Objective To investigate the relationship of MTP gene variation with type 2 diabetic angiopathy. Methods PCR and restriction-fragment-length polymorphism(PCR-RFLP) analysis and gene sequencing were used to investigate the influence of a common MTP gene polymorphism in promoter region on diabetic macroangiopathy. Results (1) A single nucleotide mutation of G→T was detected at 493 bp of upstream from the transcriptional start point.There was a significant difference in genotype frequency(χ2=9.162,P=0.01) and T allele frequency(χ2=10.322,P=0.001) between macroangiopathy group and non-macroangiopathy group.(2) MTP-493 TT group had the significantly higher serum levels of TC, TG, LDL-C, VLDL-C and lower HDL-C than other genotype groups.(3) Multivariate stepwise regression analysis showed that T allele, age, disease duration, diastolic blood pressure and total cholesterol were independent risk factors against type 2 diabetic macroangiopathy.The HDL-C level was negatively related with diabetic macroangiopathy. Conclusions MTP-493 TT genotype may be deeply involved in production of atherogenic dyslipidemia and associated with development of macroangiopathy in type 2 diabetic subjects.