Abdominal obesity and hypertriglyceridemia confer high risk for cardiometabolic disease. Few studies have investigated the associations of hypertriglyceridemic waist with cytokines and hyperglycaemia in Chinese. Anthropometric indexes, fasting plasma concentrations of glucose, glycohemoglobin, insulin, lipid profile, inflammatory factors and adipokines were measured among 3289 Chinese men and women 50-70 years of age. An increment of every 2 cm of waist circumference was associated with increased levels of high-sensitive C-reactive protein (hsCRP), interleukin 6 and RBP 4 by 0·033 mg/L, 0·018 ng/L and 0·556 mg/L and reduced levels of adiponectin by 0·269 mg/L (all P<0·05), respectively, with controlling for potential confounders. For triglycerides, each an increment of 20 mg/dL was associated with increased levels of hsCRP, RBP4, and decreased levels of adiponectin by 0·021 mg/L, 0·655 mg/L, and 0·371 mg/L (all P<0·05), respectively. Individuals with hypertriglyceridemic waist had increased risks of having hyperglycaemia (OR: 1·48; 95% CI: 1·09, 2·00) and diabetes mellitus (OR: 2·12; 95% CI: 1·47, 3·04) compared with those with neither of the phenotypes. Hypertriglyceridemic waist is associated with a worse profile of inflammatory factors and adipokines as well as with an increased risk of having hyperglycaemia among Chinese. © 2012 The Authors. European Journal of Clinical Investigation © 2012 Stichting European Society for Clinical Investigation Journal Foundation.