Abstract: Objective To investigate whether serum uric acid (SUA) is associated with 2-hour postload glucose (2-h PG) in predibetic patients. Methods There were 3 588 subjects enrolled in this study from May 2014 to March 2015 in the department of physical examination center and outpatient clinic of West China Hospital of Sichuan University. All the subjects received a 75-g oral glucose tolerance test (OGTT) and measurements of serum uric acid (SUA), Creatinine, Cystatin (Cys-C), serum lipid and glycosylated hemoglobin (HbA1c). According to the results of glucose and HbA1c, the subjects were divided into three groups, including normal glucose regulation (NGT), impaired glucose regulation (IGR) and Type 2 Diabetes Mellitus (T2DM) group. The correlation between 2-h PG and serum uric acid in each group was analyzed. Results Based on the exam results, there were 556 cases of NGT, 1 019 cases of IGR, 2 013 cases of T2DM. There were statistically significant differences of glucose, serum insulin, triglycerides, high density lipoprotein, HbA1c, SUA, Creatinine, Cys-C levels among the three groups ( P<0.05). Multiple linear regression analysis showed that SUA level was positively correlated to 2-h PG level ( P<0.05) in NGT and IGR groups, but there was no correlation in T2DM group ( P=0.156). In the entire study population, levels of HbA1c and FPG were positive to 2-h PG correlated ( P<0.05). Positive correlation existed between FPG and 2-h PG in NGT group ( P=0.031). In IGR and T2DM group, HbA1c and 2-h PG were positively correlated ( P<0.05). HbA1c, FPG and SUA levels were independent risk factors for 2-h PG. Conclusion In prediabetes, 2-h PG is associated with SUA and independent of FPG, HbA1c and other known risk factors. SUA may play a key role in the prediabetic condition as a risk indicator of T2DM.