The aim of the study was to look at the association of angiopoietin-2 (Ang-2) in Asian Indian subjects with different grades of glucose intolerance and in those with hypertension and metabolic syndrome (MS). Three groups were recruited from the Chennai Urban Rural Epidemiology Study, a population-based study in southern India, as follows: group 1, normal glucose tolerance(n = 45); group 2, impaired glucose tolerance (IGT) (n = 45); and group 3, type 2 diabetes mellitus (T2DM) (n = 40). Angiopoietin-2 was estimated by enzyme-linked immunosorbent assay. Hypertension was diagnosed based on medical history, drug treatment of hypertension, and/or if the subjects had systolic blood pressure at least 130 mm Hg and/or diastolic blood pressure at least 85 mm Hg. Metabolic syndrome was defined using modified National Cholesterol Education Program-Adult Treatment Panel III guidelines. Subjects with T2DM had higher age-adjusted Ang-2 values (3741 ± 1429 pg/mL) compared with subjects with IGT (1907 ± 855 pg/mL) and normal glucose tolerance (1462 ± 856 pg/mL) (P for trend < .001). Regression analysis showed that there was a linear increase in mean Ang-2 values with increasing severity of glucose intolerance, even after adjusting for age, sex, and body mass index. Angiopoietin-2 levels were also elevated in subjects with hypertension (P = .004) and in subjects with MS even in the absence of fasting hyperglycemia (P = .011). There was also a linear increase in the mean values of Ang-2 with increase in number of components of MS (P for trend < .001). This study demonstrates that increased levels of Ang-2 are seen in Asian Indian subjects with IGT, T2DM, and hypertension and in subjects with MS even in the absence of fasting hyperglycemia. © 2010 Elsevier Inc. All rights reserved.