Zhao M, Caserta CA, Medeiros CCM, et al. - Since there still exists controversy regarding the clinical utility of screening for pediatric metabolic syndrome (MetS) in children and adolescents, therefore, researchers assessed pediatric MetS vs clustering of cardiovascular risk factors (which are the components of MetS), in terms of performance for predicting high carotid intima–media thickness (cIMT) among children and adolescents. From population-based studies in Brazil, China, and Italy, a total of 2,427 children and adolescents (aged 6–17 years) were included. Slowly rising odds of high cIMT were noted in relation to the presence of one, two or at least three cardiovascular risk factors (applying the National Cholesterol Education Program Adult Treatment Panel III criteria) vs none. Overall, a markedly better prediction of high cIMT was afforded by a graded score based on five cardiovascular risk factors (used to define MetS), vs MetS, among children and adolescents. The clinical utility of MetS for screening youth at elevated cardiovascular risk was not supported by the findings.