the identification of type 2 diabetic patients who potentially at risk of developing severe albuminuria.