Background In this study, we aimed to evaluate the impact of abnormal glucose, lipid and Cystatin-C on the virtual P vector characteristics, which haven’t been reported in previous studies. Methods 204 of non-diabetes mellitus(NDM), 130 of DM(type 2) and 39 of impaired glucose tolerance(IGT) patients were consecutively and retrospectively recruited. We selected a one-minute length of electrocardiogram at 4AM for analysis. After a series of calculating algorisms, we obtained the virtual planar P vector parameters. Results There were no significant differences in FPV, FPA, RSPV, RSPA, HPV and HPA groups. After adjusting confounding factors, the regression coefficients(RC) were estimated as follow: for FPV, female gender(RC-0.21, P = 0.02), triglyceride(RC-0.09, P < 0.01), RVOT(RC 0.03, P = 0.02); for RSPV, female gender(RC-0.21, P < 0.01), triglyceride(RC-0.10, P < 0.01), average heart rate(RC 0.01, P = 0.02); for HPV, triglyceride(RC-0.08, P < 0.001), LDL(RC-0.19, P < 0.01), Apo B(RC 0.67, P < 0.01); for RSPA, B type of blood(RC-22.06, P = 0.02), Cystatin-C(RC-72.79, P = 0.02), thickness of interventricular septum(RC 3.70, P = 0.01). Cystatin-C was suggested as a cure related to RSPA, and the cut-off point was 1.6 mg/L. There were no significant risk factors associated with FPA and HPA. There was no difference in virtual P vector among DM, IGT and NDM groups. Conclusion Increased levels of lipid and Cystatin-C significantly impact the characteristics of virtual P vector, whereas glucose does not. These changes may come from a higher low voltage atrial area and abnormal orientation of atrial depolarization. Background In this study, we aimed to evaluate the impact of abnormal glucose, lipid and Cystatin-C on the virtual P vector characteristics, which have not been reported in previous studies. Methods 204 of non-diabetes mellitus (NDM), 130 of We selected a one-minute length of electrocardiogram at 4AM for analysis. After a series of calculating algorisms, we obtained the virtual planar P vector parameters (DM 2) and 39 of impaired glucose tolerance (IGT) patients were consecutively and retrospectively recruited. After adjusting confounding factors, the regression coefficients (RC) were estimated as follow: for FPV, female gender (RC-0.21, P = 0.02 (RC-0.21, P <0.01), triglyceride (RC-0.10, P <0.01) (RC-0.08, P <0.001), LDL (RC-0.19, P <0.01) and Apo B (RC 0. 67, P <0.01); for RSPA, B type of blood (RC-22.06, P = 0.02), Cystatin-C (RC-72.79, P = 0.02), thickness of interventricular septum (RC 3.70, P = 0.01). Cystatin-C was suggested as a cure related to RSPA, and the cut-off point was 1.6 mg / L. There were no significant risk factors associated with FPA and HPA. There was no difference in virtual P vector among DM, IGT and NDM groups. Conclusion Increased levels of lipid and Cystatin-C significantly impact the characteristics of virtual P vector, whereas glucose does not. These changes may come from a higher low voltage atrial area and abnormal orientation of atrial depolarization.