Type 2 Diabetes, Visceral Adiposity, and Carotid Intima–Media Thickness in Hospitalized Adults: A Retrospective Cross-Sectional Analysis

Background and Objectives: Type 2 diabetes mellitus (T2DM), visceral adiposity, and hypertension frequently coexist, but their independent associations with carotid intima–media thickness (cIMT) remain uncertain. We compared cardiometabolic profiles by diabetes status and evaluated adjusted associations with cIMT. Materials and Methods: This retrospective cross-sectional study included 147 adults admitted to Clinical CF Hospital Timișoara between 1 July 2025 and 30 June 2026. Bilateral cIMT was available in 141 patients. Group comparisons, Spearman correlation, and heteroscedasticity-robust multivariable linear regression were performed. Results: T2DM was present in 39 patients (26.5%), hypertension in 125 (85.0%), and obesity in 120 (81.6%). Compared with participants without diabetes, those with T2DM had higher homeostasis model assessment of insulin resistance (HOMA-IR; 4.11 vs. 3.08; p = 0.005) and fasting glucose (6.60 vs. 5.06 mmol/L; p < 0.001), but lower total cholesterol (205.2 vs. 225.9 mg/dL; p = 0.009) and non-high-density lipoprotein cholesterol (156.5 vs. 176.6 mg/dL; p = 0.006). These lower lipid values may reflect treatment or other residual confounding and should not be interpreted as an intrinsic T2DM phenotype. Mean cIMT was numerically higher in T2DM (0.619 vs. 0.592 mm; p = 0.284). Visceral fat area correlated with cIMT before adjustment (ρ = 0.237; p = 0.005), but not after adjustment. Age (β = 0.057 mm/decade; p < 0.001) and hypertension (β = 0.046 mm; p = 0.042) retained adjusted associations with cIMT. Conclusions: T2DM identified metabolic dysregulation, whereas age and hypertension showed the strongest adjusted associations with cIMT. Visceral adiposity showed an unadjusted but not independent association, supporting comprehensive cardiovascular risk assessment and rigorous blood pressure management.