Introduction. The worldwide alarming rise in the incidence of metabolic syndrome (MS) in children has made the prevention and early treatment of obesity an important medical goal. The objective of the study was to assess the role of proinflammatory markers, such as tumour necrosis factor-Alpha (TNF-) and high-sensitivity C-reactive protein (hs-CRP), and adipokines (leptin, adiponectin) in the development of MS in children and the impact of treatment with gastrointestinal lipase inhibitors on the degree of obesity and blood pressure values. Material and methods. The study included 24 children with metabolic syndrome. The serum values of lepine, adiponectin, TNF- and hs-CRP were determined in children with MS compared to a control group of 50 children of similar age. Results. The serum level of leptin, hs-CRP, and TNF- was higher in children with MS as compared with the control group. The adiponectin level was lower in children with MS, compared to the control group. After eight weeks of drug treatment with gastrointestinal lipase inhibitors in all children, a decrease in body mass index, abdominal circumference and blood pressure values was found, but the most important decreases were found in children who received non-pharmacological treatment in combination with gastrointestinal lipase inhibitors and angiotensin-converting enzyme inhibitors. Conclusions. Hypoadiponectinemia, hyperleptinemia, increased serum hs-CRP and TNF- suggest that these adipokines/cytokines contribute to subclinical inflammation in children with MS and may also serve as biomarkers of MS. In combination with a low-calorie diet, regular exercise and lifestyle changes, treatment with gastrointestinal lipase inhibitors may help to reduce the prevalence of obesity and hypertension in children.