Background and Objectives: Although Insulin resistance is considered as a common origin of metabolic syndrome, recent body of evidence suggested that metabolic syndrome has multiple physiologic origins, which might be related atherosclerosis. We invested a clustering pattern of metabolic risk factors and its association of subclinical atherosclerosis in a community based cohort in Korea. Subjects and methods: We included 1,375 healthy individual measuring carotid intima-media thickness (CIMT). Exploratory factor analysis included 10 metabolic variables; body mass index (BMI), waist circumference (WC), systolic and diastolic blood pressures (SBP and DBP), fasting blood glucose (FBG), serum triglycerides (TG), high-density lipoprotein cholesterol (HDL-C), homeostasis assessment-insulin resistance (HOMA-IR), high sestivivity C–reactive protein (hsCRP) and adiponectin. Results: Four factors were categorized as obesity-inflammatory factor (BMI, WC and hsCRP), blood pressure factor (SBP and DBP), lipid metabolic factor (HDL-C, TG, and adiponectin), and insulin resistance factor (FBG, and HOMA-IR). In a multivariate regression model(after adjustment for age, gender, low density lipoprotein cholesterol cholesterol, and smoking history), obesity-inflammatory factor (B=19.2, p <.001), blood pressure factor (B=11.1, p <.026), lipid metabolic factor (B= -10.0, p <.048), and insulin resistance factor (B=14.7, p <.003) were significantly associated with CIMT. Conclusion: Metabolic risk factors have 4 distinct clustering patterns, which are independently associated with subclinical atherosclerosis.