Objective To analyze the correlation of glucose and lipid, calcium and phosphorus metabolism disorders in young and middle-aged peritoneal dialysis patients. Methods A retrospective analysis was performed on 172 peritoneal dialysis patients who were treated and followed up in the peritoneal dialysis unit of our hospital from January 2014 to August 2020. The patients were divided into young-aged group and middle-aged group. The number of the youth group is 82, and the number of the middle-aged group is 90. Glycosylated hemoglobin A1C (HbA1c), fasting plasma glucose, 2 hours postprandial blood glucose, blood calcium and phosphorus, intact parathyroid hormone (iPTH), blood lipid and residual renal function were analyzed. Pearson and multiple stepwise regressions were used to analyze the correlation between HbA1c and metabolic related indexes. They were divided into non-diabetic group (n=134) and diabetic group (n=38) according to whether they had diabetes. The indexes of HbA1c, blood calcium, blood phosphorus and other indicators were compared between the two groups. Results The levels of HbA1c, fasting blood glucose, 2 hours postprandial blood glucose and IFG in the middle-aged group were higher than that of young-aged group (P＜0.05). The value of iPTH, blood calcium and phosphorus was lower in middle-aged group compared with young-aged group (P＜0.05). There was no difference in FGF23 and blood lipid index between the two groups (P＞0.05)，but they were all higher than the normal reference level. Pearson correlation analysis showed that HbA1c was negatively correlated with logiPTH and logFGF23 (P＜0.05), and positively correlated with triglycerides (P＜0.05). Spearman correlation analysis showed that log iPTH was positively correlated with dialysis age, logFGF23, serum calcium and phosphorus (P＜0.05), and negatively correlated with HbA1c and RRF (P＜0.05). Spearman correlation analysis showed that log FGF23 was positively correlated with dialysis age, log iPTH, serum calcium and phosphorus (P＜0.05), and HbA1c and RRF (P＜0.05). Stepwise regression analysis showed that HbA1c was negatively correlated with log iPTH, positively correlated with triglyceride (P＜0.01), but not with logFGF23 (P=0.902). HbA1c, triglyceride, cholesterol and FGF23 in diabetic group were higher than those in non-diabetic group (P＜0.05), and serum calcium, phosphorus and iPTH were lower than those in non-diabetic group (P＜0.05). Conclusion Young and middle-aged PD patients are prone to glucose and lipid metabolism and calcium and phosphorus metabolism disorders, and middle aged patients are more serious and prone to low iPTH. The level of blood glucose control in PD patients is correlated with iPTH secretion, which will affect FGF23 level. And diabetic patients, prone to lipid metabolism disorders. Long term hyperglycemia can lead to low iPTH and increase the risk of low transport osteopathy. Good blood glucose level is beneficial to the regulation of phosphorus metabolism disorder. The diagnosis and treatment of glucose metabolism and iPTH should be integrated in young and middle-aged PD patients.