Prevalência da síndrome metabólica e seus componentes em adolescentes brasileiros: uma revisão sistemática e metanálise

Paiva, Miguel Henrique Pereira de; Miranda Filho, Valberto Alencar; Oliveira, Ana Raquel Soares de; Cruz, Kyria Jayanne Clímaco; Araújo, Regina Maria Sousa de; Oliveira, Karla Andrade de

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Brasil

Revista Paulista de Pediatria

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Brasil

Español English

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Sumário

Review Article • Rev. paul. pediatr. 41 • 2023 • https://doi.org/10.1590/1984-0462/2023/41/2021145 copiar

Prevalência da síndrome metabólica e seus componentes em adolescentes brasileiros: uma revisão sistemática e metanálise

Autoria SCIMAGO INSTITUTIONS RANKINGS

RESUMO

Objetivo:

Determinar a prevalência da síndrome metabólica (SM) e seus componentes em adolescentes brasileiros.

Fontes de dados:

Realizaram-se buscas nas bases de dados Literatura Latino-Americana e do Caribe em Ciências da Saúde (Lilacs), Medical Literature Analysis and Retrieval System Online (Medline) e Scientific Electronic Library Online (SciELO) por estudos transversais originais publicados entre 2010 e 2021. Os critérios de inclusão foram determinados pelo Mnemônico CoCoPop — Condição, Contexto e População: estudos que determinam a prevalência de SM e seus componentes (condição) na população geral de adolescentes brasileiros, feminino e masculino (população), matriculados em escolas públicas ou privadas em áreas rurais ou urbanas (contexto). Revisões, editoriais, artigos não relacionados com a prevalência de SM ou que incluíssem grupos etários não adolescentes ou com condições de saúde específicas (obesidade/sobrepeso e outros) foram excluídos.

Síntese dos dados:

Quinze estudos, com 43.227 adolescentes, foram identificados. A prevalência de SM (intervalo de confiança — IC95%) no sexo masculino foi de 2,9% (2,65–3,18) e no feminino foi de 2,4% (1,90–2,90) (p<0,001), pelos critérios da Federação Internacional de Diabetes (IDF). Houve diferença significativa na prevalência de SM entre regiões brasileiras (Q=24,7; p<0,001). A menor prevalência de SM (IC95%) foi encontrada em região Norte, com 1,8% (1,52–2,13), e a maior na região Nordeste, com 2,9% (2,62–3,23). Em relação aos componentes da SM, maior prevalência (IC95%) foi encontrada para lipoproteína de baixa densidade (HDL) baixa (22,1%, 12,49–36,17), seguida de obesidade abdominal (11,0%, 8,05–14,94) e hipertensão arterial (10,3%, 7,84–13,48).

Conclusões:

Este estudo permitiu determinar a prevalência da SM e seus componentes em adolescentes brasileiros, destacando aspectos relevantes a serem abordados na gestão da saúde pública.

