Objective:To observe the association of copeptin levels with coronary atherosclerotic lesions in postmenopausal women with impaired glucose tolerance(IGT). Methods:Eighty postmenopausal women (aged 56-59 y)with the onset of IGT(fasting blood glucose,i.e. FBG<7.0 mmol/L,7.8 mmol/L≤2-hour postprandial blood glucose,i.e.2hPBG<11.0 mmol/L)were divided into group A(copeptin < 5 pmol/L)and group B(copeptin > 20 pmol/L),according to serum copeptin levels at baseline,40 cases in each group. The discrepancy of coronary CTA stenosis scores was analyzed between the two groups at baseline and after 6-month follow-up. Results:①At baseline,the difference was statistically significant in copeptin levels(P < 0.05),but not in weight,FBG,2hPBG,fasting serum triglyceride(TG),total serum cholesterol(TC),serum low-density lipoprotein cholesterol(LDL-C),mean arterial pressure,serum creatinine and age between group A and group B(P>0.05).②After 6-month therapeutic lifestyle adjustment as well as oral administration of aspirin(100 mg qd)and rosuvastain(10 mg qd),copeptin level,coronary CTA stenosis scores,FBG and 2hPBG of group B was statistically significantly higher,compared with group A,respectively(P < 0.05).Furthermore,some cases developed diabetes or coronary heart disease(CHD)in group B,while not in group A. Conclusion:On the basis of the influence of the atherosclerotic risk factors of IGT and postmenopausal female,high plasma copeptin level will further promote the occurrence and deterioration of coronary atherosclerotic lesions.