Basic fibroblast growth factor (bFGF) is a potent mitogen in endothelial and vascular smooth muscle cells that increases in serum from adults with coronary artery disease and in microalbuminuric type 2 diabetes mellitus. There has been no prior study of plasma bFGF as a possible cardiovascular risk marker in type 2 diabetes mellitus. In this study, we tested for a correlation between log plasma bFGF immunoreactivity (bFGF-IR) and baseline cardiovascular risk factors in a baseline subset of subjects with advanced type 2 diabetes mellitus from the Veterans Affairs Diabetes Trial ([mean] age, 60 years; hemoglobin A(1c), 9.5%; diabetes' duration, 11 years). Plasma bFGF-IR was determined with a sensitive, specific, 2-site enzyme-linked immunoassay in 281 patients at the baseline visit. Results were compared with baseline risk factors or baseline medication use. Baseline plasma bFGF-IR ranged from 0 to 141 pg/mL. Log plasma bFGF correlated significantly with non-Hispanic white race (P = .002), waist-hip ratio (P = .002), and plasminogen activator inhibitor-1 concentration (P < .0001). Log plasma bFGF correlated inversely with African American race (P = .0003). In multiple regression analysis, plasminogen activator inhibitor-1 and race were significantly correlated with log plasma bFGF. These results suggest a significant correlation between log plasma bFGF-IR and plasminogen activator inhibitor-1, a marker of hemostatic risk.