BACKGROUND Meteorin-like (Metrnl) is a novel adipomyokine that may improve glucose tolerance and affect insulin resistance. This study aimed to investigate the association between serum levels of Metrnl with blood glucose status and to its association with insulin resistance. MATERIAL AND METHODS The study included 160 subjects with normal glucose tolerance (NGT) (n=40), impaired fasting glucose (IFG) (n=40), impaired glucose tolerance (IGT) (n=40), and newly diagnosed type 2 diabetes mellitus (T2DM) (n=40). An enzyme-linked immunosorbent assay (ELISA) was used to measure the serum levels of Metrnl. Partial correlation analysis was used to analyze the relationship between serum levels of Metrnl and metabolic parameters. Multiple logistic regression analysis was performed to identify the association between serum levels of Metrnl with the risk of diabetes. RESULTS Serum levels of Metrnl was highest in patients with T2DM and significantly increased in patients with prediabetes compared with individuals with NGT. After adjusting for age, gender, and body mass index (BMI), serum Metrnl level was significantly correlated with lipid profile, glucose profile, and insulin resistance. Multiple logistic regression analysis showed that Metrnl significantly increased the risk of T2DM (OR=1.727; P=0.008) before adjusting for the homeostatic model assessment of insulin resistance (HOMA-IR). When further adjusted for HOMA-IR, Metrnl was no longer associated with an increased OR for T2DM (OR=1.491; P=0.066), while the HOMA-IR significantly increased the risk of T2DM (OR=1.935; P=0.008). CONCLUSIONS Serum levels of Metrnl were significantly increased in patients with T2DM and may increase the risk of T2DM independent of insulin resistance.