Objective To study the relationship between adiponectin gene +45 polymorphism and serum adiponectin(ADP), insulin resistance(IR), body fat and serum lipids in the obese children and adolescents with nonalcoholic fatty liver disease (NAFLD). Methods One hundred simple obese children and adolescents with NAFLD aged 6.5 years to18.3 years and 70 healthy children and adolescents of similar age and sex (healthy control group) were randomly enrolled in the study. Early in the morning, fasting body weights, heighs, waist circumferences and hip circumferences were measured for calculation of BMI ,WHR and WHtR, and venous blood samples were collected for test of serum insulin(FINS), glucose(FBG), total cholesterol(TC), triglycerides(TG), high density lipoprotein cholesterol(HDL-C), low density lipoprotein cholesterol (LDL-C), alanine aminotransferase(ALT) and aspartate aminotransferase (AST), which contributed to the calculation of homeostasis model assessment-Insulin resistance (IR=FINS×FBG/22.5). Ultrasonographic examinations were given to the liver and related organs. Serum ADP levels were measured by ELISA, and DNA sequencing after PCR amplification were performed with dideoxy chain termination method. Results Serun ADP level in NAFLD group was 2.79±2.19 mg/L, significantly lower than the healthy control (3.90±2.13 mg/L), it was negatively correlated with BMI, WHtR, TG, FINS and IR values, and IR was the most significant factor that affected serum ADP level. NO significant differences in genotype or allele frequency of ADP gene SNP+45 between NAFLD group and healthy controls(P>0.05). There was no difference of serum ADP, lipid, FBG, FINS and IR, BMI, WC, WHR, WHtR among different genotype of +45 site in children and adolescents with NAFLD(all P >0.05). Conclusions ADP gene SNP+45 may be not associated with occurrence of NAFLD and the metabolic parameters in Chinese simple obesity children and adolescents of Shenzhen.