{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,10,11]],"date-time":"2025-10-11T02:56:14Z","timestamp":1760151374036,"version":"build-2065373602"},"reference-count":82,"publisher":"MDPI AG","issue":"6","license":[{"start":{"date-parts":[[2022,3,13]],"date-time":"2022-03-13T00:00:00Z","timestamp":1647129600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"Project \u201cGreenHealth - Digital strategies in biological assets to improve well-being and promote green health\u201d (Norte-01-0145-FEDER-000042), supported by North Portugal Regional Operational Programme (NORTE 2020), under the PORTUGAL 2020 Partnership Agree","award":["Norte-01-0145-FEDER-000042"],"award-info":[{"award-number":["Norte-01-0145-FEDER-000042"]}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["IJERPH"],"abstract":"<jats:p>Understanding the factor weighting in the development of metabolic syndrome (MetS) may help to predict the progression for cardiovascular and metabolic diseases. Thus, the aim of this study was to develop a confirmatory model to describe and explain the direct and indirect effect of each component in MetS status change. A total of 3581 individuals diagnosed with MetS, aged 18\u2013102 years, were selected between January 2019 and December 2020 from a community-representative sample of Portuguese adults in a north-eastern Portuguese region to test the model\u2019s goodness of fit. A structural equation modelling (SEM) approach and a two-way ANOVA (age \u00d7 body composition) were performed to compare the relative contribution of each MetS component using joint interim statement (JIS). Waist circumference (\u03b2 = 0.189\u20130.373, p &lt; 0.001), fasting glucose (\u03b2 = 0.168\u20130.199, p &lt; 0.001) and systolic blood pressure (\u03b2 = 0.140\u20130.162, p &lt; 0.001) had the highest direct effect on the change in MetS status in the overall population and concerning both sexes. Moreover, diastolic blood pressure (DBP), triglycerides (TG) and high-density lipoprotein cholesterol (HDL-c) had a low or non-significant effect. Additionally, an indirect effect was reported for age and body composition involving the change in MetS status. The findings may suggest that other components with higher specificity and sensitivity should be considered to empirically validate the harmonised definition of MetS. Current research provides the first multivariate model for predicting the relative contribution of each component in the MetS status change, specifically in Portuguese adults.<\/jats:p>","DOI":"10.3390\/ijerph19063384","type":"journal-article","created":{"date-parts":[[2022,3,13]],"date-time":"2022-03-13T22:29:43Z","timestamp":1647210583000},"page":"3384","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":11,"title":["Structural Equation Modelling for Predicting the Relative Contribution of Each Component in the Metabolic Syndrome Status Change"],"prefix":"10.3390","volume":"19","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-4612-3623","authenticated-orcid":false,"given":"Jos\u00e9 E.","family":"Teixeira","sequence":"first","affiliation":[{"name":"Research Centre in Sports Sciences, Health and Human Development (CIDESD), 5001-801 Vila Real, Portugal"},{"name":"Department of Sport Sciences, Instituto Polit\u00e9cnico de Bragan\u00e7a (IPB), 5300-253 Bragan\u00e7a, Portugal"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7020-0583","authenticated-orcid":false,"given":"Jos\u00e9 A.","family":"Bragada","sequence":"additional","affiliation":[{"name":"Research Centre in Sports Sciences, Health and Human Development (CIDESD), 5001-801 Vila Real, Portugal"},{"name":"Department of Sport Sciences, Instituto Polit\u00e9cnico de Bragan\u00e7a (IPB), 5300-253 Bragan\u00e7a, Portugal"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9413-221X","authenticated-orcid":false,"given":"Jo\u00e3o P.","family":"Bragada","sequence":"additional","affiliation":[{"name":"North East Local Health Unit (ULSNE)\u2014Health Care Unit of Santa Maria, 5301-852 Bragan\u00e7a, Portugal"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5967-9017","authenticated-orcid":false,"given":"Joana P.","family":"Coelho","sequence":"additional","affiliation":[{"name":"North East Local Health Unit (ULSNE)\u2014Health Care Unit of Santa Maria, 5301-852 Bragan\u00e7a, Portugal"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7187-8580","authenticated-orcid":false,"given":"Isabel G.","family":"Pinto","sequence":"additional","affiliation":[{"name":"North East Local Health Unit (ULSNE)\u2014Health Care Unit of Santa Maria, 5301-852 Bragan\u00e7a, Portugal"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0236-1654","authenticated-orcid":false,"given":"Lu\u00eds P.","family":"Reis","sequence":"additional","affiliation":[{"name":"North East Local Health Unit (ULSNE)\u2014Health Care Unit of Santa Maria, 5301-852 Bragan\u00e7a, Portugal"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8714-4901","authenticated-orcid":false,"given":"Paula O.","family":"Fernandes","sequence":"additional","affiliation":[{"name":"Applied Management Research Unit (UNIAG), Instituto Polit\u00e9cnico de Bragan\u00e7a (IPB), 5300-253 Bragan\u00e7a, Portugal"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6885-0648","authenticated-orcid":false,"given":"Jorge E.","family":"Morais","sequence":"additional","affiliation":[{"name":"Research Centre in Sports Sciences, Health and Human Development (CIDESD), 5001-801 Vila Real, Portugal"},{"name":"Department of Sport Sciences, Instituto Polit\u00e9cnico de Bragan\u00e7a (IPB), 5300-253 Bragan\u00e7a, Portugal"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2492-1499","authenticated-orcid":false,"given":"Pedro M.","family":"Magalh\u00e3es","sequence":"additional","affiliation":[{"name":"Department of Sport Sciences, Instituto Polit\u00e9cnico de Bragan\u00e7a (IPB), 5300-253 Bragan\u00e7a, Portugal"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2022,3,13]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"33","DOI":"10.1177\/2047487319886404","article-title":"The metabolic syndrome\u2014What is it and how should it be managed?","volume":"26","author":"Nilsson","year":"2019","journal-title":"Eur. 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