Abstract： Objective To test the correlation of APN/leptin （A/L） ratio with insulin resistance in patients with IGR and NAFLD. Methods Clinical and laboratory data were collected from 30 healthy controls, 32 cases with IFG and NAFLD, 30 cases with IFG without NAFLD, 32 cases of IGT and IFG with NAFLD, 30 cases of IFG and IGT without NAFLD. FPG, FIns, leptin,APN and lipid profile were measured. The A/L ratio and the index of IR were calculated. Results In patients with IGR, serum APN and A/L ratio were significantly lower, while leptin was higher in patients with NAFLD than without NAFLD.Adiponectin and A/L ratio were negatively correlated with BMI,WHR in IGR group and IGR plus NAFLD group.Multiple regression showed that (1)in 60 patients with IGR, the A/L was significantly correlated with WHR and TG, and HOMAIR was significantly correlated with WHR. This model explained 3011% of the variance in the A/L and 1503% of the variance in HOMAIR,and（2） in 64 patients with IGR and NAFLD, the A/L was significantly correlated with WHR, TG and LDL-C, and HOMAIR was significantly correlated with WHR. This model explained 37.19% of the variance in A/L and 1217% of the variance in HOMAIR. Conclusions ①In patients with IGR, serum APN level and the A/L ratio are significantly lower, leptin level is higher than in healthy controls, and the NAFLD and glucose intolerance make the IR situation worse. ②The A/L ratio might be more useful than HOMAIR for evaluating insulin resistance in patients with IGR.