A single factor underlies the metabolic syndrome: a confirmatory factor analysis

Area of Science:

• Cardiology
• Endocrinology
• Metabolic Health

Background:

• The metabolic syndrome is a cluster of conditions that increase the risk of heart disease, stroke, and type 2 diabetes.
• Previous research has yielded conflicting results regarding whether the components of metabolic syndrome represent a single underlying factor or multiple distinct factors.

Purpose of the Study:

• To test the hypothesis that the components of the metabolic syndrome are manifestations of a single common factor using confirmatory factor analysis (CFA).
• To compare the goodness of fit of one-factor models with previously published four-factor models.

Main Methods:

• Confirmatory factor analysis (CFA) was performed on three independent datasets (Spanish, Mauritian, and U.S. populations).
• One-factor models incorporating core metabolic syndrome components (central obesity, insulin resistance, blood pressure, lipid measurements) were tested.
• Expanded models including uric acid and leptin were also evaluated.
• Model fit was compared against previously published four-factor models.

Main Results:

• The simplest one-factor model demonstrated excellent goodness-of-fit indexes (CFI=1, RMSEA=0.00) across all datasets.
• One-factor models consistently showed a better fit than four-factor models.
• Model specification and variable selection were identified as reasons for previous failures to detect a single factor.

Conclusions:

• The findings support the current clinical definition of the metabolic syndrome.
• Evidence suggests a single underlying factor connects all core components of the metabolic syndrome.