The aim was to clarify the associations of five adipocytokines: Sfrp5, Wnt5a, adiponectin, chemerin and high-sensitivity C-reactive protein (hsCRP) with blood pressure (BP), and to examine whether BP can be influenced by changes in these adipocytokines in obese children after a 6-month lifestyle intervention. We conducted a cross-sectional study in 263 obese children and performed a 6-month lifestyle intervention in a subgroup of 89 obese children with hypertension. Anthropometric data, adiponectin, chemerin, Sfrp5 and Wnt5a were assessed at baseline and after 6-month lifestyle intervention. Sfrp5 and adiponectin serum levels were significantly lower in obese children with hypertension, but Wnt5a, hsCRP and chemerin serum levels were elevated in obese children with hypertension. In multivariable linear regression analysis, Sfrp5, Wnt5a, adiponectin, chemerin and hsCRP were associated with both standard deviation score-systolic blood pressure (SDS-SBP) and -diastolic blood pressure (SDS-DBP). Lifestyle intervention resulted in a significant improvement in BP and weight loss. These were accompanied by significant decreases in hsCRP and chemerin, and significant increases in Sfrp5 and adiponectin, whereas Wnt5a was not changed. Furthermore, the changes in Sfrp5 and adiponectin act as partial mediators of the relationship between weight loss and BP reduction after controlling for covariates. Although Sfrp5, Wnt5a, adiponectin, chemerin and hsCRP levels are correlated with BP at baseline, after lifestyle intervention, the relationship between weight loss and BP reduction were partially mediated by changes in Sfrp5 and adiponectin after controlling for covariates. So we speculate that Sfrp5 and adiponectin may have some influence on BP.