Palavras-chave:
Síndrome metabólica; Prevalência; Adolescente; Brasil

Study	Age group (year)	School/Zone	Sample (n)	Prevalence of MS (%)
Quintão et al.¹⁷17 Quintão DF, Franceschini SC, Sant’Ana LF, Lamounier JA, Marins JC, Prioew SE. Cardiovascular risk factors and metabolic syndrome among adolescents in the urban area. Nutriere Rev Soc Bras Aliment Nutr. 2010;35:149-62.	16–19	Public and private/urban area of Minas Gerais (MG)	172	1.2 IDF (2005)⁶6 Zimmet P, Magliano D, Matsuzawa Y, Alberti G, Shaw J. The metabolic syndrome: a global public health problem and a new definition. J Atheroscler Thromb. 2005;12:295-300. https://doi.org/10.5551/jat.12.295 https://doi.org/10.5551/jat.12.295...
Alvarez et al.¹⁸18 Alvarez MM, Vieira AC, Sichieri R, Veiga GV. Prevalence of metabolic syndrome and of its specific components among adolescents from Niterói City, Rio de Janeiro State, Brazil. Arq Bras Endocrinol Metab. 2011;55:164-70. https://doi.org/10.1590/S0004-27302011000200009 https://doi.org/10.1590/S0004-2730201100...	12–19	Public/urban area of Rio de Janeiro (RJ)	577	6.0 Ford et al.;³⁷37 Ford ES, Ajani UA, Mokdad AH, National Health and Nutrition Examination. The metabolic syndrome and concentrations of C-reactive protein among U.S. youth. Diabetes Care. 2005;28:878-81. 1.1 Viner et al.;³²32 Viner RM, Segal TY, Lichtarowicz-Krynska E, Hindmarsh P. Prevalence of the insulin resistance syndrome in obesity. Arch Dis Child. 2005;90:10-4. https://doi.org/10.1136/adc.2003.036467 https://doi.org/10.1136/adc.2003.036467... 1.6 IDF (2005)⁶6 Zimmet P, Magliano D, Matsuzawa Y, Alberti G, Shaw J. The metabolic syndrome: a global public health problem and a new definition. J Atheroscler Thromb. 2005;12:295-300. https://doi.org/10.5551/jat.12.295 https://doi.org/10.5551/jat.12.295...
Stabelini Neto et al.¹⁹19 Stabelini Neto A, Sasaki JE, Mascarenhas LP, Boguszewski MC, Bozza R, Ulbrich AZ, et al. Physical activity, cardiorespiratory fitness, and metabolic syndrome in adolescents: a cross-sectional study. BMC Public Health. 2011;11:674. https://doi.org/10.1186/1471-2458-11-674 https://doi.org/10.1186/1471-2458-11-674...	12–18	Urban area of Paraná (PR)	582	6.7 Cook et al.³⁵35 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. 2003;157:821-7. https://doi.org/10.1001/archpedi.157.8.821 https://doi.org/10.1001/archpedi.157.8.8...
de Sousa et al.²⁰20 de Sousa MA, Guimarães IC, Daltro C, Guimarães AC. Association between birth weight and cardiovascular risk factors in adolescents. Arq Bras Cardiol. 2013;101:9-17. https://doi.org/10.5935/abc.20130114 https://doi.org/10.5935/abc.20130114...	11–18	Public and private/urban area of Bahia (BA)	250	21.6 Ferranti et al.³⁶36 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. 2004;110:2494-7. https://doi.org/10.1161/01.CIR.0000145117.40114.C7 https://doi.org/10.1161/01.CIR.000014511...
Furtado Neto e Ribeiro²¹21 Furtado Neto JF. Prevalence of syndrome metabolic in pediatric population in 06 (six) schools in the city of São Luiz/MA Brazil [thesis]. Rio de Janeiro: Uiniversidade Estadual do Rio de Janeiro; 2013.	12–17	Public and private/urban area of Maranhão (MA)	468	12.2 Cook et al.³⁵35 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. 2003;157:821-7. https://doi.org/10.1001/archpedi.157.8.821 https://doi.org/10.1001/archpedi.157.8.8...
