RE: “CLUSTERING OF PROCOAGULATION, INFLAMMATION, AND FIBRINOLYSIS VARIABLES WITH METABOLIC FACTORS IN INSULIN RESISTANCE SYNDROME”

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Abstract
Sakkinen et al. (1) derived multiple factors of insulin resistance syndrome through factor analysis of 21 metabolic and hemostatic variables. They used orthogonal transformation (varimax rotation in SAS computer software) to rotate the factors in order to achieve clearer interpretability. Thus, the derived factors including body mass, insulin/glucose, lipids, blood pressure, and so on are “uncorrelated.” While their approach is statistically sound, the logic is not consistent with the theory of insulin resistance syndrome, which postulates a common underlying biologic process for the close interrelation among obesity, hyperinsulinemia, glucose intolerance, dyslipidemia, and other metabolic disorders (2). There are substantial data that these components are all intercorrelated, both statistically and biologically. Thus, the “uncorrelated” factors identified from this study and several previous analyses may merely reflect a statistical artifact rather than a biologic reality.

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