Comparing the Diagnostic Criteria of Metabolic Syndrome in Schoolchildren: Cross-sectional Study

  • Ingred Pereira Cirino
  • Leylla Lays Alves e Silva
  • Karollayny de Macêdo Oliveira
  • Eugênio Barbosa de Melo Júnior
  • Edina Araújo Rodrigues Oliveira
  • Luisa Helena de Oliveira Lima UNIVERSIDADE FEDERAL DO PIAUÍ


Title: Comparing the diagnostic criteria of metabolic syndrome in schoolchildren: a cross-sectional study.

Introduction: The Metabolic Syndrome has been highlighted by being the result of the meeting of several cardiovascular risk factors. However, there is still no consensus for the determination of MS in children and adolescents, since the diagnostic criteria and its cut-off points considered at risk are not established and, depending on the criteria used, the prevalence of MS found in the literature may vary.

Objective: To compare the diagnostic criteria for metabolic syndrome in adolescents in the private school system.

Method: This is a cross-sectional study of 325 adolescents from private schools in the urban area of a city in northeastern Brazil. The analysis was performed through the descriptive statistics, and the verification of the agreement between the results was given by the calculation of the Kappa index. The study was approved by the Ethics Committee (opinion 352.372).

Results: In only 7 adolescents, the diagnosis was like the three definitions of metabolic syndrome. Regarding the number of components of metabolic syndrome, a large percentage of adolescents presented 02 or more altered parameters. Regarding the comparison of the diagnostic criteria, the criteria established by De Ferranti presented a higher positive proportion for the syndrome.

Conclusion: There were differences between the proportions obtained through the three diagnostic criteria, which may impair the diagnosis of the metabolic syndrome in adolescents.


