Abstract: Objective To study the relationship between T-786→C mutation in the 5′-flanking region of the endothelial nitric oxide synthase gene and type 2 diabetes(T2DM) with coronary heart disease(CHD). Methods One hundred and eighty-six T2DM were selected,and of them,65 had CHD.Meanwhile,63 healthy individuals were selected as control.PCR/ASO(allele-specific oligonucleotide probe) technique was used to determine the T-786→C mutation.Results Compared with control,the T/C genotype and C allele prevalences were significantly higher in T2DM with CHD(P<0.05).Compared with T2DM without CHD,the C allele prevalence was significantly higher in T2DM with CHD(P<0.05).Compared with T/T genotype group,the HbA1c level of T2DM was significantly higher in T/C genotype group(P<0.05).By multiple logistic regression analysis,age,blood pressure,duration of diabetes,LDL-C,Lp(a),HbA1c,C allele were associated with CHD development in T2DM(P<0.01).Conclusions T-786→C mutation in the 5′-flanking region of the endothelial nitric oxide synthase gene increases the risk for CHD development in T2DM.