Abstract: Objective To study the effect of pancreatic β-cell function on glucose metabolism in middle-aged and elderly subjects. Methods Middle-aged and elderly subjects for diabetes mellitus (DM) screening in our hospital from May 2005 to May 2007 were included in this study.Their glucose metabolism was tested by OGTT at the dose of 75g.The subjects were divided into normal glucose tolerance (NGT) group, impaired glucose tolerance (IGR) group and newly diagnosed DM group according to their OGTT.Their pancreatic β-cell function and insulin resistance were assessed, respectively, according to the HBCI/IR and HOMA-IR. Results A total of 756 subjects were included in this study.HBCI/IR showed that the glucose metabolism decreased gradually from NGT to IGR and from IGR to DM and the insulin resistance increased gradually (P< 0.001).Univariate linear regression analysis revealed that the HBCI/IR was closely related with glucose metabolism (β =-10.0, 95% CI:-12.6 and-7.3, P< 0.001).Multivariate linear regression analysis displayed that the pancreatic β-cell function was an important factor for glucose metabolism in middle-aged and elderly subjects after adjustment for sex, age, BMI, SBP, TG, HDL-C and HOMA-IR (β =-0.003, 95% CI:-0.006 and 0.000; P< 0.05). Conclusion Pancreatic β-cell function is an important factor for glucose metabolism in middle-aged and elderly subjects.