Validity of a Single-Factor Model Underlying the Metabolic Syndrome in Children

Abstract

OBJECTIVEWe used confirmatory factor analysis to test whether a single factor might explain the clustering of the metabolic syndrome (MS) components in children.RESEARCH DESIGN AND METHODSWe studied 1,020 children aged 10–13 years from 20 schools in Cuenca, Spain. The single-factor model included: waist circumference (WC), fasting insulin, triglyceride to HDL cholesterol ratio (Triglyl/HDL-C), and mean arterial pressure (MAP). The standardized scores of the four variables in the model were used to develop a continuous MS index.RESULTSFactor loadings were 0.67 for WC, 0.68 for fasting insulin, 0.57 for Triglyl/HDL-C, and 0.37 for MAP. The single-factor model also showed a good fit to the data. As compared with Adult Treatment Panel III criteria, the MS index showed strong validity in the diagnosis of MS (area under the receiver operating characteristic curve = 0.98, 95% CI 0.96–0.99).CONCLUSIONSA single underlying factor has acceptable validity to represent MS in children.

Bicycling to school is associated with improvements in physical fitness over a 6-year follow-up period in Swedish children

“…The mean arterial pressure (MAP) was calculated: diastolic blood pressure+ [0.333 × (systolic blood pressure-diastolic blood pressure)]. The cardiometabolic risk score was calculated as the sum of the age-sex standardized scores (insulin, waist circumference, TG/HDLc, and MAP) multiplied by their loadings in a factorial model validated in children and adolescents from Spain, Sweden, and Estonia (Martínez-Vizcaino et al, 2010.…”

Health Inequalities in Urban Adolescents: Role of Physical Activity, Diet, and Genetics

“…Mean arterial pressure was calculated. 30 We computed 2 well-established cardiometabolic risk scores (gender-and age-specific z scores) to be used in the main analyses, as proposed by Andersen et al 31 and Martínez-Vizcaino et al 32,33 See the biomarkers included in each score in the legend to Table 2. For sensitivity analyses, we selected these 2 risk scores, which largely differ from each other in the risk factors included (eg, markers of total versus abdominal fatness, homeostasis model assessment index versus fasting insulin, etc, for the Andersen's versus Martinez-Vizcaino scores, respectively).…”

“…The cardiometabolic risk score 1 is an average value computed from the gender-and age-specific z scores of the sum of 4 skinfolds, homoeostasis model assessment index, systolic blood pressure, triglyceride, total cholesterol/HDL ratio, and cardiorespiratory fitness (VO 2max ; this score was inverted by multiplying by -1) 31 ; the score 2 is an average value computed from the gender-and age-specific z scores of waist circumference, fasting insulin, triglyceride/HDL cholesterol ratio, and mean arterial pressure. 32,33 any marked extent for any of the confounders considered.…”

Clustering of Metabolic Risk Factors Is Associated with High-Normal Levels of Liver Enzymes Among 6- to 8-Year-Old Children: The PANIC Study

“…[3][4][5] Clustering of risk factors tracks from early childhood into adulthood 6 and may predict adulthood metabolic syndrome, type 2 diabetes, and cardiovascular disease. 7,8 Thus, there is an urgent need to better understand the pathophysiology and determinants of risk factor clustering in childhood.…”