A single factor underlies the metabolic syndrome: a confirmatory factor analysis.
OBJECTIVE
Confirmatory factor analysis (CFA) was used to test the hypothesis that the components of the metabolic syndrome are manifestations of a single common factor.


METHODS
Three different datasets were used to test and validate the model. The Spanish and Mauritian studies included 207 men and 203 women and 1,411 men and 1,650 women, respectively. A third analytical dataset including 847 men was obtained from a previously published CFA of a U.S. population. The one-factor model included the metabolic syndrome core components (central obesity, insulin resistance, blood pressure, and lipid measurements). We also tested an expanded one-factor model that included uric acid and leptin levels. Finally, we used CFA to compare the goodness of fit of one-factor models with the fit of two previously published four-factor models.


RESULTS
The simplest one-factor model showed the best goodness-of-fit indexes (comparative fit index 1, root mean-square error of approximation 0.00). Comparisons of one-factor with four-factor models in the three datasets favored the one-factor model structure. The selection of variables to represent the different metabolic syndrome components and model specification explained why previous exploratory and confirmatory factor analysis, respectively, failed to identify a single factor for the metabolic syndrome.


CONCLUSIONS
These analyses support the current clinical definition of the metabolic syndrome, as well as the existence of a single factor that links all of the core components.
Pladevall
Manel
M
Henry Ford Health System, Center for Health Services Research, One Ford Place, Suite 3A, Detroit, Michigan 48202, USA. mpladev1@hfhs.org
Singal
Bonita
B
Williams
L Keoki
LK
Brotons
Carlos
C
Guyer
Heidi
H
Sadurni
Josep
J
Falces
Carles
C
Serrano-Rios
Manuel
M
Gabriel
Rafael
R
Shaw
Jonathan E
JE
Zimmet
Paul Z
PZ
Haffner
Steven
S
D001794:Blood Pressure; D015992:Body Mass Index; D049628:Body Size; D003430:Cross-Sectional Studies; D016208:Databases, Factual; D005260:Female; D006801:Humans; D007333:Insulin Resistance; D008075:Lipoproteins, HDL / Q000097:blood; D008297:Male; D008436:Mauritius; D024821:Metabolic Syndrome / Q000209:etiology*; D015233:Models, Statistical; D013030:Spain; D014280:Triglycerides / Q000097:blood
D008075:Lipoproteins, HDL; D014280:Triglycerides