Objective: Serum C-reactive protein (CRP) and adiponectin levels predict atherosclerosis and coronary heart disease. However, the efficacy of the combination of both markers remains unknown. In the present study, we investigated whether the combination of CRP and adiponectin is associated with further metabolic abnormalities compared to each of them alone. Research design and methods: Eighty-three Japanese type 2 diabetic outpatients participated in this study. We measured serum high-sensitive CRP and high molecular weight (HMW)-adiponectin, and investigated their relationship with various metabolic parameters. Results: In univariate analysis, CRP was significantly correlated with diastolic blood pressure and HDL-cholesterol. On the other hand, HMW-adiponectin was significantly correlated with systolic (SBP) and diastolic blood pressure, plasma glucose, HDL-cholesterol, triglycerides and HOMA-IR, but not with CRP. We then classified the subjects into three groups: low CRP and high HMW-adiponectin levels (low risk group, 19%), high CRP and low HMW-adiponectin levels (high risk group, 22%), and others. In Spearman rank correlation coefficient analysis, this classification was significantly associated with a larger number of metabolic risk factors: SBP, glucose, HbA1c, LDL-cholesterol, HDL-cholesterol, triglycerides and HOMA-IR, compared with classification by CRP or HMW-adiponectin alone. Conclusion: These results suggest that combination of CRP and HMW-adiponectin reflects further metabolic abnormalities compared with each of them in type 2 diabetic subjects. The combined measurement of both markers may be useful to detect cardiovascular high risk patients.