Prevalence of metabolic syndrome in Brazilian children using three different sets of international criteria

Background: the aim of the present study was to compare the prevalence of metabolic syndrome in Brazilian children aged 6-10 years using three different international criteria. Methods: systolic and diastolic blood pressure (SBP and DBP), high-density lipoprotein (HDL) cholesterol, low-density lipoprotein (LDL) cholesterol, triglycerides, fasting glucose, and insulin levels were measured in 290 schoolchildren, and the presence of metabolic syndrome was analyzed according to the criteria established by Cook, Boney, and Ferreira. Results: the prevalence of metabolic syndrome was 2.27 % (Boney and Ferreira criteria) and 7.58 % (Cook criteria) for girls, and 3.8 % (Boney and Ferreira criteria) and 5.06 % (Cook criteria) for boys. Agreement in pairs showed a concordance of 57.5 % (Kappa = 0.57) between Boney and Cook criteria, and 65.2 % (Kappa = 0.65) between Cook and Ferreira. The greatest concordance found was 77 % (Kappa = 0.77) between Boney and Ferreira criteria, demonstrating a substantial agreement. Conclusion: prevalence according to Boney and Ferreira criteria was lower than according to Cook criteria. Therefore, we suggest the use of Cook criteria in clinical practice for the diagnosis of metabolic syndrome, since this criterion provided a wider diagnostic range, thereby reducing the risk of underdiagnosis.