The aims of the current work are; to assess the frequency of premature subclinical atherosclerosis in Egyptian B-TM patients by determining their carotid artery intima-media thickness, to figure-out the associated clinical and laboratory risk factors, and to evaluate the validity of OPG assay as a new biomarker for early diagnosis of atherosclerosis in these high-risk population. Here, TNFRSF11B is linked to atherosclerosis.