INTRODUCTION: Metabolic syndrome is increasing among adolescents. We examined 
the utility of body mass index (BMI) and waist circumference to identify 
metabolic syndrome in adolescent girls.
METHODS: We conducted a cross-sectional analysis of 185 predominantly African 
American girls who were a median age of 14 years. Participants were designated 
as having metabolic syndrome if they met criteria for 3 of 5 variables: 1) high 
blood pressure, 2) low high-density lipoprotein cholesterol level, 3) high 
fasting blood glucose level, 4) high waist circumference, and 5) high 
triglyceride level. We predicted the likelihood of the presence of metabolic 
syndrome by using previously established cutpoints of BMI and waist 
circumference. We used stepwise regression analysis to determine whether 
anthropometric measurements significantly predicted metabolic syndrome.
RESULTS: Of total participants, 18% met the criteria for metabolic syndrome. BMI 
for 118 (64%) participants was above the cutpoint. Of these participants, 25% 
met the criteria for metabolic syndrome, whereas only 4% of participants with a 
BMI below the cutpoint met the criteria for metabolic syndrome (P <.001). Girls 
with a BMI above the cutpoint were more likely than girls with a BMI below the 
cutpoint to have metabolic syndrome (P = .002). The waist circumference for 104 
(56%) participants was above the cutpoint. Of these participants, 28% met the 
criteria for metabolic syndrome, whereas only 1% of participants with a waist 
circumference below the cutpoint met the criteria for metabolic syndrome (P 
<.001). Girls with a waist circumference above the cutpoint were more likely 
than girls with a waist circumference below the cutpoint to have metabolic 
syndrome (P = .002). Stepwise regression showed that only waist circumference 
significantly predicted metabolic syndrome.
CONCLUSION: Both anthropometric measures were useful screening tools to identify 
metabolic syndrome. Waist circumference was a better predictor of metabolic 
syndrome than was BMI in our study sample of predominantly African American 
female adolescents living in an urban area.