Introduction: At present, the number of people suffering from diabetes and obesity is increasing in China, and also all over the world. Researchers found that decreased expression of A-kinase anchoring protein 1 (AKAP1), which was thought to regulate the function and structure of mitochondria, might be related to these two diseases. However, as far as we know, there is no study about the changes of serum AKAP1 protein in these two diseases. Hence we conducted this experiment to study the relationship between serum levels of AKAP1 with T2DM and obesity. Material and methods: There were 261 subjects involved in the experiment, including 130 patients with newly diagnosed T2DM and 131 individuals with normal glucose tolerance (NGT). They were further divided into four groups as follows. Subjects with NGT and normal weight (NW) were assigned to the NGT+NW group, those with NGT but with overweight (OW) or obesity (OB) were assigned to the NGT+OW/OB group, and so on; the rest were divided into the T2DM+NW group and the T2DM+OW/OB group. Serum AKAP1 levels were tested by ELISA method and compared by T-test. Linear regression was applied to discuss independent factors of AKAP1. Multiple logistic regression was used to analyse the relationship between AKAP1 and the prevalence of T2DM. Results: Serum AKAP1 in the NGT+NW group was 1.74 ± 0.42 ng/mL, higher than that in the NGT+OW/OB group, at 1.59 ± 0.41 ng/mL (t = 2.114, p = 0.036), and the T2DM+OW/OB group, at 1.52 ± 0.36 ng/ml (t = 3.219, p = 0.002). A-kinase anchoring protein 1 in 130 subjects with T2DM was lower than that in subjects with NGT, 1.57 ± 0.35 ng/mL vs. 1.67 ± 0.42 ng/mL, t = 2.036, p = 0.043. Liner regression showed that insulin resistance (IR) and body mass index (BMI) were independent factors negatively related to AKAP1: b = -0.019 and -0.032, respectively. Compared to the highest tertile of AKAP1, the prevalence of T2DM was higher in the other two tertiles; OR was 2.207 (1.203, 4.050) and 2.051 (1.121, 3.753), respectively. Conclusions: Serum AKAP1 level decreases slightly in patients with T2DM and obesity. Subjects with lower leve1s of serum AKAP1 are susceptible to T2DM.