Background: Menopause is associated with osteoporosis and an increased risk of metabolic disorders, including obesity, abdominal adiposity, hyperlipidemia, hypertension, and insulin resistance, which may increase the risk of cardiovascular disease (CVD). Recent studies have demonstrated a correlation between fat, glucose, and bone metabolism which could contribute to CVD and osteoporosis. This study examined the association between metabolic risk factors and bone mineral density (BMD) in postmenopausal women. Materials and Methods: The authors determined the anthropometric values [waist-hip ratio (WHR), visceral fat area (VFA), body fat mass (BFM), and skeletal muscle mass (SMM)], lipid profile, fasting plasma glucose levels, high-sensitivity C-reactive protein levels, homeostasis model assessment of insulin resistance (HOMA-IR) scores, serum leptin and adiponectin levels, serum osteocalcin level [total osteocalcin (tOC) and undercarboxylated osteocalcin (ucOC)], and BMDs of the lumbar spine and femoral neck in 137 postmenopausal women. Results: There was a positive correlation between BFM, HOMA-IR score, serum leptin level, and BMD of the lumbar spine, and a negative correlation between BFM, total cholesterol, serum adiponectin, and BMD of the lumbar spine after adjusting for age, years since menopause, current alcohol consumption, and current smoking status. In a multiple regression analysis, serum adiponectin level and SMM were the most important predictors of the BMD of the lumbar spine. Conclusion: There were several metabolic risk variables that had a harmful effect on the BMD of the lumbar spine, but not the femoral neck. However, higher serum adiponectin levels were negatively correlated with BMD of the lumbar spine as adiposity decreased.