Figure 3— Comparison of the four-factor CFA models with one-factor CFA models of the metabolic syndrome (MetS) in three study populations from Spain, Mauritius, and the U.S.

Study population (N)Model tested (Men/Women or Men standardized weights)Goodness of Fit Indices
χ2 [df] (P value)SRMRRMSEARMSEA (90% CI)AICCFI
Hypothetical (X)One- or 4-factor hypothetical model with perfect fit0[−] (1.00)00(0.00–0.05)lowest1.00
Spanish (410)The original 4-factor Novak et al. Model (25) did not fit the data
Spanish (410)Modified (one-factor) Novak et al. model including the same variables at the original 4-factor Novak et al. model*60.3 [30] (<0.01)0.050.05(0.03–0.07)144.30.96
MetS factor
BMI (0.67/0.85)
Waist-hip ratio (0.27/0.47)
Fasting insulin (0.47/0.48)
Fasting glucose (0.41/0.48)
Triglycerides (0.44/0.46)
HDL-c (-0.19/-0.32)
SBP (0.53/0.65)
DBP (0.52/0.61)
Mauritian (3061)Original 4-factor Novak et al. model (25)414.2 [26] (<0.001)0.070.07(0.06–0.08)506.20.94
Obesity factor
    BMI (0.87/0.80)
    Waist-hip ratio (0.67/0.65)
IR factor
    Fasting insulin (0.92/0.66)
    Fasting glucose (0.23/0.33)
Lipids factor
    Triglycerides (0.60/0.57)
    HDL-c (-0.47/-0.33)
Hypertension factor
    SBP (0.74/0.88)
    DBP (0.99/0.83)
Range of correlations between factors (0.22–0.73/0.35–0.91)
Mauritian (3061)Modified (one-factor) Novak et al. model including the same variables as the original 4-factor Novak et al. model*445.5 [30] (<0.001)0.070.07(0.06–0.07)529.50.93
MetS factor
BMI (0.77/0.76)
Waist-hip ratio (0.57/0.62)
Fasting insulin (0.73/0.62)
Fasting glucose (0.22/0.33)
Triglycerides (0.53/0.44)
HDL-c (-0.37/-0.26)
SBP (0.25/0.37)
DBP (0.37/0.36)
USA (847 men)Original 4-factor Shen et al. model (24)101.8 [27] (<0.01)NA0.06NA159.4§0.97
Obesity factor
    BMI (0.78)
    Waist-hip ratio (0.59)
IR factor
    Fasting insulin (0.83)
    Glucose (0.38)
    PGC insulin (0.78)
    PGC glucose (0.37)
Lipids factor
    Triglycerides (0.78)
    HDL-c (-0.65)
Hypertension factor
    SBP (0.71)
    DBP (0.81)
Range of correlations between factors (0.17–0.66)
USA (847 men)Original 1-factor Shen et al. model (24)631.4 [32] (<0.01)NA0.15NA681.5§0.74
MetS factor
BMI (0.58)
Waist-hip ratio (0.46)
Fasting insulin (0.79)
PGC insulin (0.76)
Fasting glucose (0.33)
PGC glucose (0.38)
Triglycerides (0.46)
HDL-c (-0.35)
SBP (0.26)
DBP (0.25)
USA (847 men)Modified 1-factor Shen et al. model (different residual correlations) with the same variables as in the original 1-factor model#103.4 [29] (<0.01)0.030.06(0.04–0.07)155.40.97
MetS factor
BMI (0.59)
Waist-hip ratio (0.46)
Fasting insulin (0.72)
PGC insulin (0.68)
Fasting glucose (0.36)
PGC glucose (0.41)
Triglycerides (0.46)
HDL-c (-0.34)
SBP (0.26)
DBP (0.24)
Mauritian (3061)Original 4-factor Shen et al. (model (24)612.2 [54] (<0.001)0.070.06(0.05–0.06)724.20.94
Obesity factor:
    BMI (0.88/0.81)
    Waist-hip ratio (0.66/0.63)
IR factor:
    Fasting insulin (0.93/0.87)
    Glucose (0.23/0.25)
    PGC insulin (0.65/0.54)
    PGC glucose (0.31/0.26)
Lipids factor:
    Triglycerides (0.59/0.55)
    HDL-c (-0.47/-0.35)
Hypertension factor:
    SBP (0.74/0.89)
    DBP (0.99/0.83)
Range of correlations between factors (0.21–0.74/0.21–0.72)
Mauritian (3061)Original 1-factor Shen et al. model (24)3127.6 [66] (<0.001)0.110.12(0.12–0.13)3125.60.67
MetS factor
BMI (0.77/0.74)
Waist-hip ratio (0.62/0.62)
Fasting insulin (0.75/0.63)
PGC insulin (0.59/0.46)
Fasting glucose (0.24/0.32)
PGC glucose (0.33/0.34)
Triglycerides (0.52/0.44)
HDL-c (-0.37/-0.27)
SBP (0.31/0.45)
DBP (0.40/0.43)
Mauritian (3061)Modified 1-factor Shen et al. model (different residual (correlations) with the same variables as in the original 1-factor model#601.7 [58] (<0.001)0.060.06(0.05–0.06)705.70.94
MetS factor
BMI (0.75/0.77)
Waist-hip ratio (0.56/0.63)
Fasting insulin (0.75/0.62)
PGC insulin (0.55/0.40)
Fasting glucose (0.24/0.31)
PGC glucose (0.34/0.33)
Triglycerides (0.52/0.43)
HDL-c (-0.37/-0.26)
SBP (0.25/0.36)
DBP (0.36/0.35)
  • * Triglycerides and insulin were log transformed. Residuals correlation between BMI and waist-to-hip ratio, triglycerides and HDL cholesterol (HDL-c), systolic blood pressure (SBP) and diastolic blood pressure (DBP), between fasting glucose and insulin, and between glucose and triglycerides.

  • Residuals correlation between fasting glucose and triglycerides. All possible correlations among the four factors were allowed.

  • Glucose, postchallenge glucose, insulin, postchallenge insulin, and triglycerides were log transformed. Residuals correlation between glucose and post-glucose challenge (PGC) glucose and between PGC insulin and PGC glucose. All possible correlations among the four factors were allowed.

  • § AIC obtained from analyzing the published variance-covariance matrix. The index was not available in the original publication.

  • Glucose, PGC glucose, insulin, PGC insulin, and triglycerides were log transformed. Residuals correlation between glucose and PGC glucose and between PGC insulin and PGC glucose.

  • # Glucose, PGC glucose, insulin, PGC insulin, and triglycerides were log transformed. Residuals correlation between BMI and waist-to-hip ratio, triglycerides and HDL cholesterol, SBP and DBP, and insulin resistance (IR) measures (fasting insulin and PGC insulin, PGC glucose and PGC insulin, and glucose and PGC glucose). CFI, comparative fit index; NA, not available; SRMR, standardized root mean-square residual; RMSEA, root mean-square error of approximation.