title: Construct validity of a continuous metabolic syndrome score in children.
abstract: OBJECTIVE
  The primary purpose of this study was to examine the construct validity of a continuous metabolic syndrome score (cMetS) in children. The secondary purpose was to identify a cutpoint value(s) for an adverse cMetS based on receiver operating characteristic (ROC) curve analysis.
  
  
  METHODS
  378 children aged 7 to 9 years were assessed for the metabolic syndrome which was determined by age-modified cutpoints. High-density-lipoprotein cholesterol, triglycerides, the homeostasis assessment model of insulin resistance, mean arterial pressure, and waist circumference were used to create a cMetS for each subject.
  
  
  RESULTS
  About half of the subjects did not possess any risk factors while about 5% possessed the metabolic syndrome. There was a graded relationship between the cMetS and the number of adverse risk factors. The cMetS was lowest in the group with no adverse risk factors (-1.59 +/- 1.76) and highest in those possessing the metabolic syndrome (> or =3 risk factors) (7.05 +/- 2.73). The cutoff level yielding the maximal sensitivity and specificity for predicting the presence of the metabolic syndrome was a cMetS of 3.72 (sensitivity = 100%, specificity = 93.9%, and the area of the curve = 0.978 (0.957-0.990, 95% confidence intervals).
  
  
  CONCLUSIONS
  The results demonstrate the construct validity for the cMetS in children. Since there are several drawbacks to identifying a single cut-point value for the cMetS based on this sample, we urge researchers to use the approach herein to validate and create a cMetS that is specific to their study population.
authors.affiliation: Departments of Kinesiology and Pediatrics & Human Development, Michigan State University, East Lansing, MI, USA. jce@msu.edu
authors.forename: Joey C
authors.initials: JC
authors.lastname: Eisenmann
authors.forename: Kelly R
authors.initials: KR
authors.lastname: Laurson
authors.forename: Katrina D
authors.initials: KD
authors.lastname: DuBose
authors.forename: Bryan K
authors.initials: BK
authors.lastname: Smith
authors.forename: Joseph E
authors.initials: JE
authors.lastname: Donnelly