Background：The incidence of cardiovascular diseases (CVDs) has been increasing globally. Type 2 diabetes mellitus (T2DM) is a hazard factor for CVDs. Objective: Carotid intima–media thickness (CIMT) and carotid-femoral pulse wave velocity (cf-PWV) were two classical markers, which were selected to assess the degree of atherosclerosis (AS). Our study was to assess the differences of CIMT and cf-PWV between T2DM patients and healthy people through a systematic review followed by meta-analysis, thus exploring whether T2DM can increase the CVD risk. Methods：Relevant literatures from the database of EMBASE, PubMed, Web of Science, and The Cochrane Library were extracted, which focused on studies comparing CVD risk markers in T2DM patients and healthy individuals. Study characteristics, the overall standard mean differences (SMDs) of CIMT and cf-PWV along with their 95% confidence interval (CI) were analyzed. Cochrane Q and I2 statistics were used to evaluate heterogeneity. Results：Our study found that T2DM patients displayed an increased CIMT (SMD: 0.88; 95% CI, 0.70-1.07; p lt;0.00001) and faster cf-PWV (SMD: 0.48; 95% CI, 0.30-0.67; p lt;0.00001) than healthy controls. Subgroup analysis further indicated that CIMT values in T2DM patients were remarkably influenced by geographic region rather than disease duration of T2DM. Conclusions：These findings reinforce existing evidence of an elevated risk of cardiovascular events in T2DM patients, thus highlighting the clinical value of subclinical atherosclerosis markers, such as CIMT and cf-PWV, in the management of T2DM.
Zhang et al. (2026) studied this question.