Prevalence of metabolic syndrome among adolescents in Cape Town, South Africa: a cross-sectional analysis comparing five diagnostic criteria to explore suitability

Our results underscore the need for locally validated, population-specific MetS criteria and diagnostic thresholds to support early identification of adolescents at risk of cardiometabolic disease (CMD). In the absence of such criteria, the Cook and Ford definitions appear particularly suitable for identifying MetS among South African adolescents, while the Agudelo definition is appropriate when waist circumference (WC) measures are unavailable. Finally, our findings reveal a concerning CMD risk profile among adolescents in Cape Town, South Africa, with a particularly high burden observed in females.