Cross-sectional association of fitness, fatness, and dyslipidemia with metabolic syndrome in youth.

Background: The prevalence of metabolic syndrome (MetS) in adolescents is rising, correlating with the global increase in obesity and physical inactivity.

Aim: To examine the individual and combined associations of fitness, fatness, visceral adiposity index (VAI), and lipid ratios with MetS risk in Nigerian adolescents.

Methods: This cross-sectional study included a sample of 403 adolescents (201 girls and 202 boys) aged 11-19 years. Participants were assessed for cardiorespiratory fitness, body mass index (BMI), VAI, triglyceride-to-high-density lipoprotein cholesterol ratio (TG/HDL-C), and total cholesterol-to-high-density lipoprotein cholesterol ratio (TC/HDL-C). Regression models adjusted for age and sexual maturity were used to determine the associations between these health markers and MetS risk.

Results: Among the 177 high-risk adolescents, 56.6% were at risk of central obesity, 49.1% had low fitness, 33.3% had dyslipidemia, and 11.7% were obese. After controlling for confounding variables, all health markers were independently and jointly associated with MetS risk, with VAI displaying the strongest explanatory power (girls: β = 1.308, P < 0.001; boys: β = 2.300, P < 0.001). Unfit girls were 5.1% more likely to be at risk of MetS, while the odds of unfit boys being at risk of MetS is 3.6. Boys with elevated VAI were 22.3 times more likely to be at risk of MetS, while the likelihood of girls with elevated VAI developing MetS risk is 2.78.

Conclusion: Health markers were independently and jointly associated with MetS risk in adolescents, with VAI and dyslipidemia contributing most significantly. Promoting healthy eating and also aerobic activities among adolescents is crucial for improving metabolic health.