To our knowledge, the current study is the first to explore the potential mediating effect of hypertriglyceridemia, insulin resistance and hyperglycemia on the relationship between serum levels of ANGPTL8 and c-IMT and the possibility of identifying ANGPTL8 as a risk biomarker for subclinical atherosclerosis in type 2 diabetes through cross-sectional study in China. Here, ANGPTL8 is linked to hypertriglyceridemia.