BACKGROUND: C-reactive protein and adipokines are associated with obesity and insulin resistance. The relations between C-reactive protein, adipokines and metabolic risk factors have been extensively studied in adults, but there are no comparable data in pre-pubertal children. We investigated the associations between C-reactive protein, several adipokines and metabolic risk factors in pre-pubertal Korean children. METHODS: A total of 324 pre-pubertal children (149 boys and 175 girls) aged 8~9 years were evaluated for height, weight, blood pressure and body mass index (BMI). The serum hs-CRP, adiponectin, TNF-alpha, vaspin, RBP4, fasting glucose, insulin, lipid profile were also measured. Overweight was defined as being at or above the 85th percentile of the gender-specific BMI for age in the 2007 Korean National Growth Chart. RESULTS: In boys, serum hs-CRP levels were correlated with BMI (r = 0.339, P < 0.001), waist circumference (r=0.356, P<0.001), systolic blood pressure (r = 0.183, P < 0.05), diastolic blood pressure (r = 0.168, P < 0.05), ALT (r = 0.311, P < 0.001), insulin (r = 0.226, P < 0.05) and HOMA-IR (r = 0.199, P < 0.05). In girls, serum hs-CRP levels were correlated with BMI (r = 0.332, P < 0.001), waist circumference (r = 0.311, P < 0.001), Triglycerides (r = 0.177, P < 0.05), HDL-C (r = -0.232, P < 0.001), ALT (r = 0.152, P < 0.05), insulin (r = 0.238, P < 0.01), HOMA-IR (r = 0.233, P < 0.01). Serum adiponectin levels were negatively correlated with ALT and AST in boys and total cholesterol levels in girls, respectively. There was no correlation between serum TNF-alpha, vaspin, RBP4 levels and metabolic risk factors in boys. In girls, serum fasting glucose levels was negatively correlated with serum TNF-alpha levels, and positively correlated with serum vaspin levels. In multiple linear regression analysis, body mass index was best predictor of hs-CRP in boys and girls. CONCLUSION: Serum hs-CRP was significantly associated with BMI, waist circumference and other metabolic risk factors in pre-pubertal children. Among these metabolic risk factors, BMI was the best predictor of hs-CRP concentration in both boys and girls. A larger study might be helpful to characterize the relationship between metabolic risk factors and inflammatory markers in this age group.