1. Muruci GR, Francisco I, Alves MAR. Prevalência de componentes da síndrome metabólica associadas no Brasil e análise crítica dos fatores dietéticos na prevenção e tratamento. Rev Rede Cuid Saúde [Internet]. 2015; 9(1):1-15. Available from: Access in 17 Feb 2016.
2. Prado MI, Mercadante MP, Zanatta MF, Ramos VCS, Nascimento SD, Miranda JEB. Prevalence of overweight among students of public and private elementary and middle schools in Sorocaba, state of São Paulo, Brazil. Rev Bras Med Fam Comunidade [Internet]. 2013; 8(26):43-50. Available from: doi:
3. Cruz IRD, Freitas DA, Soares WD, Mourão DM, Aidar FJ, Carneiro AL. Metabolic syndrome and its association with socio-economic level in students. Rev. CEFAC [Internet]. 2014; 16(4):1294-302. Available from: doi:
4. Sociedade Brasileira de Cardiologia. I Diretriz brasileira de diagnóstico e tratamento da Síndrome Metabólica. Arq Bras Cardiol [Internet]. 2005; 84 supl 1:3-28. Available from: doi:
5. Marco M, Simone G, Izzo R, Mancusi C, Sforza A, Giudice R, et al. Classes of antihypertensive medications and blood pressure control in relation to metabolic risk factors. J Hypertens [Internet]. 2012; 30(1): 188-93. Available from: doi: 10.1097/HJH.0b013e32834e1eda .
6. Fonoff J, Souza LC, Celeghin TA, Gobato AO. Prevalência de síndrome metabólica em adolescentes obesos: critérios diagnósticos. CuidArte enferm [Internet]. 2015; 9(1):78-84. Available from:
7. Cook S, Weitzman M, Auinger P, Nguyen M, Dietz WH. Prevalence of a Metabolic Syndrome Phenotype in Adolescents: Findings From the Third National Health and Nutrition Examination Survey, 1988-1994. Arch Pediatr Adolesc Med [Online]. 2003; 157(8):821-27. Available from: doi: 10.1001/archpedi.157.8.821 . Access in 2016 Feb 27.
8. World Health Organization. Growth reference 5-19 years. 2007. Available from: Access in 2016 Mar 17.
9. Rodrigues NLA, Lima LHO, Carvalho ES, Vera PVS, Frota KMG, Lopes MVO, et al. Risk factors for cardiovascular diseases in adolescents. Invest Educ Enferm [Online]. 2015; 33(2): 315-24. Available from: doi: 10.17533/udea.iee.v33n2a14 . Access in 2016 Mar 30.
10. Carvalho EV, Costa VVL, Araújo MS, Martens IB, Sá NNB, Silva RA. Correlação entre o estado nutricional e o risco coronariano de adultos atendidos em uma ação educativa em Belém Pará. Rev Bras Obes Nutr Emag [Internet]. 2016; 10(55):40-9. Available from:
11. Sociedade brasileira de cardiologia. VI Diretrizes brasileiras de hipertensão. Rev Bras Hipertens [Online]. 2010; 17(1):4-64. Available from: Access in 02 Mar 2016.
12. National high blood pressure education program working group on hypertension control in children and adolescents (NHBPEP). The Fourth Report on the diagnosis, evaluation, and treatment of high blood pressure in children and adolescents. Pediatrics [Internet]. 2004; 114 supl 1:555-76. Available from: Access in 15 Mar 2016.
13. De Ferranti SD, Gauvreau K, Ludwig DS, Neufeld EJ, Newburger JW, Rifai N. Prevalence of the metabolic syndrome in American adolescents: findings from the third National Health and Nutrition Examination Survey. Circulation [Internet]. 2004; 110(16):2494-97. Available from: doi: 10.1161/01.CIR.0000145117.40114.C7.
14. Zimmet P, Alberti G, Kaufman F, Tajima N, Silink M, Arslanian S, et al. The metabolic syndrome in children and adolescents: the IDF consensus. Diabetes Voice [Internet]. 2007; 52(4):29-32. Available from: Access in 15 Mar 2016.
15. Landis JR, Koch GG. The measurement of observer agreement
for categorical data. Biometrics [Online]. 1977; 33(1):159-74. Available from: doi: 10.2307/2529310. Access in 2016 Apr 11.
16. Ministério da Saúde (BR). Conselho Nacional de Saúde. Comissão Nacional de Ética em Pesquisa. Diretrizes e Normas regulamentadoras de pesquisa envolvendo seres humanos. Resolução n. 466/12 de 12 de dezembro de 2012. Brasília: Ministério da Saúde; 2012. Available from: Access in 02 Mar 2016.
17. Faria ER, Faria FR, Franceschini SCC, Peluzio MCG, Sant’Ana LFR, Novaes JF, et al. Insulin resistance and components of metabolic syndrome, analysis by gender and stage of adolescence. Arq Bras Endocrinol Metab [Internet]. 2014; 58(6):610-18. Available from: doi:
18 - Ashwell M, Gunn P, Gibson S. Waist-to-height ratio is a better screening tool than waist circumference and BMI for adult cardiometabolic risk factors: systematic review and meta-analysis. Obes Ver [Internet]. 2012; 13(3):275-86. Available from:;jsessionid=0E7696F409A372BD85477E8B3490D29E.f01t04. doi: 10.1111/j.1467-789X.2011.00952.x.
19. Costa RF, Santos NS, Goldraich NP, Barski TF, Andrade KS, Kruel LFM. Metabolic syndrome in obese adolescents: a comparison of three different diagnostic criteria. J Pediatr (Rio J) [Internet]. 2012; 88(4):303-9. Available from: doi:
How to Cite
CIRINO, Ingred Pereira et al. Comparing the Diagnostic Criteria of Metabolic Syndrome in Schoolchildren: Cross-sectional Study. International Archives of Medicine, [S.l.], v. 10, july 2017. ISSN 1755-7682. Available at: <>. Date accessed: 20 apr. 2019. doi:

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