Asthma and obesity are prevalent disorders, each with a significant impact on the public health. The causality relating obesity and asthma has not been established. The objective of this article is to investigate whether asthma could exacerbate the endothelial activation and to determine the relationship between systemic inflammation and endothelial activation in obese asthmatic children. Eighty-nine children (10-16 years old) were divided according to their diagnosis (asthma, obese nonasthmatic, and obese asthmatic children). Twenty healthy children formed the control group. Three adhesion molecules (E-selectin, sICAM-1, and sVCAM-1) and C-reactive protein (CRP) were measured in serum samples. The levels of sICAM-1 were significantly higher in obese nonasthmatic and obese asthmatic children versus control and lean asthmatic children (414.7+/-154.7, 434.9+/-181.1, 238.6+/-117.8, and 351.2+/-153.5 ng/mL, respectively). No difference was observed between obese nonasthmatic and obese asthmatic groups. No difference of the levels of CRP, E-selectin, and sVCAM-1 was found among the study groups. Correlation analysis showed that E-selectin associated significantly with body mass index (BMI), CRP and the other two adhesion molecules. CRP depended on BMI. sICAM-1 associated with CRP, BMI, and triglycerides. Correlations were verified in multiple regression analysis models in the whole study groups: CRP levels depended on sICAM-1, E-selectin, and sICAM-1 concentrations depended on BMI. Correlations were verified in asthmatic subjects: CRP depended on sICAM-1. These results confirmed the endothelial activation in obese children. Mild nonallergic asthma in our study did not exacerbate the endothelial activation in obese or lean asthmatic children. Significant association between systemic inflammation and endothelial activation was observed in asthmatic children.