Obesity, an escalating problem worldwide, increases the risk of serious disease, particularly atherosclerosis. A community-based cross-sectional study was designed to screen for undetected atherosclerosis. High-sensitivity C-reactive protein (hs-CRP), the presence of the metabolic syndrome (MetS), and ultrasound studies to detect fatty liver and measure carotid intimal-medial thickness were performed. A total of 1,005 subjects (595 men and 410 women; mean age of 52.4 ± 11.1 years) were included in the final study cohort. 237 subjects (23.7%) fulfilled National Cholesterol Education Program Adult Treatment Panel ATP-III criteria for MetS. Significant differences between female and male subjects were noted in body mass index (BMI), % body fat mass (Fat%), waist-to-hip ratio, waist circumference, fasting glucose levels, triglyceride levels, fatty liver, and carotid artery changes (P < 0.05). When female subjects were classified by hs-CRP levels, significant differences were reported among the three groups in age, BMI, Fat%, waist-to-hip ratio, waist circumference, blood pressure, fasting glucose, HDL, triglycerides, fatty liver grade and common carotid artery changes (P < 0.05). In this study, high hs-CRP was associated with increased cholesterol and cardiovascular changes supporting the idea that it may be a useful biomarker for detecting early asymptomatic vascular and coronary heart disease resulting from obesity.