Granjeiro et al.²²22 Granjeiro PA, Silva TM, Dorim DD, Vieira MS, Borges Neto JS, Santos ME. Frequency of metabolic syndrome in children and adolescents from public schools of Divinópolis, Minas Gerais, Brazil, according to three international diagnostic criteria. Sci Med. 2016;26:1-9. https://doi.org/10.15448/1980-6108.2016.3.22854 https://doi.org/10.15448/1980-6108.2016....	10–17	Public/urban area of Minas Gerais (MG)	202	0.50 Viner et al.³²32 Viner RM, Segal TY, Lichtarowicz-Krynska E, Hindmarsh P. Prevalence of the insulin resistance syndrome in obesity. Arch Dis Child. 2005;90:10-4. https://doi.org/10.1136/adc.2003.036467 https://doi.org/10.1136/adc.2003.036467...
Kuschnir et al.²³23 Kuschnir MC, Bloch KV, Szklo M, Klein CH, Barufaldi LA, Abreu GA, et al. ERICA: prevalence of metabolic syndrome in Brazilian adolescents. Rev Saude Publica. 2016;50(Suppl 1):11s. https://doi.org/10.1590/S01518-8787.2016050006701 https://doi.org/10.1590/S01518-8787.2016...	12–17	Public and private/urban area of Brazil: 26 States and Distrito Federal (DF)	37,504	2.6 IDF (2005):⁶6 Zimmet P, Magliano D, Matsuzawa Y, Alberti G, Shaw J. The metabolic syndrome: a global public health problem and a new definition. J Atheroscler Thromb. 2005;12:295-300. https://doi.org/10.5551/jat.12.295 https://doi.org/10.5551/jat.12.295... North: 1.8; Northeast: 2.9; Midwest: 2.8; Southeast: 2.6; South: 4.1
Assis et al.²⁴24 Assis MM, Novaes JF, Cândido AP, Leite IC, Oliveira RM. Dietary consumption and metabolic syndrome in adolescents. Sci Med. 2017;27:1-9. https://doi.org/10.15448/1980-6108.2017.1.25496 https://doi.org/10.15448/1980-6108.2017....	15–17	Public and private/urban area of Minas Gerais (MG)	302	4.0 IDF (2005)⁶6 Zimmet P, Magliano D, Matsuzawa Y, Alberti G, Shaw J. The metabolic syndrome: a global public health problem and a new definition. J Atheroscler Thromb. 2005;12:295-300. https://doi.org/10.5551/jat.12.295 https://doi.org/10.5551/jat.12.295...
Pani et al.²⁵25 Pani VO, Cardoso LD, Paula H, Faria ER. Anthropometric and body composition variables as predictors of cardiovascular risk and metabolic syndrome in adolescents. Braspen J. 2017;32:259-67.	11–15	Public/urban area of Espírito Santo (ES)	85	2.4 Faria et al.³³33 Faria FR, Faria ER, Faria FR, Paula HA, Franceschini SC, Priore SE. Association between metabolic syndrome and anthropometric and body composition indicators in adolescents. Rev Assoc Bras Nutr. 2014;6:13-20.
dos Santos et al.²⁶26 dos Santos MC, Coutinho AP, Dantas M, Yabunaka LA, Guedes DP, Oesterreich SA. Correlates of metabolic syndrome among young Brazilian adolescents population. Nutr J. 2018;17:66. https://doi.org/10.1186/s12937-018-0371-9 https://doi.org/10.1186/s12937-018-0371-...	12–18	Public/urban area of Mato Grosso do Sul (MS)	274	4.7 IDF (2005)⁶6 Zimmet P, Magliano D, Matsuzawa Y, Alberti G, Shaw J. The metabolic syndrome: a global public health problem and a new definition. J Atheroscler Thromb. 2005;12:295-300. https://doi.org/10.5551/jat.12.295 https://doi.org/10.5551/jat.12.295...
Nobre et al.²⁷27 Nobre RS, Guimarães MR, Batista AM, Sousa AF, Lima LH, Silva AR. Anthropometric indicators that predict metabolic syndrome among adolescents. Texto Contexto Enferm. 2018;27:e5270016. https://doi.org/10.1590/0104-070720180005270016 https://doi.org/10.1590/0104-07072018000...	10–19	Public/urban area of Piauí (PI)	716	3.2 Cook et al.³⁵35 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. 2003;157:821-7. https://doi.org/10.1001/archpedi.157.8.821 https://doi.org/10.1001/archpedi.157.8.8...
