Abstract:Objective To investigate the effect of visceral fat area (VFA) on carotid atherosclerotic plaque in patients with type 2 diabetes mellitus(T2DM). Methods From August 2018 to August 2023, 683 T2DM patients included in the database of the National Metabolic Management Center (MMC) were selected from the Department of Endocrinology, the Affiliated Geriatric Hospital of Nanjing Medical University. Medical history, physical examination, serum biochemical indicators, VFA and other data were collected from the study subjects. According to the presence or absence of carotid atherosclerotic plaque, all patients were divided into T2DM patients with plaque (n=342) and T2DM patients without plaque (n=341), and statistical analysis was performed. Results There were statistically significant differences in age, body mass index (BMI), waist circumference, diastolic blood pressure (DBP), total cholesterol (TC), low-density lipoprotein cholesterol (LDL-C), high-density lipoprotein cholesterol (HDL-C), abdominal subcutaneous fat area (SFA) and VFA between the two groups (P<0.05). Multivariate logistic stepwise regression analysis showed that older age (OR=1.070,95%CI:1.050-1.091) and higher level of VFA (OR=1.020,95%CI:1.012-1.028) were the risk factors for the formation of carotid atherosclerotic plaque in T2DM patients (P＜0.01). The area under the curve (AUCs) of VFA, BMI, waist circumference, and abdominal SFA for predicting atherosclerosis in T2DM were 0.673, 0.590, 0.621, and 0.601, respectively, with VFA being the highest. When the critical value of VFA was 85 cm2, its sensitivity and specificity were 95.3% and 61.6% ,respectively. Conclusion Age and VFA are independent influencing factors for atherosclerotic plaque formation in patients with T2DM，and as a new obesity assessment index, VFA can better predict and assess the risk of atherosclerotic plaque formation in T2DM patients.