Research Article A New Approach to Define and Diagnose Cardiometabolic Disorder in Children Lars Bo Andersen, 1,2 Jeppe Bo Lauersen, 2 Jan Christian Brønd, 1 Sigmund Alfred Anderssen, 2 Luis B. Sardinha, 3 Jostein Steene-Johannessen, 2 Robert G. McMurray, 4 Mauro V. G. Barros, 5 Susi Kriemler, 6 Niels Christian Møller, 1 Anna Bugge, 1 Peter Lund Kristensen, 1 Mathias Ried-Larsen, 1,7 Anders Grøntved, 1 and Ulf Ekelund 2,8 1 Center of Research in Childhood Health, Department of Sport Sciences and Clinical Biomechanics, University of Southern Denmark, Campusvej 55, 5230 Odense M, Denmark 2 Department of Sports Medicine, Norwegian School of Sport Sciences, Sognsveien 220, 0806 Oslo, Norway 3 Exercise and Health Laboratory, CIPER, Fac Motricidade Humana, Universidade de Lisboa, Estrada Dacosth, Cruz-Quebrada, 1499 Lisbon, Portugal 4 Department of Exercise and Sport Science, University of North Carolina, 025 Fetzer Gym, CB No. 8700, Chapel Hill, NC 27599-8700, USA 5 School of Physical Education, University of Pernambuco, Campus Universitario HUOC-ESEF, Arnobio Marques 310, Santo Amaro, 50.100-130 Recife, PE, Brazil 6 Epidemiology, Biostatistics and Prevention Institute, University of Z¨ urich, Hirschengraben 84, 8001 Z¨ urich, Switzerland 7 he Centre of Inlammation and Metabolism and Trygfondens Center for Aktiv Sundhed, Department of Infectious Diseases and CMRC, Rigshospitalet, Faculty of Health Sciences, University of Copenhagen, Tagensvej 20, 2100 Copenhagen, Denmark 8 MRC Epidemiology Unit, Institute of Metabolic Science, Addenbrooke’s Hospital, University of Cambridge, Hills Road, Cambridge CB2 0QQ, UK Correspondence should be addressed to Lars Bo Andersen; lboandersen@health.sdu.dk Received 26 November 2014; Accepted 17 March 2015 Academic Editor: Francesco Chiarelli Copyright © 2015 Lars Bo Andersen et al. his is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. he aim of the study was to test the performance of a new deinition of metabolic syndrome (MetS), which better describes metabolic dysfunction in children. Methods. 15,794 youths aged 6–18 years participated. Mean z-score for CVD risk factors was calculated. Sensitivity analyses were performed to evaluate which parameters best described the metabolic dysfunction by analysing the score against independent variables not included in the score. Results. More youth had clustering of CVD risk factors (>6.2%) compared to the number selected by existing MetS deinitions (International Diabetes Federation (IDF) < 1%). Waist circumference and BMI were interchangeable, but using insulin resistance homeostasis model assessment (HOMA) instead of fasting glucose increased the score. he continuous MetS score was increased when cardiorespiratory itness (CRF) and leptin were included. A mean z-score of 0.40–0.85 indicated borderline and above 0.85 indicated clustering of risk factors. A noninvasive risk score based on adiposity and CRF showed sensitivity and speciicity of 0.85 and an area under the curve of 0.92 against IDF deinition of MetS. Conclusions. Diagnosis for MetS in youth can be improved by using continuous variables for risk factors and by including CRF and leptin. 1. Introduction Metabolic syndrome (MetS) was irst described by Reaven in the mid 1980s [1]. MetS is a conceptual framework, which links several apparently unrelated biological events into a sin- gle pathophysiological assemble; that is, several cardiovascu- lar disease (CVD) risk factors seemed to be increased simul- taneously in some individuals. Despite diferent deinitions Hindawi Publishing Corporation Journal of Diabetes Research Volume 2015, Article ID 539835, 10 pages http://dx.doi.org/10.1155/2015/539835