Background: Obesity and related metabolic diseases are associated with a state of chronic low-grade inflammation, which is characterized by abnormal cytokine production and increased synthesis of proinflammatory proteins. Recent studies have indicated that visfatin is both an adipokine and an inflammatory cytokine. Objective: In this study, we assessed the association between serum visfatin concentrations and markers of systemic inflammation [high-sensitivity C-reactive protein (hs-CRP), interleukin 6 (IL-6), and tumor necrosis factor a (TNF-alpha)] and insulin resistance in Chinese obese children. Methods: A total of 44 obese Chinese children (23 boys and 21 girls) and 50 age-and gender-matched normal-weight children (23 boys and 27 girls) were enrolled in the study. Anthropometric measurements and blood pressure were taken. Fasting levels of visfatin, hs-CRP, IL-6, TNF-a, glucose, insulin, and lipid profile were assayed, and the homeostasis model assessment for insulin resistance was calculated as a marker of insulin resistance. Results: Serum visfatin levels [obese group (OB): 7.48 +/- 0.39 vs. C: 5.31 +/- 0.28, p<0.05], hs-CRP (OB: 2.25 +/- 0.51 vs. C: 0.87 +/- 0.18, p<0.05), and IL-6 levels (OB: 2.22 +/- 0.28 vs. C: 1.31 +/- 0.19, p<0.05) in obese children were significantly higher than those in the control group, whereas serum TNF-a levels were not significantly different (OB: 2.43 +/- 0.37 vs. C: 1.89 +/- 0.19, p>0.05); there were no significant differences in visfatin, hs-CRP, IL-6, and TNF-a concentrations between girls and boys. The correlations between visfatin and anthropometric, metabolic parameters, and inflammatory [body mass index (BMI), waist circumference, triglyceride, hs-CRP, IL-6, TNF-a] revealed differences between genders; visfatin correlated with BMI (r=0.247, p=0.029) and IL-6 (r=0.427, p=0.013) in boys only. Conclusion: The association of circulating visfatin with anthropometric parameters, metabolic parameters, and inflammatory factors is dependent on gender, although no such correlation was observed between serum visfatin concentration and insulin resistance. Visfatin could be an important inflammatory cytokine representing a low-grade inflammatory state in obesity.