Objectives: We investigated serum albumin levels and their association with insulin resistance (IR), metabolic syndrome (MS), coronary heart disease (CHD), and traditional risk factors among Turkish adults. Study design: Serum albumin levels were measured colorimetrically in 1052 subjects representing the population of Western Turkey (Marmara and Central Anatolian regions), and were studied cross-sectionally. Metabolic syndrome was identified by modified criteria of the Adult Treatment Panel III. Results: The median age was 53 years. Metabolic syndrome was identified in 44.7% of males and in 49.4% of females. The mean serum albumin level was 4.39±0.38 mg/dl in males and 4.34±0.33 mg/dl in females (p=0.01). In univariate analyses, serum albumin concentrations showed positive correlations with apolipoprotein B, HDL-cholesterol, and total bilirubin in both genders, a positive correlation with systolic blood pressure in females, and an inverse correlation with log CRP in males. In a linear regression analysis with 11 variables for serum albumin levels, age showed an inverse, and total cholesterol showed a positive independent effect in both genders. While smoking significantly affected serum albumin levels in females, this relationship was only of near significance in males. Other independent variables were serum creatinine in females (positive), and diastolic blood pressure (positive) and log HOMA (inverse) in males. In age- and sex-adjusted analyses, serum albumin showed no correlations with MS and CHD. Conclusion: Independent of renal dysfunction, insulin resistance may contribute to low serum albumin levels in Turkish men and, in this context, may be playing a mediating role for oxidative stress and subclinical chronic inflammation.