Background: Due to the lack of consensus on its definition, the metabolic syndrome (MS) in children and adolescents is not formally recognized. However, several researchers have changed the adult criteria for pediatric standards in order to assess the prevalence. Objective: The aim of this study was to evaluate the frequency of MS and its components according to two of the currently used definitions in overweight and obese adolescents. Methods: A cross-sectional study with 232 adolescents with excess weight from a public school of the city of Rio de Janeiro. Anthropometric, blood pressure, and biochemical variables were assessed. MS was defined using two different diagnostic criteria: the National Cholesterol Education Program Adult Treatment Panel III (NCEP-ATPIII) and International Diabetes Federation (IDF). Results: MS was diagnosed in 40.4 and 24.6% of obese adolescents and 9.4 and 1.9% of overweight adolescents according to the NCEP-ATPIII and IDF criteria, respectively. The degree of agreement, assessed by the κ index, from the definitions adopted in this study was 0.48. Conclusion: The results show a significant difference between the two diagnostic criteria. A higher frequency was found when the NCEP-ATPIII was used, which is of concern given the association of MS with diabetes and cardiovascular disease.

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