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BACKGROUND and AIM:The prevalence of metabolic syndrome (MS) increased in recent years in both adolescents and children groups.The aim of the study is evaluating the relationship between insulin and uric acid (UA) level in MS in adolescents.MATERIALS and METHODS:we studied 120 adolescence aged 10 to 19 in two groups:control group without metabolic syndrome and case group with metabolic syndrome.The Criteria of ATP Ⅲ was considered as a diagnosis factor for metabolic syndrome.DISCUSSION:Various studies have been conducted in various populations to evaluate the relationship between UA level and MS in adolescents.Abdominal obesity,low HDL,hypertriglyceridemia and hypertension are associated with high UA level.In their analysis,the MS OR in UA level ≤ 4.9,4.9-5.8 and ≥ 5.8 mg/dl was 1,2.53 and 9.03,respectively,which were higher than our findings in current study.Hyperinsulinemia caused by insulin resistance is one of the complications associated with MS,which puts individuals at risk of diabetes and cardiovascular events.RESULTS:Uric acid level in the Case group was significantly higher than the control group (p =0.0001,43.8± 1.4 vs.4.1 ± 1 mg/dl,respectively).Insulin level was significantly higher in the case group in compare to the control group (p =0.008,9.8±5.3 vs.12.2±6 μU/ml,respectively).CONCLUSION:The findings of this case-control study showed that adolescents with metabolic syndrome have a higher uric acid and insulin level in compare to normal subjects.We hypothesis that increase in serum insulin and uric acid level can be a risk factor in the development of metabolic syndrome.