Variations in the prevalence of metabolic syndrome in adolescents according to different criteria used for diagnosis: which definition should be chosen for this age group?

BACKGROUND: Despite the increasing prevalence of metabolic syndrome in adolescents, there is no consensus for its diagnosis.
METHODS: A cross-sectional study was conducted to compare the prevalence of metabolic syndrome in adolescents by different definitions, evaluate their concordance, and suggest which definition to apply in this population. A total of 851 adolescents between 10 and 18 years of age were evaluated. Anthropometric (weight, height, waist circumference), biochemical (glucose, lipid profile), and blood pressure data were taken. The prevalence of metabolic syndrome was determined by the definitions of the International Diabetes Federation (IDF) and four published studies by Cook et al., de Ferranti et al., Agudelo et al., and Ford et al. Concordance was determined according to the kappa index.
RESULTS: The prevalence of metabolic syndrome was 0.9%, 3.8%, 4.1%, 10.5%, and 11.4%, according to the IDF, Cook et al., Ford et al., Agudelo et al., and de Ferranti et al. definitions, respectively. The most prevalent components were hypertriglyceridemia and low high-density lipoprotein cholesterol, whereas the least prevalent components were abdominal obesity and hyperglycemia. The highest concordance was found between the definitions by Cook et al. and Ford et al. (kappa=0.92), whereas the greatest discordance was between the de Ferranti et al. and IDF definitions (kappa=0.14).
CONCLUSIONS: Metabolic syndrome and its components were conditions present in the adolescents of this study. In this population, with a high prevalence of dyslipidemia and a lower prevalence of abdominal obesity and hyperglycemia, the recommendation to diagnose metabolic syndrome would be that used by Ford et al.