(1) Metabolic syndrome, hyperglycemia, hypertriglyceridemia and D-dimer were positively correlated with arterial measurements, whereas inflammatory and coagulatory markers often exhibited paradoxical association; (2) stratification confirmed that at certain levels of systemic inflammation or body mass index, acute phase proteins and other markers became unreliable or shifted signals; (3) when controlled for blood pressure, PWV was only moderately elevated, and IMT remained normal; (4) taken together, these findings are consistent with a unique interaction between adiposity, inflammation, and cardiovascular risk in seriously obese subjects.