Reuter et al.²⁸28 Reuter CP, Burgos MS, Barbian CD, Renner JD, Franke SI, Mello ED. Comparison between different criteria for metabolic syndrome in schoolchildren from southern Brazil. Eur J Pediatr. 2018;177:1471-7. https://doi.org/10.1007/s00431-018-3202-2 https://doi.org/10.1007/s00431-018-3202-...	10–17	Urban and rural areas of Rio Grande do Sul (RS)	1,200	1.9 Cook et al.;³⁵35 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. 2003;157:821-7. https://doi.org/10.1001/archpedi.157.8.821 https://doi.org/10.1001/archpedi.157.8.8... 5.0 Ferranti et al.;³⁶36 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. 2004;110:2494-7. https://doi.org/10.1161/01.CIR.0000145117.40114.C7 https://doi.org/10.1161/01.CIR.000014511... 2.1 IDF (2005)⁶6 Zimmet P, Magliano D, Matsuzawa Y, Alberti G, Shaw J. The metabolic syndrome: a global public health problem and a new definition. J Atheroscler Thromb. 2005;12:295-300. https://doi.org/10.5551/jat.12.295 https://doi.org/10.5551/jat.12.295...
Guilherme et al.²⁹29 Guilherme FR, Nascimento MA, Fernandes CA, Guilherme VR, Sntos SR, Elias RG, et al. Comparison of different criteria in the prevalence of metabolic syndrome in students from Paranavaí, Paraná. Rev Paul Pediatr. 2019;37:332-7. https://doi.org/10.1590/1984-0462/;2019;37;3;00007 https://doi.org/10.1590/1984-0462/;2019;...	10–14	Public and private/urban area of Paraná (PR)	241	1.7 IDF (2005);⁶6 Zimmet P, Magliano D, Matsuzawa Y, Alberti G, Shaw J. The metabolic syndrome: a global public health problem and a new definition. J Atheroscler Thromb. 2005;12:295-300. https://doi.org/10.5551/jat.12.295 https://doi.org/10.5551/jat.12.295... 3.3 Cook et al.;³⁵35 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. 2003;157:821-7. https://doi.org/10.1001/archpedi.157.8.821 https://doi.org/10.1001/archpedi.157.8.8... 17.4 Ferranti et al.³⁶36 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. 2004;110:2494-7. https://doi.org/10.1161/01.CIR.0000145117.40114.C7 https://doi.org/10.1161/01.CIR.000014511...
Lustosa et al.³⁰30 Lustosa LC, Nascimento LM, Lavor LC, Gomes KR, Mascarenhas MD, Frota KM. Metabolic syndrome in adolescents and its association with diet quality. Rev Nutr. 2019;32:e180004. https://doi.org/10.1590/1678-9865201932e190004 https://doi.org/10.1590/1678-9865201932e...	14–19	Public and private/urban area of Piauí (PI)	327	3.4 IDF (2005)³⁴34 Expert Panel on Detection, Evaluation, and Treatment of High Blood Cholesterol in Adults. Executive summary of the Third Report of The National Cholesterol Education Program (NCEP) expert panel on detection, evaluation, and treatment of high blood cholesterol in adults (Adult Treatment Panel III). JAMA. 2001;285:2486-97. https://doi.org/10.1001/jama.285.19.2486 https://doi.org/10.1001/jama.285.19.2486...
Mendes et al.³¹31 Mendes MG, Nascimento LM, Gomes KR, Moreira AR, Rodrigues MT, Araújo TM, et al. Prevalence of metabolic syndrome and associations with nutritional status in adolescents. Cad Saúde Colet. 2019;27:374-9. https://doi.org/10.1590/1414-462X201900040066 https://doi.org/10.1590/1414-462X2019000...	14–19	Public and private/urban area of Piauí (PI)	327	7.0 NCEP-ATP III

