This study aimed to compare carotid atherosclerotic indicators among patients with newly diagnosed type 2 diabetes mellitus (NT2DM), pre-diabetes mellitus (PDM), and healthy controls (HCs), and to investigate associations between nonalcoholic fatty liver disease (NAFLD) and carotid atherosclerosis. A total of 240 participants were enrolled (120 NT2DM, 60 PDM, and 60 HCs). Liver fat content (LFC) was assessed using proton magnetic resonance spectroscopy ([1H]-MRS). Carotid intima-media thickness (CIMT) and carotid pulse wave velocity (PWV) at the beginning (BS-PWV) and end of systole (ES-PWV) were measured by ultrasonography. The levels of LFC were significantly higher in NT2DM (14.57% ± 6.49%) and PDM (11.44% ± 5.62%) than in HCs (5.73% ± 4.08%; P=.000). The prevalence of NAFLD was 66.7% in NT2DM, 38.3% in PDM, and 25.0% in HCs. CIMT, BS-PWV, and ES-PWV were significantly elevated in NT2DM compared with PDM and HCs (all P < .05). Multiple linear regression (MLR) analyses showed LFC and triglycerides were strong contributors to both BS-PWV and ES-PWV. Elevated LFC and NAFLD prevalence in NT2DM, together with their associations with carotid atherosclerosis, suggest a potential link between NAFLD and cardiovascular disease in T2DM.
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