Objective: To observe the adiponectin mRNA expression in subcutaneous and omental adipose tissue of type 2 diabetic patients and their relation with serum adiponectin, body mass index(BMI), waist circumference(WC),waist hip ratio(WHR), blood pressure, fasting plasma glucose(FPG), HbA1c, blood lipids and uric acid(UA). Methods:Twenty-three T2DM patients with obesity, 23 T2DM patients, 33 obesity patients and 23 controls were selected. The adiponectin mRNA expression level in adipose tissue was assayed by RT-PCR. The level of serum adiponectin was measured with ELISA kit. FBG, triglyceride(TG), total cholesterol(TC), high-density lipoprotein cholesterol(HDL-C), low-density lipoprotein cholesterol(LDL-C), HbA1c, UA of all subjects were determined and their blood pressure, height, weight, waist circumference, hip circumference were measured to calculate BMI,WHR. Results:①The SBP, DBP, FPG, HbA1c, TG, LDL-C, UA were significantly higher, and serum adiponectin, HDL-C and adiponectin mRNA expression level in both subcutaneous and omental adipose tissue were significantly lower in diabetic obesity group than in obesity group(P < 0.05), the adiponectin mRNA expression level in omental were significantly lower than in subcutaneous adipose tissue in both groups(P < 0.01). ②The FPG, HbA1c, TG, UA were higher, serum adiponectin, HDL-C and adiponectin mRNA levels expressed in both subcutaneous and omental adipose tissue were lower in diabetic group without obesity than in control group without obesity(P < 0.05), the adiponectin mRNA expression level in omental was lower than in subcutaneous adipose tissue in both groups(P < 0.01). ③The BMI,WHR,SBP,DBP,FPG,HbA1C,TG,UA were higher, serum adiponectin and adiponectin mRNA level expressed in both subcutaneous and omental adipose tissue were lower in diabetic obese group than in diabetic group without obesity(P < 0.05). ④The adiponectin mRNA expression level in omental adipose tissue of diabetic obesity group was negatively correlated to BMI,WHR,FPG(P < 0.05), and was positively correlated to serum adiponectin(P < 0.01). Conclusion:T2DM patients with obesity show down-regulated expression of adiponectin mRNA in omental adipose tissue and lower serum adiponectin than control obese group,BMI,WC,WHR,FPG are correlated with adiponectin mRNA expression and insulin resistance.