Table 1.
Diagnosis of metabolic syndrome in children and adolescents.
| AHA Criteria [21] | IDF Criteria | WHO Criteria | NCEP ATP III Criteria | ||||
|---|---|---|---|---|---|---|---|
| Necessary components for the MS diagnosis | 3 of the 5 must be present | Central obesity and 2 of 4 other components must be present [21] | At least 3 or hyperinsulinemia and at least 2 must be present [22] | At least 3 must be present [23] | |||
| Age (years) | 12–19 | 6–9 [21] | 10–15 [21] 10–16 [23] |
>15 [21] ≥16 [24] |
ND | ND | |
| Essential criteria | ND | ND | ND | ND | Insulin resistance [23] | None [23] | |
| Waist circumference | WC ≥ 90th percentile for age, sex and race/ethnicity | WC ≥ 90th percentile for age (MS as entity is not diagnosed) [21] | WC ≥ 90th percentile [23] or adult cut-off if lower [21] | WC ≥ 90 cm in boys and ≥80 cm in girls [24] WC ≥ 94 cm in boys and ≥80 cm in girls [21] |
Waist-to-hip ratio > 0.9 in boys and >0.85 in girls [23] BMI ≥ 75/85/95th percentile by age, sex [22] |
WC ≥102 cm in boys and ≥88 cm in girls [23] WC > 90th percentile or BMI ≥ 97th percentile [22] WC > 75th percentile for age and sex [24] |
|
| BMI | ND | ND | ND | ND | >30 kg/m2 [23] | ND | |
| Blood pressure | ≥90th percentile for age, sex, and height | ND | SBP ≥ 130 mmHg [23] SBP ≥ 130 mmHg or DBP ≥ 85 mmHg [24] |
SBP ≥ 130 mmHg or DBP ≥85 mmHg [24] or treatment of previously diagnosed hypertension [21] | SBP ≥ 140 mmHg [23] | SBP ≥ 130 mmHg [23] SBP > 90th percentile for age and sex [24] |
|
| Dyslipidemia | Triglyceride | ≥1.23 mmol/L (≥110 mg/dL) | ND | ≥1.7 mmol/L (≥150 mg/dL) [23] | ≥1.7 mmol/L (≥150 mg/dL) [24] or specific treatment for high triglycerides [21] | ≥1.7 mmol/L (≥150 mg/dL) [23] | ≥1.7 mmol/L (≥150 mg/dL) [23] ≥100 mg/dL [24] |
| HDL-C | ≤10th percentile for race and sex [21] | ND | <1.03 mmol/L (<40 mg/dL) [23] | <1.03 mmol/L (<40 mg/dL) in boys and <1.29 mmol/L (<50 mg/dL) in girls [24] or specific treatment for low HDL-C [21] | <0.91 mmol/L in boys <1.0 mmol/L in girls [23] |
<1.0 mmol/L [23] 500 mg/dL, except boys from 15 to 18 years, whose cutoff point was <45 mg/dL [24] |
|
| Glucose | Fasting glucose ≥5.6 mmol/L (≥100 mg/dL) [21] | ND | Fasting glucose ≥5.6 mmol/L (≥100 mg/dL) [23] | Fasting glucose ≥5.6 mmol/L (≥100 mg/dL) [24] or known T2DM [21] | Insulin resistance or diabetes [23] Fasting glucose ≥ 6.1 mmol/L (≥110 mg/dL) or ≥80/90th percentile by age, sex or diabetes [22] |
Fasting glucose ≥6.1 mmol/L (≥110 mg/dL) [23] Fasting glucose ≥5.6 or 6.1 mmol/L (≥100 or 110 mg/dL) or 2 h glucose ≥140 mg/dL [22] |
|
| Insulin | ND | ND | ND | ND | Insulin resistance [23] | ND | |
AHA: American Heart Association; BMI: body mass index; cm: centimeters; DBP: diastolic blood pressure; HDL-C: high-density lipoprotein cholesterol (lipoproteins that carry cholesterol from the tissues of the body to the liver); IDF: International Diabetes Federation; MS: metabolic syndrome; NCEP ATP III: National Cholesterol Education Program’s Adult Treatment Panel; ND: not declared; SBP: systolic blood pressure; T2DM: type 2 diabetes mellitus (type of glycerol that belongs to the family of lipids, in mammals it is transported throughout the body while supplying energy or is stored as fat, for long periods; WC: waist circumference; WHO: World Health Organization.