Journal
DIABETOLOGIA
Volume 57, Issue 5, Pages 940-949Publisher
SPRINGER
DOI: 10.1007/s00125-014-3172-5
Keywords
Cardiovascular; Children; Confirmatory factor analysis; Metabolic syndrome; Metabolic syndrome score
Categories
Funding
- Ministry of Social Affairs and Health of Finland [1491/9.02.00/2009]
- Ministry of Education and Culture of Finland [121/627/2009, 722 and 627]
- Finnish Innovation Fund Sitra
- Social Insurance Institution of Finland [22/26/2008, 4/26/2010]
- Finnish Cultural Foundation
- Juho Vainio Foundation
- Foundation for Pediatric Research
- Kuopio University Hospital EVO [5031343]
- KIHD Study from the Academy of Finland [41471, 1041086, 2041022]
- Academy of Finland [167/722/96, 157/722/97, 156/722/98]
- Ministry of Education of Finland [HL44199]
- National Heart, Lung, and Blood Institute of the USA
- City of Kuopio
- Academy of Finland
- European Commission FP6 Integrated Project [LSHM-CT- 2004-005272]
- Paivikki and Sakari Sohlberg Foundation
- Finnish Diabetes Association
- Finnish Foundation for Cardiovascular Research
- Kuopio University Hospital
- [102318]
- [104943]
- [123885]
- [211119]
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Aims/hypothesis We validated the metabolic syndrome (MetS) score by confirmatory factor analysis (CFA) in children, middle-aged men, and older women and men and by investigating the relationships of the MetS score to incident type 2 diabetes, myocardial infarction, and cardiovascular and overall death in middle-aged men. Methods We assessed the core features of MetS, calculated the MetS score using z scores for waist circumference, insulin, glucose, triacylglycerols, HDL-cholesterol and blood pressure, and carried out CFA to investigate whether MetS represents a single entity in population samples of 491 children, 1,900 middle-aged men, 614 older women and 555 older men from Finland. We also followed-up incident type 2 diabetes for 11 years and other outcomes for 17-18 years in middle-aged men. Results We carried out second-order CFAs in which the MetS was represented by a second-order latent variable underlying four latent variables characterised by abdominal obesity, insulin resistance, dyslipidaemia and raised blood pressure in different age groups. These second-order factors and factors derived from first-order CFA using previously proposed models were strongly associated with a composite MetS score in all age groups (r=0.84-0.94) and similarly predicted type 2 diabetes, cardiovascular outcomes and mortality in middle-aged men. The risk of type 2 diabetes, myocardial infarction, cardiovascular death and overall death increased 3.67-, 1.38-, 1.56- and 1.44-fold, respectively, for a 1 SD increase in the MetS score. Conclusions The MetS can be described as a single entity in all age groups. The MetS score is a valid tool for research evaluating cardiometabolic risk in different age groups. Further research is needed to define cut-off points for risk estimation in clinical practice.
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