Study	Was the sample representative of the target population?	Were participants recruited in an appropriate way?	Was the sample size adequate?	Were the study subjects and the setting described in detail?	Was the analysis conducted with sufficient coverage of the sample?	Were objective, standard criteria used for the measurement?	Was the condition measured reliably?	Was there appropriate statistical analysis?	Are all important confounding factors/subgroups identified and accounted for?	Were subpopulations identified using objective criteria?
Quintão et al.¹⁷17 Quintão DF, Franceschini SC, Sant’Ana LF, Lamounier JA, Marins JC, Prioew SE. Cardiovascular risk factors and metabolic syndrome among adolescents in the urban area. Nutriere Rev Soc Bras Aliment Nutr. 2010;35:149-62.	Yes	Unclear	Yes	No	Unclear	Yes	Yes	Yes	Yes	Yes
Alvarez et al.¹⁸18 Alvarez MM, Vieira AC, Sichieri R, Veiga GV. Prevalence of metabolic syndrome and of its specific components among adolescents from Niterói City, Rio de Janeiro State, Brazil. Arq Bras Endocrinol Metab. 2011;55:164-70. https://doi.org/10.1590/S0004-27302011000200009 https://doi.org/10.1590/S0004-2730201100...	Yes	Yes	Yes	No	Unclear	Yes	Unclear	Yes	Yes	Yes
Stabelini Neto et al.¹⁹19 Stabelini Neto A, Sasaki JE, Mascarenhas LP, Boguszewski MC, Bozza R, Ulbrich AZ, et al. Physical activity, cardiorespiratory fitness, and metabolic syndrome in adolescents: a cross-sectional study. BMC Public Health. 2011;11:674. https://doi.org/10.1186/1471-2458-11-674 https://doi.org/10.1186/1471-2458-11-674...	Yes	No	Yes	No	Yes	Yes	Yes	Yes	Yes	Yes
de Sousa et al.²⁰20 de Sousa MA, Guimarães IC, Daltro C, Guimarães AC. Association between birth weight and cardiovascular risk factors in adolescents. Arq Bras Cardiol. 2013;101:9-17. https://doi.org/10.5935/abc.20130114 https://doi.org/10.5935/abc.20130114...	Yes	Yes	Yes	Yes	Unclear	Yes	Unclear	Yes	Yes	Yes
Furtado Neto e Ribeiro²¹21 Furtado Neto JF. Prevalence of syndrome metabolic in pediatric population in 06 (six) schools in the city of São Luiz/MA Brazil [thesis]. Rio de Janeiro: Uiniversidade Estadual do Rio de Janeiro; 2013.	Yes	Yes	Yes	Yes	Unclear	Yes	Unclear	Yes	Yes	Yes
Granjeiro et al.²²22 Granjeiro PA, Silva TM, Dorim DD, Vieira MS, Borges Neto JS, Santos ME. Frequency of metabolic syndrome in children and adolescents from public schools of Divinópolis, Minas Gerais, Brazil, according to three international diagnostic criteria. Sci Med. 2016;26:1-9. https://doi.org/10.15448/1980-6108.2016.3.22854 https://doi.org/10.15448/1980-6108.2016....	Yes	Yes	Yes	Yes	Yes	Yes	Unclear	Yes	Yes	Yes
Kuschnir et al.²³23 Kuschnir MC, Bloch KV, Szklo M, Klein CH, Barufaldi LA, Abreu GA, et al. ERICA: prevalence of metabolic syndrome in Brazilian adolescents. Rev Saude Publica. 2016;50(Suppl 1):11s. https://doi.org/10.1590/S01518-8787.2016050006701 https://doi.org/10.1590/S01518-8787.2016...	Yes	Yes	Yes	No	Yes	Yes	Yes	Yes	Yes	Yes
