Objective:To investigate the relationship between serum thyrotropin(TSH)levels and major cardiovascular risk factors in elderly type 2 diabetes(T2DM)patients with normal thyroid function.Methods:A total of 510 elderly T2DM patients with normal thyroid function were included in this study, including 265 males and 245 females.Blood samples of all patients were collected after an overnight fast.Thyroid function and blood levels of lipids, glucose, glycated hemoglobin(HbA1c)and other components were measured.Basic information of all patients was collected and body mass index(BMI), visceral adiposity index(VAI)and lipid accumulation product index(LAP)were calculated.Results:The levels of BMI, VAI, LAP, triglycerides(TG), total cholesterol(TC), low density lipoprotein(LDL-C), HbA1c, fasting blood glucose(FBG)and 2h-postprandial blood glucose(2 h PBG)were higher in the high TSH group than in the low TSH group(31.7±5.5 kg/m 2vs.27.6±2.1 kg/m 2, 7.20±1.18 vs.5.88±0.51, 61.88±6.36 vs.52.76±7.09, 6.49±2.64 mmol/L vs.5.84±2.41 mmol/L, 2.73±1.30 mmol/L vs.1.99±0.54 mmol/L, (2.86±0.93 mmol/L vs.2.55±0.81 mmol/L, 9.10±1.35% vs.7.80±1.76%, 9.64±2.03 mmol/L vs.7.55±1.72 mmol/L, 19.20±2.99 mmol/L vs.15.33±2.36 mmol/L, t=5.32, 8.06, 10.88, 8.13, 8.30, 5.90, 5.83, 6.51 and 6.82, all P<0.05). Multivariate Logistic regression analysis showed that cardiovascular risk factors including HbA1c( OR=1.21, 95% CI: 1.01-1.52, P=0.020), LDL-C( OR=1.88, 95% CI: 1.78-2.01, P=0.000), LAP( OR=3.01, 95% CI: 2.98-3.12, P=0.010), and BMI( OR=2.58, 95% CI: 2.45-2.68, P=0.000)were influencing factors for TSH. Conclusions:In elderly patients with T2DM, TSH levels within the normal range but close to the upper limit are closely related to cardiovascular risk factors such as increased visceral fat and high TG levels, and may increase the risk of cardiovascular disease.