This work aimed to investigate the association between NGAL and sdlDL-C levels and major adverse cardiovascular and cerebrovascular events (MACCE: cardiovascular or cerebrovascular death, acute coronary syndrome, coronary stent implantation, and stroke) in T2DM patients aged ≥ 65 years, to evaluate the predictive value of NGAL and sdlDL-C for MACCE in these patients, and to determine whether they are more suitable than other lipid biomarkers such as LDL-C. The gene discussed is LCN2; the disease is acute coronary syndrome.