Background. Metabolic syndrome (MS) is a pathological condition characterized by abdominal obesity, insulin resistance, arterial hypertension (HTN) and dyslipidemia. MS contributes to type 2 diabetes mellitus, coronary heart disease, stroke and other cardiovascular events. Currently, much attention is paid to the study of the underlying factors, including hormones involved in fat metabolism. The changes in the level of hormones affecting the metabolism of adipose tissue in MS, as well as the relationship of these changes with various MS components, should be studied for the development of effective treatment approaches. Objective. To study the relationship of various MS components with the level of hormones affecting the metabolism of adipose tissue in patients with MS. Design and methods. The study included 88 obese patients (26 males; 62 females), average age 42,0 ± 11,2 years, average body weight 109,7 ± 25,1 kg, body mass index (BMI) 37,9 ± 6,2 kg/m2. Dyslipidemia was detected in 60 patients, carbohydrate metabolism disturbance (impaired glucose tolerance) was recorded in 12 patients, and HTN - in 22 patients. All patients underwent an assessment of the level of hormones involved in the regulation of fat metabolism (glucagon-like peptide 1 (GLP.1), glucose-dependent insulinotropic peptide (GIP), ghrelin, leptin, adiponectin), lipid profiles (cholesterol, high-density lipoprotein, low density lipoprotein, triglyceride), fasting venous plasma glucose, insulin. The HOMA-IR index was calculated. Results. Levels of leptin and GLP-1 were increased in MS compared with healthy people, and levels of ghrelin, adiponectin, and GIP were reduced. Women showed a more significant increase in leptin and a less pronounced decrease in ghrelin than in men. BMI positively correlated with the level of insulin, leptin, the HOMA-IR index and negatively with the level of ghrelin. Waist circumference correlated positively with insulin levels and the HOMA-IR index and negatively with ghrelin and adiponectin levels. Ghrelin was associated with glucose level and diastolic blood pressure correlated with the GIP level. Conclusions. Our study confirms the previously established relationships between BMI and waist circumference with the severity of insulin resistance (increased insulin levels and the HOMA-IR index), leptin resistance (increased leptin levels) and the development of adiponectin deficiency. The dynamics of adiponectin and ghrelin were more closely related to the visceral type of obesity. The established relationships between the levels of GIP and ghrelin and relationship of GIP with diastolic blood pressure require further investigation. © 2019 All-Russian Public Organization Antihypertensive League. All rights reserved.