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Background: Differences in sex hormone levels contribute to sex differences in cardiovascular disease (CVD). Adipokines, which are central to cardiometabolic disease, differ by sex and have divergent associations with CVD. However the link between sex hormones and adipokines is not well established. We hypothesized that an androgenic sex hormone profile is associated with higher leptin & resistin and lower adiponectin levels among postmenopausal women and men. Methods: We performed an analysis of 1822 adults in MESA who had sex hormones and adipokines measured. Sex hormones [Testosterone (T), estradiol (E2), sex hormone binding globulin (SHBG)] were measured at exam 1; free T was estimated. Serum adipokines [leptin, resistin, adiponectin] were measured at visits 2 or 3, an average of 2.6 yrs later. We used multivariable linear regression to examine the cross-sectional associations between sex hormones and adipokines. Results: The mean age was 63 (10), 48% were women; 41% White, 13% Chinese American, 20% Black, 26% Hispanic. Leptin: After adjusting for demographics (model 1), higher free T & E2 and lower SHBG were associated with greater leptin levels in women and men; higher DHEA was associated with lower leptin in men ( Table ). With full covariate adjustment (model 3), this remained statistically significant for E2 & SHBG in women and for DHEA in men. Adiponectin: With demographic adjustment, higher free T, E2, DHEA & lower SHBG were associated with lower adiponectin in women, and higher free T & lower SHBG with lower adiponectin in men. After full covariate adjustment, these same relationships were slightly attenuated but remained significant for women and men. Resistin: no association in either sex. Conclusion: A more androgenic profile (higher free T & lower SHBG) was independently associated with lower adiponectin in men and women. Higher E2 & lower SHBG in women, and lower DHEA in men, were associated with leptin. These findings may provide mechanistic insight into the interplay between sex hormones, adipokines and CVD risk.