Background: First-degree relatives (FDR) of individuals with type 2 diabetes mellitus (T2DM) are at higher risk of developing early metabolic disturbances, particularly insulin resistance and lipid metabolism abnormalities. These issues contribute to a greater predisposition to cardiovascular disease compared to the general population. Despite the significant contribution, there is limited information on the relationship between atherogenic lipoproteins of normotensive and normoglycemic young FDR in Indonesia. Therefore, this study aimed to evaluate the correlation between small dense low-density lipoprotein (sdLDL) levels and HOMA-IR in FDR with T2DM, as well as assess variation in sdLDL levels within FDR and non-FDR groups. Methods: This cross-sectional study analyzed secondary data from the Metabolic Endocrine and Diabetes Division of the Internal Medicine Department, Faculty of Medicine, Universitas Indonesia, and Cipto Mangunkusumo Hospital. The primary study, titled “Early Cardio-Metabolic Disorders in the First-Degree Relative Population of Type 2 Diabetes Mellitus,” was expanded to include sdLDL measurements. Bivariate analysis and correlation tests were used to explore the relationship between sdLDL and HOMA-IR. Results: The experiment included 125 subjects consisting of 62 FDR and 63 non-FDR. Based on the results, sdLDL levels were significantly higher in the FDR group compared to the non-FDR group (31.42 (IQR 20.1-41.39) vs 21.05 (IQR 12.18-26.13) mg/dL, p<0.0001). However, no significant correlation was observed between sdLDL levels and HOMA-IR in the FDR group (r=0.059, p=0.649). Conclusion: This study showed a significant difference in sdLDL levels between FDR and non-FDR of T2DM patients. However, no correlation was found between sdLDL and HOMA-IR in the FDR group. © 2025, Indonesian Society of Internal Medicine. All rights reserved.