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The diagnostic performance of anthropometric indicators of obesity that better predicts metabolic syndrome (MetS) risk in Nigerian adolescents is not clear. This study examined the diagnostic precision of body fat indicators that would better identify the risk of MetS in north central Nigerian adolescents, aged 11 to 19 years. This cross-sectional study comprised 206 adolescent boys (101) and girls (105) from Kogi East, North Central Nigeria. Participants were evaluated for five indices of body fat, fasting blood glucose, triglycerides, high density lipoprotein cholesterol and systolic blood pressure. Receiver operating characteristic curve (ROC) analysis was used to determine the predictive capacities of the body fat proxies to detect the risk of MetS. The prevalence of MetS was 5.8% (Girls=3.4%; Boys=2.4%). Waist circumference (WC), waist-to-height ratio (WHtR) and conicity index (C-index) had significant (p<0.001) areas under the curve (AUC), with WC (AUC: girls=91.7%; boys=91.3%) as the best body fat indicator for identifying risk of MetS in both sexes. Relative fat (%Fat) and body mass index (BMI) had no discriminatory capacities to detect MetS risk in participants. This study has demonstrated that WC is the best tool for identifying MetS risk in Nigerian adolescents, while WHtR and C-index are reasonable second and third choices, respectively. It is recommended that public health professionals should use WC for preliminary screening for risk of MetS in Nigerian adolescents prior to referral for confirmation and medical follow-up.
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