Criteria of metabolic syndrome in children and adolescents

Age 6 to <10 years

  • Obesity > 90th percentile as assessed by waist circumference
  • Metabolic syndrome cannot be diagnosed, but further measurements should be made if family history of metabolic syndrome, type 2 diabetes mellitus, dyslipidaemia, cardiovascular disease, hypertension, or obesity
  • IDF suggests that a strong message for weight reduction should be delivered for those with abdominal obesity

Age 10 to <16 years

  • Obesity > 90th percentile (or adult cut-off if lower) as assessed by waist circumference
  • Triglycerides > 1.7 mmol/L
  • HDL-cholesterol <1.03 mmol/L
  • Blood pressure > 130 mm Hg systolic or ?85 mm Hg diastolic
  • Glucose > 5.6 mmol/L (oral glucose tolerance test recommended) or known type 2 diabetes mellitus

Age >16 years

Use existing IDF criteria for adults :

According to the new IDF definition, for a person to be defined as having the metabolic syndrome they must have:

Central obesity (defined as waist circumference* with ethnicity specific values) plus any two of the following four factors: 

  • Raised TG level: > 150 mg/dL (1.7 mmol/L), or specific treatment for this lipid abnormality
  • Reduced HDL cholesterol: < 40 mg/dL (1.03 mmol/L) in males and < 50 mg/dL (1.29 mmol/L) in females, or specific treatment for this lipid abnormality
  • Raised blood pressure: systolic BP > 130 or diastolic BP ? 85 mm Hg, or treatment of previously diagnosed hypertension
  • Raised fasting plasma glucose (FPG): > 100 mg/dL (5.6 mmol/L), or previously diagnosed type 2 diabetes (If above 5.6 mmol/L or 100 mg/dL, OGTT is strongly recommended but is not necessary to define presence of the syndrome).

* If BMI is >30kg/m², central obesity can be assumed and waist circumference does not need to be measured.

Country/Ethnic group

Waist circumference

Europids*

In the USA, the ATP III values (102 cm male; 88 cm female) are likely to continue to be used for clinical purposes

Male

> 94 cm

Female

> 80 cm

South Asians

Based on a Chinese, Malay and Asian-Indian population

Male

> 90 cm

Female

> 80 cm

Chinese

Male

> 90 cm

Female

> 80 cm

Japanese**

 

Male

> 90 cm

Female

> 80 cm

Ethnic South and Central Americans

Use South Asian recommendations until more specific data are available

Sub-Saharan Africans

Use European data until more specific data are available

Eastern Mediterranean and Middle East (Arab) populations

Use European data until more specific data are available

* In future epidemiological studies of populations of Europid origin, prevalence should be given using both European and North American cut-points to allow better comparisons.

** Subsequent data analyses suggest that Asian values (male 90cm; female 80cm) should be used for Japanese populations until more data are available.

Note: Children younger than 6 years were excluded from the definition because of insufficient data for this age-group.