Abstract: Objective To observe the predictive value of high-sensitive C-reactive protein(hs-CRP) as a marker in progression of borderline coronary lesion in patients with diabetes mellitus. Methods From December 2015 to December 2016, 587 subjects with type 2 diabetes mellitus(T2 DM) and coronary borderline lesion diagnosed by coronary CT angiography in the first medical center, Chinese PLA General Hospital were enrolled in our study. All patients were followed up for 1 year and their plasma hsCRP level and parameters of coronary atherosclerosis plaque(plaque thickness, plaque burden, and plaque presence) were assessed at baseline and 1 year later. According to plasma hs-CRP level, the patients were divided into hs-CRP level ≥ 2 mg/L group and hs-CRP level < 2 mg/L group. The plaque progression was assessed by CCTA 1 year later and compared between two groups. Results There was no significant difference in baseline data between two groups. T2 DM patients with hs-CRP level ≥ 2 mg/L had higher percentage of coronary plaque progression compared with patients in hs-CRP level < 2 mg/L group(37.5% vs 23.8%, P=0.003). The total plaque number between two groups had no statistically significant difference. But the percentages of positive remolding, spotty calcification and low density plaque were significantly higher in hs-CRP level ≥ 2 mg/L group than hs-CRP level < 2 mg/L group(all P< 0.05). Patients with hs-CRP level ≥ 2 mg/L had higher rate of main adverse cardiac events than those with hs-CRP level < 2 mg/L after 1-year follow-up. Conclusion hs-CRP level ≥ 2 mg/L is a risk factor of plaque progression in patients with T2 DM.