Which metabolic syndrome criteria best predict non-alcoholic fatty liver disease in children?

  • Mehmet Emre Atabek
  • Beray Selver Eklioglu
  • Nesibe Akyürek
Original Article



The aim of this study was to identify which metabolic syndrome criteria (WHO or IDF) better reflect the presence of non-alcoholic fatty liver disease (NAFLD) and to determine the prevalence of metabolic syndrome (MS) and NAFLD.


Two hundred and seventeen obese children and adolescents, 8–15 years of age (body mass index >95 p), were included in the study. Anthropometric measurements, blood pressure measurements, an oral glucose tolerance test and lipid profile were measured. MS was diagnosed according to WHO and IDF criteria. NAFLD risk ratio was assessed according to the two MS criteria.


The prevalence of MS according to the IDF criteria was 43.3 %, and according to WHO criteria it was 55.2 %. NAFLD prevalence in the metabolic syndrome group according to IDF criteria was 25.5 % and this was statistically significant (p = 0.007). The prevalence of NAFLD was 20.8 % in the group with MS according to WHO criteria and this was not a statistically significant difference (p = 0.15). NAFLD hazard ratios were 7.06 (95 % CI 1.29–5.50) in the MS group according to IDF criteria and 2.02 (95 % CI 0.81–3.53) in the group with metabolic syndrome according to WHO criteria. IDF criteria were found to have a higher odds ratio.


The prevalence of MS depends on the diagnostic criteria used. IDF criteria give the best measure for the presence of NAFLD. NAFLD might be important as diagnostic criterion for MS.


Obesity Metabolic syndrome Non-alcoholic fatty liver disease Children 



Metabolic syndrome


Insulin resistance


Non-alcoholic fatty liver disease


Body mass index


Waist circumference


Oral glucose tolerance test


Low-density lipoprotein


High-density lipoprotein


Homeostasis model assessment of insulin resistance


World Health Organization criteria adapted for children


International Diabetes Federation


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Copyright information

© Springer International Publishing Switzerland 2014

Authors and Affiliations

  • Mehmet Emre Atabek
    • 1
  • Beray Selver Eklioglu
    • 1
  • Nesibe Akyürek
    • 1
  1. 1.Necmettin Erbakan University, School of Medicine, Department of Pediatrics, Division of Pediatric Endocrinology and DiabetesKonyaTurkey

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