A confirmatory factor analysis evaluation of the coronary heart disease risk factors of metabolic syndrome with emphasis on the insulin resistance factor.

AIM: The goals of this study were: (1) to analyse the underlying associations between coronary risk factors and the metabolic syndrome and (2) to evaluate the construct validity of the variables used to measure each factor.
METHODS: The subjects were from a previously studied cohort of 284 middle-aged Caucasian males from Goteborg, Sweden, who were selected from the National Population Register. A confirmatory factor analysis was performed using EQS Multivariate Software Version 5.7b with maximum likelihood estimation. Hypertension, obesity, insulin resistance and hyperlipidaemia were the latent factors hypothesized.
RESULTS: The final, four-factor model showed good fit, with significant intercorrelations noted between all factors. The highest correlations were noted between the insulin resistance factor and the obesity factor (r = 0.887) and the insulin resistance factor and the lipid factor (r = 0.835). All factors exhibited good values for construct reliability and variance extracted except for the insulin resistance factor, which was measured with the variables of fasting insulin and fasting glucose levels.
CONCLUSIONS: A four-factor model of metabolic syndrome including the coronary heart disease risk factors of hypertension, obesity, insulin resistance and hyperlipidaemia was developed using this sample of European, middle-aged Caucasian males. Insulin resistance was not well defined using the variables of fasting insulin and fasting glucose levels. Other possible variables to include in the measurement of this factor are discussed.