Considering the inhibitory effect of CTRP9 on vascular smooth muscle cell growth and neointimal formation in mice [13], a detrimental impact of CTRP9 on carotid IMT in this study could be explained by a compensatory response of CTRP9 to the conditions predisposing to the development of atherosclerosis in subjects with T2D. Here, C1QTNF9 is linked to type 2 diabetes mellitus.