Relevance. The main component of the metabolic syndrome (MS) is the abdominal obesity (AO) which inevitably leads to insulin resistance (IR). Adiponectin (AN) secreted by the adipocytes protects from the IR development, increases the sensitivity of skeletal muscles to insulin, reduces intake of free fatty acids in a liver and, thus reduces the synthesis of atherogenic lipoproteins. Some investigations prove that the level of the adiponectin in blood plasma correlates back with the mass of the fatty tissue, the waist-hip ratio and IR expressiveness. With obesity, AN secretion decreases, losing its protective role as for the risk of IR development and metabolic violations. It is known that ADIPOQ gene has several polymorphic sites, which influence the production and activity of AN. Allelic options of its polymorphic marker G276T are associated with the development of the AO, IR, and diabetes. The aim of the study was to investigate the association of the genetic polymorphism of the G276T marker of the adiponectin gene with changes in metabolic parameters in patients with arterial hypertension (AH) and concomitant obesity. We examined 300 patients with AH 45 to 55 years old who gave informed written consent to participate in the study and met the inclusion criteria. Group 1 consisted of 200 patients with AH and class I–II obesity, group 2 – 50 patients with AH and normal body weight, group 3 – 50 patients with AH and overweight. The control group consisted of 30 practically healthy individuals, in whom AH and obesity were excluded on the basis of clinical and instrumental examination data. As a result of the study the association of T-allele of the polymorphic marker G276T of the adiponectin gene with the development of comorbidity of AH and obesity was established. It has been proven that adiponectin gene polymorphism influenced changes in metabolic parameters in hypertensive patients with obesity: more pronounced impairment of metabolic parameters in G/T and T/T genotypes as compared to G/G genotype. G/T and T/T genotypes of the polymorphic marker G276T of the adiponectin gene were associated with a significantly higher body mass index, higher triglyceride levels, more pronounced insulin resistance and adipokine imbalance.