Fatty acid-binding protein 4 (FABP4/A-FABP/aP2) is expressed in both adipocytes and macrophages. Recent studies have shown secretion of FABP4 from adipocytes and association of elevated serum FABP4 level with obesity, insulin resistance, hypertension, and atherosclerosis. However, little is known about role of FABP4 in cardiac function. From database of the Tanno-Sobetsu Study, a study with prospective population-based cohort design, all data from female subjects who were on no medication and underwent echocardiography in 2011 (n = 108) were retrieved for analyses of relationships between serum FABP4 concentration, metabolic markers and parameters of echocardiography. FABP4 level was positively correlated with age, body mass index (BMI), blood pressure, triglycerides, HOMA-R, left ventricular (LV) wall thickness (LVWT; r = 0.39, p < 0.01), and E/e’ (r = 0.32, p < 0.01), an index of impaired LV relaxation, and negatively correlated with the ratio of early diastolic to atrial systolic velocity (E/A) of transmitral flow (r = -0.30, p < 0.01). FABP4 concentration was not significantly correlated with LV ejection fraction or LV diastole diameter. Multiple regression analysis adjusted by age and blood pressure revealed that FABP4 concentration was independently correlated with LVWT and E/e’. However, FABP4 level was not selected as an independent determinant of LVWT or E/e’ when BMI and/or HOMA-R were additionally incorporated into the adjustment. In conclusion, FABP4 may contribute to LV hypertrophy and diastolic dysfunction via facilitation of obesity and insulin resistance in the general population.