Were investigated the relationship between gender, cardiovascular risk factors and inflammation in metabolic syndrome (MetS) patients. 100 consecutive patients (75 women), 73 with MetS, mean age 57.52�9.77 years, were examined. Adhesion molecules (sICAM1, sVCAM1) were measured in the stored serum samples collected using the ELISA method. The classification of MetS was based on IDF guidelines. The study was carried out at the Department of Cardiology, Clinical Rehabilitation Hospital, Cluj-Napoca, Romania. MetS patients presented lower sICAM1 values (225.01�86.75 ng/mL vs 234.22�82.23 ng/mL, p=NS), but higher sVCAM1 values (605.34�298.69 ng/mL vs 552.29�233.77 ng/mL, p=NS). Differences between patients with vs without metabolic syndrome were found only in men for sICAM1 (194.73�37.92 ng/mL vs 282�27.15 ng/mL, p[0.001). Considering the HOMA index, a significant difference for sICAM1 was found in men (patients within the upper quartile vs the lower quartile, p=0.002), but also between women and men within the upper quartile of HOMA (for sICAM1 p=0.038). No significant differences were found for sVCAM1. In the case of males, sICAM1 was an independent predictor of metabolic syndrome, with a very good capacity to identify metabolic syndrome (AUROC=0.987, p=0.0001, Se=89.47%, Sp=100%). In conclusion, just in men, sICAM1 seems to have an excellent capacity to differentiate between MetS+ and MetS- patients, to predict MetS development.