OBJECTIVE: The metabolic syndrome (MetS) is typically diagnosed based on 
abnormalities in specific clustered clinical measures that are associated with 
increased risk for coronary heart disease (CHD) and Type 2 diabetes mellitus 
(T2DM). However, current MetS criteria result in racial/ethnic discrepancies. 
Our goals were to use confirmatory factor analysis (CFA) to delineate 
differential contributions to MetS by sub-group, and if contributions were 
discovered, develop sex and racial/ethnic-specific equations to calculate MetS 
severity.
RESEARCH DESIGN AND METHODS: Using data on adults from the National Health and 
Nutrition Examination Survey 1999-2010, we performed a CFA of a single MetS 
factor that allowed differential loadings across groups, resulting in a sex and 
race/ethnicity-specific continuous MetS severity score.
RESULTS: Loadings to the single MetS factor differed by sub-group for each MetS 
component (p<0.001), with lower factor loadings among non-Hispanic-blacks for 
triglycerides and among Hispanics for waist circumference. Systolic blood 
pressure exhibited low factor loadings among all groups. MetS severity scores 
were correlated with biomarkers of future disease (high-sensitivity 
C-reactive-protein, uric acid, insulin resistance). Non-Hispanic-black-males 
with diabetics had a low prevalence of MetS but high MetS severity scores that 
were not significantly different from other racial/ethnic groups.
CONCLUSIONS: This analysis among adults uniquely demonstrated differences 
between sexes and racial/ethnic groups regarding contributions of traditional 
MetS components to an assumed single factor. The resulting equations provide a 
clinically-accessible and interpretable continuous measure of MetS for potential 
use in identifying adults at higher risk for MetS-related diseases and following 
changes within individuals over time. These equations hold potential to be a 
powerful new outcome for use in MetS-focused research and interventions.