Characteristics of metabolic syndrome based on clustering pattern among Korean adolescents: findings from the Korean National Health and Nutrition Examination Survey, 2007-2008.

To define the factors that influence the development of metabolic syndrome (MetS) characteristics in adolescents, this study assessed the clustering pattern for MetS using confirmatory factor analysis (CFA). Components of metabolic syndrome, including abdominal obesity, insulin resistance, high blood pressure, and dyslipidemia, were analyzed in 1,514 Korean adolescents aged 10 to 18 years. The validities of one-factor models underlying a unifying etiology and a four-factor model based on more than one physiologic process for MetS across sex and age groups were assessed using the CFA method. The one-factor model, which incorporated waist circumference (WC), homeostasis model assessment-insulin resistance (HOMA-IR), systolic blood pressure (SBP), and high-density lipoprotein (HDL) values, had the best goodness-of-fit indices among the models (comparative fit index 0.99, root mean square error of approximation 0.04), with stability over sex and age groups. MetS was mainly defined by WC, SBP, HOMA-IR, and HDL values, with factor loadings of 0.78, 0.47, 0.44, and -0.37, respectively. WC contributed the most to MetS, with the highest factor loading value across sex and age groups. In conclusion, a single underlying factor representing the common pathway linking abdominal obesity, SBP, HOMA-IR, and HDL may explain MetS in Korean adolescents with stability across sex and age groups.