Aim To investigate the association of lipoproteins subfractions with intimal medial thickness(IMT) of carotid artery in type 2 diabetic patients. Methods The subfractions of lipoproteins were determined by ultracentrifugation and high-performance liquid chromatiography,and the IMT of both sides carotid artery were measured by B-mode ultrasonography in 55 type 2 diabetic patients,divided into two groups by the IMT >1.2 mm(n=20) and ≤1.2 mm(n=35).The relationship between the lipoprotein subfractions and IMT was investigated. Result The older age was more common in patients with IMT>1.2 mm compared to those with IMT≤1.2 mm(p<0.05).The serum level of lipoprotein(a) was higher in group IMT>1.2 mm(0.122±0.077 mmol/L vs 0.081±0.049 mmol/L,p<0.05).After adjusting the age,sex and BMI,the higher IMT was positively correlated with Lp(a) and LDLb;Lp(a) was positively correlated with LDL;TG was positively correlated with fasting blood glucose and LDLb,inverse correlated with HDL、HDL2 and LDLa(p<0.05). With stepwise multivariate logistic regression analysis,older age and Lp(a) were identified as significant and independent risk factors for higher IMT of carotid artery in type 2 diabetic patients(p<0.001 and P=0.021 respectively). Conclusion The results suggest that Lp(a) has a strong association with IMT of carotid arteries and might be the important predictor for early atherosclerosis in type 2 diabetic patients.