INTRODUCTION: Canadian Aboriginal people have been disproportionately affected by obesity and type 2 diabetes (T2D). Our objective was to determine the prevalence of obesity, glucose intolerance and the components of metabolic syndrome (MetS) in Tsimshian Nation youth living in 3 remote coastal communities.METHODS: A medical history, anthropometric measurements and an oral glucose tolerance test were performed in youth aged 6-18 years. We defined "overweight" by a body mass index (BMI) at the 85th percentile or higher and "obese" by a BMI at the 95th percentile or higher, by age and sex. We used the International Diabetes Federation criteria for MetS.RESULTS: Of the 224 eligible youth, 192 (85%) participated in the study. Nineteen percent were overweight, 26% were obese and 36% had central obesity (waist circumference ¡Ý 90th percentile for age and sex). No new cases of T2D were identified. The prevalence of impaired fasting glucose (IFG 5.6¨C6.9 mmol/L) and impaired glucose tolerance (IGT 2-hr glucose 7.8¨C11.0 mmol/L) were 19.3% and 5.2%, respectively. Five of the 10 youth with IGT had a fasting glucose less than 5.6 mmol/L. The prevalence of MetS was 4.7% and increased to 8.3% when pediatric hypertension norms were applied.CONCLUSION: Tsimshian Nation youth have a high prevalence of central obesity, impaired glucose homeostasis and other components of MetS. The oral glucose tolerance test may be a more appropriate screening test to identify IGT in Aboriginal youth.