Objective To investigate the mechanism of calcium binding protein A6 (S100A6) mediated by terminal glycosylation product receptor (RAGE) on vascular endothelial injury in obese children,in order to provide the basis for further targeted treatment programs. Methods Totally 91 obese children admitted to Shiyan Maternal and Child Health Hospital from July 2015 to July 2018 were divided into injury group (n=43) and non-injury group (n=48) according to the presence or absence of vascular endothelial injury.Meanwhile,45 healthy children who underwent physical examination in this hospital during the same period were selected as control group.Serum levels of S100A6 and free RAGE (sRAGE) were measured on the day of admission in all three groups.The levels of vascular endothelial injury markers including vascular endothelial adhesion molecule-1 (sVCAM-1),soluble cell adhesion molecule-1 (sICAN-1) and von Willebrand factor (vWF) were measured by ELISA. Results The levels of serum S100A6 and sRAGE in the injured group were significantly higher than those in the non-injured group and the control group (P<0.05).The serum levels of sVCAM-1,vWF and sICAN-1 in the injured group were higher than those in the non-injured group and the control group (P < 0.05).Pearson linear correlation analysis showed that S100A6 and sRAGE levels were positively correlated with sVCAM-1,vWF and sICAN-1 levels(P<0.05). Conclusions Compared with normal children and obese children without vascular endothelial injury,the serum levels of S100A6 and sRAGE are significantly increased in obese children with vascular endothelial injury,which may be related to the increase of sRAGE leading to the increase of S100A6,thereby further increasing sVCAM-1,vWF and sICAN-1 levels.