Obesity, impaired glucose tolerance, type 2 diabetes, hyperlipidemia, hypertension, and insulin resistance are wellknown components of metabolic syndrome and are associated to increased cardiovascular morbidity. The present study aimed to evaluate the relationships between cardiorespiratory fitness, body fat distribution, and selected coronary heart disease risk factors. A total of 22 untrained subjects affected by one or more features of metabolic syndrome and without clinical history of cardiovascular disease were studied. Nondiabetic subjects underwent an oral glucose tolerance test for glucose and insulin measurement; fasting glucose and insulin were measured in diabetic patients. Complete lipid profile, thyroid hormones, and thyroid-stimulating hormone were measured in all subjects. Basal energy expenditure and cardiorespiratory fitness were measured using a K4 analyzer. Cardiorespiratory fitness ( VO(2max)/kg) was assessed using a treadmill graded exercise test. Peak aerobic capacity ( VO(2max)/kg) was predicted by body fat distribution, insulin sensitivity index, and high-density lipoprotein (HDL) and low-density lipoprotein (LDL) cholesterol ( p<0.001). A significant relationship was found between cardiorespiratory fitness ( VO(2max)/kg) and body mass index (BMI), insulin sensitivity index, and LDL cholesterol ( r=0.60, p<0.05; r=0.66, p<0.01 and r=0.54, p<0.05, respectively). Data demonstrated that aerobic fitness is related to metabolic parameters and to body fat distribution, and suggest that its modification may improve well-known predictors of coronary artery disease.