Objective <p>The aim of this study is to evaluate sRAGE levels in adolescents with obesity, and to determine the relationship between sRAGE, insulin resistance, and metabolic syndrome in a case-control study.</p> Methods <p>Thirty adolescents with insulin resistance, 28 adolescents without insulin resistance between 10 and 18 years old and 30 Healthy gender and age matched control group were included in the study. Patients with a body mass index z-score above 2, comprised the obesity group. HOMA-IR value above 3.16 was accepted as insulin resistance. Metabolic syndrome was defined based on the International Diabetes Federation definition.</p> Results <p>sRAGE levels of the both groups with obesity were lower than control and they were negative correlated with weight, body mass index, C-reactive protein, uric acid, diastolic blood pressure, waist circumference, waist circumference/height ratio and white blood cell count. There were no significant differences in sRAGE levels between adolescents with or without metabolic syndrome, nor between boys and girls. Also, there were no significant differences in sRAGE levels between with or without insulin resistance.</p> Conclusions <p>sRAGE levels of the adolescents with obesity decreased. There was no difference in sRAGE levels between those with insulin resistance and metabolic syndrome compared to those without. Metabolic complications associated with obesity are important in terms of causing mortality and morbidity. Understanding the mechanisms could help to identify therapeutic strategies.</p> Trial registration <p>NCT06771986| |<a href="https://www.clinicaltrials.gov/">https://www.clinicaltrials.gov/</a>. Clinical Trial Registration Date: 2025/01/13</p>