title: Stability of the factor structure of the metabolic syndrome across pubertal development: confirmatory factor analyses of three alternative models.
abstract: OBJECTIVE
  To test the fit and stability of 3 alternative models of the metabolic syndrome's factor structure across 3 developmental stages.
  
  
  METHODS
  With data from the Fels Longitudinal Study, confirmatory factor analyses tested 3 alternative models of the factor structure underlying relationships among 8 metabolic syndrome-associated risks. Models tested were a 1-factor model (A), a 4-factor model (B), and a second-order latent factor model (C). Developmental stages assessed were prepuberty (ages 8-10), puberty (ages 11-15), and postpuberty (ages 16-20).
  
  
  RESULTS
  Convergence was achieved for all developmental stages for model A, but the fit was poor throughout (root mean square error of approximation > 0.1). Standardized factor loadings for waist circumference and body mass index were much stronger than those for fasting insulin at all 3 time points. Although prepuberty and postpuberty models converged for models B and C, each model had problems with Heywood cases. The puberty model did not converge for either model B or C.
  
  
  CONCLUSIONS
  The hypothetical structures commonly used to support the metabolic syndrome concept do not provide adequate fit in a pediatric sample and may be variable by maturation stage. A components-based approach to cardiovascular risk reduction, with emphasis on obesity prevention and control, may be a more appropriate clinical strategy for children and youth than a syndromic approach.
authors.affiliation: Department of Pediatrics and Public Health, Floating Hospital for Children at Tufts Medical Center, Tufts University School of Medicine, Boston, MA 02111, USA. egoodman@tuftsmedicalcenter.org
authors.forename: Elizabeth
authors.initials: E
authors.lastname: Goodman
authors.forename: Chaoyang
authors.initials: C
authors.lastname: Li
authors.forename: Yu-Kang
authors.initials: YK
authors.lastname: Tu
authors.forename: Earl
authors.initials: E
authors.lastname: Ford
authors.forename: Shumei S
authors.initials: SS
authors.lastname: Sun
authors.forename: Terry T-K
authors.initials: TT
authors.lastname: Huang
mesh_terms: D000293:Adolescent; D041923:Adolescent Development / Q000502:physiology; D000367:Age Factors; D001786:Blood Glucose / Q000378:metabolism; D001794:Blood Pressure; D015992:Body Mass Index; D002318:Cardiovascular Diseases / Q000097:blood / Q000175:diagnosis* / Q000453:epidemiology*; D015984:Causality; D002648:Child; D008076:Cholesterol, HDL / Q000097:blood; D005163:Factor Analysis, Statistical; D005260:Female; D006801:Humans; D007328:Insulin / Q000097:blood; D008137:Longitudinal Studies; D008297:Male; D024821:Metabolic Syndrome / Q000097:blood / Q000175:diagnosis* / Q000453:epidemiology*; D008954:Models, Biological; D011627:Puberty / Q000502:physiology*; D012307:Risk Factors; D014280:Triglycerides / Q000097:blood; D055105:Waist Circumference; D055815:Young Adult
chemical_list: D001786:Blood Glucose; D008076:Cholesterol, HDL; D007328:Insulin; D014280:Triglycerides