In multivariable analysis, DM + HTN etiology (HTN-alone vs. DM + HTN odds ratio [OR]: 0.0013, 95% confidence interval [CI]: 0.00002-0.0999, <i>p</i> = 0.003; confirmed by Firth's penalized logistic regression sensitivity analysis, and lower platelet count (OR: 0.92 per 1 × 10<sup>9</sup>/L increase, 95% CI: 0.87-0.98, <i>p</i> = 0.006) independently predicted aCL positivity. Here, ACLY is linked to diabetes mellitus.