Assis et al.²⁴24 Assis MM, Novaes JF, Cândido AP, Leite IC, Oliveira RM. Dietary consumption and metabolic syndrome in adolescents. Sci Med. 2017;27:1-9. https://doi.org/10.15448/1980-6108.2017.1.25496 https://doi.org/10.15448/1980-6108.2017....	Yes	Unclear	Yes	No	Yes	Yes	Yes	Yes	Yes	Yes
Pani et al.²⁵25 Pani VO, Cardoso LD, Paula H, Faria ER. Anthropometric and body composition variables as predictors of cardiovascular risk and metabolic syndrome in adolescents. Braspen J. 2017;32:259-67.	Yes	Unclear	Yes	No	Unclear	Yes	Yes	Yes	Yes	Yes
dos Santos et al.²⁶26 dos Santos MC, Coutinho AP, Dantas M, Yabunaka LA, Guedes DP, Oesterreich SA. Correlates of metabolic syndrome among young Brazilian adolescents population. Nutr J. 2018;17:66. https://doi.org/10.1186/s12937-018-0371-9 https://doi.org/10.1186/s12937-018-0371-...	Yes	Unclear	Yes	Yes	Unclear	Yes	Unclear	Yes	Yes	Yes
Nobre et al.²⁷27 Nobre RS, Guimarães MR, Batista AM, Sousa AF, Lima LH, Silva AR. Anthropometric indicators that predict metabolic syndrome among adolescents. Texto Contexto Enferm. 2018;27:e5270016. https://doi.org/10.1590/0104-070720180005270016 https://doi.org/10.1590/0104-07072018000...	Yes	Unclear	Yes	Yes	Unclear	Yes	Unclear	Yes	Yes	Yes
Reuter et al.²⁸28 Reuter CP, Burgos MS, Barbian CD, Renner JD, Franke SI, Mello ED. Comparison between different criteria for metabolic syndrome in schoolchildren from southern Brazil. Eur J Pediatr. 2018;177:1471-7. https://doi.org/10.1007/s00431-018-3202-2 https://doi.org/10.1007/s00431-018-3202-...	Yes	Yes	Yes	Yes	Yes	Yes	Unclear	Yes	Yes	Yes
Guilherme et al.²⁹29 Guilherme FR, Nascimento MA, Fernandes CA, Guilherme VR, Sntos SR, Elias RG, et al. Comparison of different criteria in the prevalence of metabolic syndrome in students from Paranavaí, Paraná. Rev Paul Pediatr. 2019;37:332-7. https://doi.org/10.1590/1984-0462/;2019;37;3;00007 https://doi.org/10.1590/1984-0462/;2019;...	Yes	Yes	Yes	No	Unclear	Yes	Yes	Yes	Yes	Yes
Lustosa et al.³⁰30 Lustosa LC, Nascimento LM, Lavor LC, Gomes KR, Mascarenhas MD, Frota KM. Metabolic syndrome in adolescents and its association with diet quality. Rev Nutr. 2019;32:e180004. https://doi.org/10.1590/1678-9865201932e190004 https://doi.org/10.1590/1678-9865201932e...	Yes	Yes	Yes	Yes	Yes	Yes	Unclear	Yes	Yes	Yes
Mendes et al.³¹31 Mendes MG, Nascimento LM, Gomes KR, Moreira AR, Rodrigues MT, Araújo TM, et al. Prevalence of metabolic syndrome and associations with nutritional status in adolescents. Cad Saúde Colet. 2019;27:374-9. https://doi.org/10.1590/1414-462X201900040066 https://doi.org/10.1590/1414-462X2019000...	Yes	Unclear	Yes	Yes	Yes	Yes	Unclear	Unclear	Yes	Yes

