Stability of the factor structure of the metabolic syndrome across pubertal development: confirmatory factor analyses of three alternative models.
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.
Goodman
Elizabeth
E
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
Li
Chaoyang
C
Tu
Yu-Kang
YK
Ford
Earl
E
Sun
Shumei S
SS
Huang
Terry T-K
TT
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
D001786:Blood Glucose; D008076:Cholesterol, HDL; D007328:Insulin; D014280:Triglycerides