Abstract: Objective: To investigate the relationship between epicardial adipose tissue (EAT) thickness and carotid intima-media thickness (CIMT) in overweight and obese patients with type 2 diabetes (T2DM).Methods: A total of 131 T2DM patients from the Department of Endocrinology in Binhu District of Hefei First People’s Hospital were selected and divided into normal weight group (BMI 18.5-23.9 kg/m²,n=44) and overweight and obese group (BMI≥24.0 kg/m²,n=87) according to BMI.The general clinical data and biochemical test indexes of patients were collected,and the carotid artery ultrasound was improved to record CIMT and the cardiac ultrasound to record EAT thickness.The measurement data between the two groups were compared by independent sample t test and Mann-Whitney U test.Statistical data were compared between the two groups using χ²test.Spearman correlation analysis was performed for the relationship between CIMT and EAT thickness in the T2DM patients in the overweight and obese group,and multiple stepwise linear regression analysis was performed for the independent risk factors of CIMT.Results: Compared with the normal weight group,fasting plasma glucose (FPG),fasting c-peptide (FC-P),triglyceride (TG),serum uric acid (SUA),monocyte (MO),EAT thickness and CIMT in overweight and obese patients with T2DM were all increased,and the difference was statistically significant (P＜0.05).In overweight and obese T2DM patients,CIMT was positively correlated with BMI,TG,SUA,MO and EAT thickness (r=0.683,0.236,0.621,0.936,P＜0.01),EAT thickness was positively correlated with BMI,TG,MO and CIMT (r=0.648,0.234,0.603,0.936,P＜0.01),and EAT thickness and BMI were risk factors for CIMT.Conclusion: The increase of EAT thickness in overweight and obese T2DM patients is closely related to CIMT,which is a risk factor for CIMT.