OBJECTIVE: To investigate whether the obesity observed among the Inuit of Greenland and in a general Danish population was associated with the same degree of metabolic disturbances. DESIGN: Comparison of data from two population-based cross-sectional surveys conducted in 1999-2001. SUBJECTS: A total of 7892 individuals aged 30-60 y, 1108 Inuit participants from the Greenland Population study, and 6784 Danish participants in the Danish Inter99 study. MEASUREMENTS: Height, weight, waist and hip circumference were measured, and BMI and waist-to-hip ratio were calculated. The participants received a standard 75 g OGTT. s-Triglyceride, s-HDL cholesterol, fasting and 2 h p-glucose and s-insulin were analysed. Blood pressure was measured. Information on lifestyle factors was obtained by a questionnaire and interview. RESULTS: The Inuit had lower levels of 2-h glucose and insulin, blood pressure, triglyceride, and higher levels of HDL cholesterol than the Danish participants at any given level of obesity. Fasting glucose and fasting insulin levels within obesity categories were not different in the two populations. Adjustment for physical activity, smoking, school education, and alcohol consumption did not change these findings. CONCLUSION: The trends in the association between obesity and metabolic effects among the Inuit and a Northern European population were the same, but the levels of the risk factors were significantly different. This may be due to genetic factors and differences in body composition.