PMID- 24290837
OWN - NLM
STAT- MEDLINE
DCOM- 20140307
LR  - 20221207
IS  - 1532-8600 (Electronic)
IS  - 0026-0495 (Print)
IS  - 0026-0495 (Linking)
VI  - 63
IP  - 2
DP  - 2014 Feb
TI  - An examination of sex and racial/ethnic differences in the metabolic syndrome 
      among adults: a confirmatory factor analysis and a resulting continuous severity 
      score.
PG  - 218-25
LID - S0026-0495(13)00338-7 [pii]
LID - 10.1016/j.metabol.2013.10.006 [doi]
AB  - OBJECTIVE: The metabolic syndrome (MetS) is typically diagnosed based on 
      abnormalities in specific clustered clinical measures that are associated with 
      increased risk for coronary heart disease (CHD) and Type 2 diabetes mellitus 
      (T2DM). However, current MetS criteria result in racial/ethnic discrepancies. Our 
      goals were to use confirmatory factor analysis (CFA) to delineate differential 
      contributions to MetS by sub-group, and if contributions were discovered, develop 
      sex and racial/ethnic-specific equations to calculate MetS severity. RESEARCH 
      DESIGN AND METHODS: Using data on adults from the National Health and Nutrition 
      Examination Survey 1999-2010, we performed a CFA of a single MetS factor that 
      allowed differential loadings across groups, resulting in a sex and 
      race/ethnicity-specific continuous MetS severity score. RESULTS: Loadings to the 
      single MetS factor differed by sub-group for each MetS component (p<0.001), with 
      lower factor loadings among non-Hispanic-blacks for triglycerides and among 
      Hispanics for waist circumference. Systolic blood pressure exhibited low factor 
      loadings among all groups. MetS severity scores were correlated with biomarkers 
      of future disease (high-sensitivity C-reactive-protein, uric acid, insulin 
      resistance). Non-Hispanic-black-males with diabetics had a low prevalence of MetS 
      but high MetS severity scores that were not significantly different from other 
      racial/ethnic groups. CONCLUSIONS: This analysis among adults uniquely 
      demonstrated differences between sexes and racial/ethnic groups regarding 
      contributions of traditional MetS components to an assumed single factor. The 
      resulting equations provide a clinically-accessible and interpretable continuous 
      measure of MetS for potential use in identifying adults at higher risk for 
      MetS-related diseases and following changes within individuals over time. These 
      equations hold potential to be a powerful new outcome for use in MetS-focused 
      research and interventions.
CI  - (c) 2013.
FAU - Gurka, Matthew J
AU  - Gurka MJ
AD  - Department of Biostatistics, School of Public Health, West Virginia University, 
      Morgantown, West Virginia. Electronic address: mgurka@hsc.wvu.edu.
FAU - Lilly, Christa L
AU  - Lilly CL
AD  - Department of Biostatistics, School of Public Health, West Virginia University, 
      Morgantown, West Virginia.
FAU - Oliver, M Norman
AU  - Oliver MN
AD  - Department of Family Medicine, School of Medicine, University of Virginia, 
      Charlottesville, Virginia.
FAU - DeBoer, Mark D
AU  - DeBoer MD
AD  - Department of Pediatrics, School of Medicine, University of Virginia, 
      Charlottesville, Virginia.
LA  - eng
GR  - R21 DK085363/DK/NIDDK NIH HHS/United States
GR  - U54 GM104942/GM/NIGMS NIH HHS/United States
GR  - 5K08HD060739-03/HD/NICHD NIH HHS/United States
GR  - U54GM104942/GM/NIGMS NIH HHS/United States
GR  - K08 HD060739/HD/NICHD NIH HHS/United States
GR  - 1R21DK085363/DK/NIDDK NIH HHS/United States
PT  - Journal Article
PT  - Research Support, N.I.H., Extramural
DEP - 20131024
PL  - United States
TA  - Metabolism
JT  - Metabolism: clinical and experimental
JID - 0375267
RN  - 0 (Triglycerides)
SB  - IM
MH  - Adult
MH  - Black or African American/*statistics & numerical data
MH  - Factor Analysis, Statistical
MH  - Female
MH  - Hispanic or Latino/*statistics & numerical data
MH  - Humans
MH  - Insulin Resistance
MH  - Male
MH  - Metabolic Syndrome/blood/*diagnosis/*ethnology
MH  - Middle Aged
MH  - Nutrition Surveys
MH  - *Severity of Illness Index
MH  - Sex Factors
MH  - Triglycerides/blood
MH  - United States/epidemiology
MH  - Waist Circumference
MH  - White People/*statistics & numerical data
PMC - PMC4071942
MID - NIHMS535223
OTO - NOTNLM
OT  - AIC
OT  - ATP-III
OT  - AUC
OT  - Adult Treatment Panel III
OT  - Akaike's Information Criteria
OT  - Area under the curve
OT  - Bentler-Bonett Normed Fit Index
OT  - CDC
OT  - CFA
OT  - CHD
OT  - CHF
OT  - CVD
OT  - Cardiovascular disease
OT  - Centers for Disease Control
OT  - Clinical studies
OT  - Confirmatory Factor Analysis
OT  - Congestive heart failure
OT  - Coronary heart disease
OT  - Epidemiology
OT  - GFI
OT  - Goodness of Fit Index
OT  - HOMA-IR
OT  - High-sensitivity C-reactive protein
OT  - Hisp
OT  - Hispanic
OT  - Homeostasis model of insulin resistance
OT  - MI
OT  - MetS
OT  - Metabolic syndrome
OT  - Myocardial infarction
OT  - NFI
OT  - NHANES
OT  - NHB
OT  - NHW
OT  - National Health and Nutrition Examination Survey
OT  - Non-Hispanic Black
OT  - Non-Hispanic White
OT  - Obesity
OT  - RMSEA
OT  - ROC
OT  - Racial/ethnic differences
OT  - Receiver operating characteristic
OT  - Root Mean Square Error of Approximation
OT  - SBP
OT  - SRMR
OT  - Standardized Root Mean Square Residual
OT  - Systolic blood pressure
OT  - T2DM
OT  - Type 2 diabetes mellitus
OT  - WC
OT  - Waist circumference
OT  - hsCRP
COIS- Disclosure statement: The authors have no conflicts of interest.
EDAT- 2013/12/03 06:00
MHDA- 2014/03/08 06:00
PMCR- 2015/02/01
CRDT- 2013/12/03 06:00
PHST- 2013/07/02 00:00 [received]
PHST- 2013/09/24 00:00 [revised]
PHST- 2013/10/15 00:00 [accepted]
PHST- 2013/12/03 06:00 [entrez]
PHST- 2013/12/03 06:00 [pubmed]
PHST- 2014/03/08 06:00 [medline]
PHST- 2015/02/01 00:00 [pmc-release]
AID - S0026-0495(13)00338-7 [pii]
AID - 10.1016/j.metabol.2013.10.006 [doi]
PST - ppublish
SO  - Metabolism. 2014 Feb;63(2):218-25. doi: 10.1016/j.metabol.2013.10.006. Epub 2013 
      Oct 24.