Although metabolic syndrome (MetS) has become a significant public health problem worldwide, little evidence exists to describe the prevalence of MetS in school children using MetS different classifications, and its association with health-related behaviors. Using data on 393 children and adolescents aged 13-16 years participating in the Ubon Ratchathani Metabolic Syndrome in Adolescent (UMeSIA) Project, the prevalence of MetS was determined using the International Diabetes Federation (IDF) 2007 definition and other three classifications reported in the previous literature. The prevalence of the MetS was compared across sex, a family history of diabetes, type of schools, and health behaviors using chi-square test. The prevalence of MetS and proportion of abnormalities in MetS components were compared across different MetS classifications using Cochran Q test. The prevalence of MetS in Thai school children was 3.1%, 5.8%, 6.9%, and 11.2% when using IDF, Cook's, Ford's, and De Ferranti's classifications respectively (Difference in MetS prevalence across the four MetS classifications, P < 0.001). Using IDF classification, prevalence was higher in male than female students (5.9% and 1.2%, respectively, P < 0.001) and higher in those with a family history of diabetes than those without (8.5% and 2.3%, respectively, P < 0.001). Students from a sports school had considerably lower MetS prevalence than those from conventional schools (1.9% and 3.5% respectively, P < 0.001). Those with MetS spent significantly longer time watching TV than those without (median (interquartile range) time to watch TV 180.0 (120.0, 240.0) and 120.0 (60.0, 180.0) min per day respectively, P = 0.002). The prevalence of MetS in Thai school children was modest and varied greatly when different MetS definitions were applied. Interventions to optimize time spent watching TV and increase physical activity may be beneficial in reducing the risk of the MetS in children and adolescents.
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