Contrasting prevalence of and demographic disparities in the World Health Organization and National Cholesterol Education Program Adult Treatment Panel III definitions of metabolic syndrome among adolescents

J Pediatr. 2004 Oct;145(4):445-51. doi: 10.1016/j.jpeds.2004.04.059.


Objective: To determine prevalence of metabolic syndrome (MS) among adolescents by using definitions from the National Cholesterol Education Program Adult Treatment Panel III (NCEP) and World Health Organization (WHO) guidelines and to compare the populations identified by these definitions.

Study design: School-based, cross-sectional study of 1513 black, white, and Hispanic teens who had a fasting morning blood sample drawn and a physical examination.

Results: Overall, the prevalence of NCEP-defined MS was 4.2% and of WHO-defined MS was 8.4%. MS was found almost exclusively among obese teens, for whom prevalence of NCEP-defined MS was 19.5% and prevalence of WHO-defined MS was 38.9%. Agreement between definitions was poor (kappa statistic=0.41). No race or sex differences were present for NCEP-defined MS. However, nonwhite teens were more likely to have MS by WHO criteria (RR, 1.40; 95% CI, 1.04, 1.87), and MS was more common among girls if the WHO-based definition was used (RR, 1.26; 95% CI, 1.08, 1.88).

Conclusions: Among adolescents, obesity is a powerful risk for MS. Important demographic and clinical differences exist in the typology of MS, depending on the definition. Such discrepancies suggest that the concept of a common pathologic syndrome or etiologic mechanism underlying MS as defined by these guidelines may be flawed.

Publication types

  • Comparative Study
  • Research Support, Non-U.S. Gov't
  • Research Support, U.S. Gov't, P.H.S.

MeSH terms

  • Adolescent
  • Adult
  • African Continental Ancestry Group*
  • Child
  • Cohort Studies
  • European Continental Ancestry Group*
  • Female
  • Hispanic Americans*
  • Humans
  • Male
  • Metabolic Syndrome / diagnosis*
  • Metabolic Syndrome / ethnology*
  • Practice Guidelines as Topic
  • Prevalence
  • Risk Factors
  • World Health Organization