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MODELING METABOLIC SYNDROME SEVERITY USING ANDROID FAT PERCENTAGE

Abstract

The disease state metabolic syndrome (MetSyn) is defined by underlying physiological dysfunction that manifests as hypertension, dyslipidemia, insulin resistance, and central adiposity. MetSyn is associated with several negative health outcomes including cardiovascular disease, diabetes, proinflammatory state, and reproductive disorders. As a constellation of metabolic conditions, MetSyn cannot be measured directly, and its diagnosis typically requires dysfunction across at least three metabolic indicators. In recent years, however, latent variable models have been employed which can quantify the severity of MetSyn. These models generally employ waist circumference (WC) as a manifest measure of central adiposity, but it is unknown whether a more precise and specific measure of central adiposity, such as android fat percentage (AFP), would produce a better model for MetSyn severity. PURPOSE: The purpose of this study was to determine if MetSyn severity could be modeled more accurately by using AFP instead of WC. METHODS: Data were extracted from the National Health and Nutrition Examination Study from 2003-2006 (n = 4010). MetSyn was measured using factor analysis with fasting blood glucose, systolic blood pressure, plasma triglycerides, plasma HDL cholesterol, plasma LDL cholesterol, and a measure of central adiposity as manifest indicators. A model was fit using WC and another using AFP measured via dual-energy x-ray absorptiometry. Data-model fit was compared between the models to determine which better approximated MetSyn severity. RESULTS: All measurement models were over-identified in accordance with the t-rule. The AFP model demonstrated adequate fit (CFI = .941, TLI = .900, RMSEA = .067, SRMR = .036). Data-model fit for the WC model, however, was poor (CFI = .905, TLI = .822, RMSEA = .096, SRMR < .046). Model information criteria comparisons also indicated that the AFP model was a better measurement model compared to the WC model (AIC = 218464.68 vs. 220805.00, BIC = 218546.54 vs. 220886.85). CONCLUSION: AFP is a better manifest indicator of central adiposity compared to WC for purposes of modeling a quantifiable measure of MetSyn severity.

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