Background Obesity is an important pediatric public health problem associated with increased risk of many complications in childhood and increased morbidity and mortality throughout adult life.

Aim of Study o assess the prevalence of Metabolic Syndrome in obese children and the relationship between Metabolic Syndrome and Body mass index (BMI), sex, age and family risk factors like obesity, hypertension, diabetes mellitus and cardiovascular disease

Methods An analytic cross-sectional study was conducted in 178 overweight and obese children and adolescents aged 5-16 years old seen at the General Pediatric Clinic of the Tishreen University Hospital between March 2020 and February 2021. Weight, high, waist Circumference and blood pressure were measured. Blood samples were taken after 12 hours fasting and fasting blood glucose (FBG), total cholesterol (T Cho), high- density lipoprotein cholesterol (HDL) and low- density lipoprotein cholesterol (LDL) were measured. The Metabolic Syndrome MS was diagnosed based on pediatric and adolescent criteria adapted from the National Cholesterol Education Program Third Adult Treatment Panel (NCEP-ATP III) definition.

Results A total of 178 children, 82 males (46.1%) and 96 females (53.9%) with mean age 9.9±2.5 SD were in our study. Out of the 178 children, 62 (34.8%) were overweight, 101 (56.7%) obese and 15 (8.4%) were severe obese. According to the NCEP ATP III, (32.6%) out of (178) children were diagnosed with MS. Among children with MS, most components of MS were increased waist circumference WC (93.1%), increased TG (86.2%), reduced HDL (51.7%), increased BP (50%) and increased FBS (25.9%). MS prevalence was 12.9%, 36.6%, 86.7% in overweight, obese and severe obese children respectively

Conclusion(s) Our study showed a high prevalence of Metabolic Syndrome in obese children and increased prevalence with increased BMI values. Central obesity and dyslipidemia were the most important risk factors for MS among children. MS prevalence was significantly higher in children with positive family risk factors like obesity, hypertension, diabetes mellitus and cardiovascular disease. Strong measures should be done to reduce obesity prevalence in children. Early diagnosis of MS and identifying risk factors in children (silent phase) and early intervention may help controlling MS and its complications..