BackgroundComparing body fat and the effect of body fat on metabolic abnormalities in Chinese and USA teenagers may provide clues for the early prevention and control of cardiovascular disease (CVD). We aimed to compare the prevalence of glucose and lipid metabolism abnormalities, body fat amount and distribution, and the effect of body fat on glucose and lipid metabolism in Chinese and US teenagers.MethodsWe included 5424 Chinese teenagers (48.5% male) from the China Child and Adolescent Cardiovascular Health (CCACH) study and 8704 USA teenagers (55.6% male) from the USA National Health and Nutrition Examination Survey (NHANES). Blood lipid, blood glucose, and body fat indicators were obtained using the same standardised measurements.ResultsThe prevalence of dyslipidaemia in Chinese teenagers was of those in the USA (hypercholesterolaemia = 3.5% vs 7.4%; high low-density lipoprotein cholesterol (LDL-C) = 3.6% vs 5.0%; low high-density lipoprotein cholesterol (HDL-C) = 9.9% vs 14.3%; hypertriglyceridaemia = 3.7% vs 10.1%) (P< 0.05). However, with the increase in body mass index (BMI), the prevalence of high LDL-C increased more in Chinese than in US teenagers, even exceeding them in the obese group (2.7% in non-overweight to 9.7% in overweight group in China,P< 0.05; 3.5% in non-overweight to 6.5% in the obese group in the USA,P< 0.05). The prevalence of impaired fasting glucose was higher in China than in the USA (28.0% vs 17.5%,P< 0.05). Besides, Chinese adolescents are more likely to accumulate fat in the abdomen, and the per-unit fat increase would bring a higher risk of dyslipidaemia in Chinese boys than in USA boys.ConclusionsDyslipidaemia was more prevalent in US teenagers than in Chinese teenagers, but with the increase in BMI, the prevalence of high LDL-C increased more in Chinese than in US teenagers. Impaired fasting glucose (IFG) was significantly more prevalent in China than in the USA. The unfavoured body fat and higher risk of body fat on metabolic disorders in Chinese teenagers suggest that Chinese teenagers should pay more attention to the adverse effect of body fat on metabolic abnormalities.