Study	Prevalence (%) or 95%CI^* * Some studies showed the prevalence of components MS, whereas others showed the prevalence and confidence interval for those components. MS: metabolic syndrome; 95%CI: confidence interval; AO: abdominal obesity; BP: blood pressure; HG: hyperglycemia; HDL-C: high-density lipoprotein cholesterol; HTG: high serum triglyceride; OW: overweight; OB: obesity; LW: low weight; ET: eutrophy. of MS components					Nutritional status (%)
Study	AO	High BP	HG	Low HDL-C	HTG	Nutritional status (%)
Quintão et al.¹⁷17 Quintão DF, Franceschini SC, Sant’Ana LF, Lamounier JA, Marins JC, Prioew SE. Cardiovascular risk factors and metabolic syndrome among adolescents in the urban area. Nutriere Rev Soc Bras Aliment Nutr. 2010;35:149-62.	1.4 (males) 4.0 (females)	16.7 (males) 3.0 (females)	0 (males) 1.0 (females)	30.6 (males) 35.0 (females)	0 (males) 4.0 (females)	OW: 11.6 OB: 2.9
Alvarez et al.¹⁸18 Alvarez MM, Vieira AC, Sichieri R, Veiga GV. Prevalence of metabolic syndrome and of its specific components among adolescents from Niterói City, Rio de Janeiro State, Brazil. Arq Bras Endocrinol Metab. 2011;55:164-70. https://doi.org/10.1590/S0004-27302011000200009 https://doi.org/10.1590/S0004-2730201100...	9.0 (6.30–12.90)	12.5 (7.90–17.05)	22.3 (13.30–31.70)	32.5 (23.60–41.40)	3.7 (1.90–5.40)	OW–OB: 15.8
Stabelini Neto et al.¹⁹19 Stabelini Neto A, Sasaki JE, Mascarenhas LP, Boguszewski MC, Bozza R, Ulbrich AZ, et al. Physical activity, cardiorespiratory fitness, and metabolic syndrome in adolescents: a cross-sectional study. BMC Public Health. 2011;11:674. https://doi.org/10.1186/1471-2458-11-674 https://doi.org/10.1186/1471-2458-11-674...	Not informed	18.9	4.7	29.2	18.3	LW: 5.2 ET: 77.8 OW: 11.0 OB: 6.0
de Sousa et al.²⁰20 de Sousa MA, Guimarães IC, Daltro C, Guimarães AC. Association between birth weight and cardiovascular risk factors in adolescents. Arq Bras Cardiol. 2013;101:9-17. https://doi.org/10.5935/abc.20130114 https://doi.org/10.5935/abc.20130114...	46.8	18.4	16.0	54.0	27.6	Not informed
Furtado Neto e Ribeiro²¹21 Furtado Neto JF. Prevalence of syndrome metabolic in pediatric population in 06 (six) schools in the city of São Luiz/MA Brazil [thesis]. Rio de Janeiro: Uiniversidade Estadual do Rio de Janeiro; 2013.	12.2	12.2	0.40	37.4	17.7	LW: 30.3 ET: 33.1 OW: 11.1 OB: 25.4
Granjeiro et al.²²22 Granjeiro PA, Silva TM, Dorim DD, Vieira MS, Borges Neto JS, Santos ME. Frequency of metabolic syndrome in children and adolescents from public schools of Divinópolis, Minas Gerais, Brazil, according to three international diagnostic criteria. Sci Med. 2016;26:1-9. https://doi.org/10.15448/1980-6108.2016.3.22854 https://doi.org/10.15448/1980-6108.2016....	2.0 (0.64–4.70)	12.9 (8.76–18.03)	4.5 (2.19–8.07)	23.3 (17.83–29.47);	6.9 (3.99–11.09)	OW–OB: 14.4
Kuschnir et al.²³23 Kuschnir MC, Bloch KV, Szklo M, Klein CH, Barufaldi LA, Abreu GA, et al. ERICA: prevalence of metabolic syndrome in Brazilian adolescents. Rev Saude Publica. 2016;50(Suppl 1):11s. https://doi.org/10.1590/S01518-8787.2016050006701 https://doi.org/10.1590/S01518-8787.2016...	12.6 (11.60–13.70)	8.2 (7.60–8.90)	4.1 (3.50–4.80)	32.7 (30.30–35.20)	4.6 (4.10–5.10)	Not informed
Assis et al.²⁴24 Assis MM, Novaes JF, Cândido AP, Leite IC, Oliveira RM. Dietary consumption and metabolic syndrome in adolescents. Sci Med. 2017;27:1-9. https://doi.org/10.15448/1980-6108.2017.1.25496 https://doi.org/10.15448/1980-6108.2017....	19.9 (15.52–24.82)	7.6 (4.89–11.21)	2.9 (1.37–5.58)	23.5 (18.84–28.70)	8.0 (5.16–11.59)	OB: 27.5
Pani et al.²⁵25 Pani VO, Cardoso LD, Paula H, Faria ER. Anthropometric and body composition variables as predictors of cardiovascular risk and metabolic syndrome in adolescents. Braspen J. 2017;32:259-67.	11.3	1.9	7.5	22.6	20.7	OW: 17.0 OB: 7.5
dos Santos et al.²⁶26 dos Santos MC, Coutinho AP, Dantas M, Yabunaka LA, Guedes DP, Oesterreich SA. Correlates of metabolic syndrome among young Brazilian adolescents population. Nutr J. 2018;17:66. https://doi.org/10.1186/s12937-018-0371-9 https://doi.org/10.1186/s12937-018-0371-...	15.3	8.8	5.1	25.2	6.6	LW: 6.6 ET: 67.5 OW:15.3 OB: 10.6
Reuter et al.²⁸28 Reuter CP, Burgos MS, Barbian CD, Renner JD, Franke SI, Mello ED. Comparison between different criteria for metabolic syndrome in schoolchildren from southern Brazil. Eur J Pediatr. 2018;177:1471-7. https://doi.org/10.1007/s00431-018-3202-2 https://doi.org/10.1007/s00431-018-3202-...	7.6	18.7	14.1	3.3	4.7	LW–ET: 72.2 OW: 16.6 OB: 11.2
Guilherme et al.²⁹29 Guilherme FR, Nascimento MA, Fernandes CA, Guilherme VR, Sntos SR, Elias RG, et al. Comparison of different criteria in the prevalence of metabolic syndrome in students from Paranavaí, Paraná. Rev Paul Pediatr. 2019;37:332-7. https://doi.org/10.1590/1984-0462/;2019;37;3;00007 https://doi.org/10.1590/1984-0462/;2019;...	Not informed	15.4	12.4	Not informed	Not informed	Not informed
Lustosa et al.³⁰30 Lustosa LC, Nascimento LM, Lavor LC, Gomes KR, Mascarenhas MD, Frota KM. Metabolic syndrome in adolescents and its association with diet quality. Rev Nutr. 2019;32:e180004. https://doi.org/10.1590/1678-9865201932e190004 https://doi.org/10.1590/1678-9865201932e...	11.9	5.2	18.6	50.5	4.3	LW: 2.5 ET: 80.7 OW: 12.5 OB: 4.3

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[1] *Corresponding author. E-mail: karlandradedeoliveira@yahoo.com.br (K. A. Oliveira).