OBJECTIVE: Although African American adolescents have the highest prevalence of 
obesity, they have the lowest prevalence of metabolic syndrome across all 
definitions used in previous research. To address this paradox, we sought to 
develop a model of the metabolic syndrome specific to African American 
adolescents.
RESEARCH DESIGN AND METHODS: Data from the National Health and Nutrition 
Examination Survey (2003-2010) of 822 nonpregnant, nondiabetic, African American 
adolescents (45% girls; aged 12 to 17 years) who underwent physical examinations 
and fasted at least 8 h were analyzed. We conducted a confirmatory factor 
analysis to model metabolic syndrome and then used latent profile analysis to 
identify metabolic syndrome risk groups among African American adolescents. We 
compared the risk groups on probability of prediabetes.
RESULTS: The best-fitting metabolic syndrome model consisted of waist 
circumference, fasting insulin, HDL, and systolic blood pressure. We identified 
three metabolic syndrome risk groups: low, moderate, and high risk (19% boys; 
16% girls). Thirty-five percent of both boys and girls in the high-risk groups 
had prediabetes, a significantly higher prevalence compared with boys and girls 
in the low-risk groups. Among adolescents with BMI higher than the 85th 
percentile, 48 and 36% of boys and girls, respectively, were in the high-risk 
group.
CONCLUSIONS: Our findings provide a plausible model of the metabolic syndrome 
specific to African American adolescents. Based on this model, approximately 19 
and 16% of African American boys and girls, respectively, are at high risk for 
having the metabolic syndrome.