Derivation and validation of sex-specific continuous metabolic syndrome scores for the Mexican adult population

Abstract

Traditionally the diagnosis of Metabolic syndrome (MetS) is binary (present/absent). The goal of this work is to propose a sex-specific continuous score to measure the severity of MetS in Mexican adults using waist circumference and body mass index as adiposity measures. MetSx-WC and MetSx-BMI indexes by sex were derived by confirmatory factor analysis (CFA) using data for 6567 adult participants of the National Health and Nutrition Survey 2018. The overall fit of the two proposed CFA models was excellent. We then validated these scores using a community-based health study of 862 university participants and determined that the reliability and strength of agreement between the MetSx-WC and MetSx-BMI scores were excellent. The ROC analysis of the resulting indexes indicates that they have excellent ability to discriminate a MetS classification according to the different criteria. The correlations of MetSx scores and surrogate markers of insulin resistance and obesity ranged from weak to strong. Subsequently, a retrospective study of 310 hospitalized patients with COVID-19 was used to determined that MetSx-BMI score was associated with the mortality of patients with COVID-19. The proposed indices provide a continuous measure in the identification of MetS risk in Mexican adults.

Development and validation of a continuous metabolic syndrome severity score in the Tehran Lipid and Glucose Study

“…Developed models from studies in Iran, Korea, and the USA were approximately similar in terms of fit indices values 11 , 12 . Although the studies conducted in Mexico 14 and Singapore 13 showed higher fit indices, they were limited by not excluding participants with CVD as the MetS endpoint, and those on antihypertensive, antihyperlipidemic, and anti-diabetic medications as the important confounders. Moreover, the MetS severity score in the Mexican population was developed using the international diabetes federation (IDF) MetS definition, with assumption of MetS-WC (MetS-waist circumference) and not MetS as the latent variable, making it different in the design.…”

“…With the use of confirmatory factor analysis (CFA), Gurka et al 11 took a step further by considering the correlation of these components as an indicator of the underlying processes involved in MetS, as well as the variation of this correlation by sex (male/female) and race (Hispanic, Non-Hispanic Black, and Non-Hispanic White). MetS severity scores were previously developed using CFA in the American (White, Hispanic, Black races), Korean, Mexican, and Singaporean adults 11 – 14 . However, no MetS severity score has been created for the adult population in Western Asia.…”

Comparison of the ability of HOMA-IR, VAI, and TyG indexes to predict metabolic syndrome in children with obesity: a cross-sectional study

“…In addition, some studies have suggested that TyG is a better indicator than VAI also in adults. [ 32 , 46 ]. Nevertheless, it should be taken into account that in studies that indicate that VAI or Tyg is a superior predictor, the male/female ratio of participants may have affected the results.…”