The total number of people with diabetes has been projected to rise from 94 million in 2003 to 333 million in 2025. Those who have untreated diabetes can develop multiple complications, such as diabetic nephropathy and cardiovascular disease, and have reduced healthy life expectancies. Therefore, it is important to identify persons who are at a high risk of diabetes onset, and to prevent these persons from developing abnormal glucose intolerance. Uric acid is the final oxidation product of purine catabolism. Elevated uric acid is considered to be a precursor of gout, one of the most common metabolic diseases, and is also related to the development of multiple complications in other diseases. With respect to glucose metabolism, some cross-sectional and longitudinal studies have found no association between uric acid Cycloheximide levels and the risk of type 2 diabetes but other studies have reported their association. Most notably, a meta-analysis by Kodama et al. found an association between uric acid levels and the development of type 2 diabetes. To date, however, the majority of studies have not differentiated between men and women. Indeed, only a few studies include sex-specific analyses. Yet, uric acid is metabolized differently in men and women because of the estrogen effect, which promotes the excretion of uric acid. Indeed, uric acid levels are generally higher in men. The World Health Organization, International Diabetes Federation, and Japan Diabetes Society distinguish between normal and impaired fasting glucose because impaired fasting glucose is independently associated with the onset of type 2 diabetes mellitus. In addition, several research groups have reported that impaired fasting glucose is a risk factor for coronary artery disease. It is not known whether uric acid level is a risk factor for the onset of impaired fasting glucose, regardless of the baseline fasting plasma glucose level, which is itself a known risk factor for the onset of prediabetes and type 2 diabetes. This large, community-based longitudinal cohort study was designed to allow an epidemiologic assessment of the potential relationship between uric acid levels and the onset of impaired fasting glucose, as stratified by fasting plasma glucose levels at baseline. Ideally, the results of the present study will help clinicians to recognize the patients who are at greatest risk by identifying additional factors that could help to stratify patient risk. One-way analysis of variance was used to analyze betweengroup differences in baseline characteristics, such as age, results of the physical examinations, and anthropometric and routine biochemical variables. The groups were defined according to fasting plasma glucose levels and uric acid levels. The chi-square test was used to analyze the presence or absence of fatty liver and health-related behaviors.