To assess the relationship between fat mass percentage (
FMP) and
glucose metabolism in children aged 0−18 years we performed a systematic review of the literature on Medline/PubMed, SinoMed, Embase and Cochrane Library using the
PRISMA 2020 guidelines up to 12 October 2021 for observational studies that assessed the relationship of
FMP and
glucose metabolism. Twenty studies with 18,576 individuals were included in the meta-analysis. The results showed that
FMP was significantly associated with fasting plasma
glucose (FPG) (r = 0.08, 95% confidence interval (CI): 0.04−0.13, p < 0.001), fasting plasma
insulin (INS) (r = 0.48, 95% CI: 0.37−0.57, p < 0.001), and homeostasis model assessment (HOMA)-
insulin resistance (IR) (r = 0.44, 95% CI: 0.33−0.53, p < 0.001). The subgroup analysis according to country or
overweight and
obesity indicated that these associations remained significant between
FMP and INS or HOMA-IR. Our results demonstrated that there is a positive relationship between
FMP and FPG. Moreover, subgroup analysis according to country or
overweight and
obesity indicated that
FMP is significantly associated with INS and HOMA-IR. This is the first known systematic review and meta-analysis to determine the associations of
FMP with
glucose metabolism in children and adolescents.