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Adjusting adiposity and body weight measurements for height alters the relationship with blood pressure in children.

ABSTRACT: Adiposity measures are associated with increased pediatric blood pressure (BP). However, this correlation can be confounded by the relationship of both variables to height. We evaluated whether adiposity and anthropometric measures were associated with pediatric BP before and after adjusting each value for height.Participants included 281 African-American (AA), European-American (EA), and Hispanic-American (HA) children aged 7-12 years. BP percentiles were calculated according to pediatric guidelines using the average of four measurements. Total fat mass was determined using dual-energy X-ray absorptiometry. Socioeconomic status (SES) was calculated with the Hollingshead index. Adiposity measures were indexed for height using log-log regression analysis. Partial correlations identified measures associated with BP. Linear regression was used to test the association of those measures with absolute BP, whereas logistic regression was used to evaluate the odds for hypertension.More AAs (16.3%) presented with potential hypertension than EA (5.1%) or HA (2.7%) children. After adjusting for covariates, fat mass, body mass index, and waist circumference were positively significantly associated with absolute BP and hypertension in AA and EA children (P < 0.05). When these measures were height-indexed, only waist remained significantly positively associated with hypertension risk in these two groups. No measures were significantly associated with BP among HA children.In this multiethnic pediatric population, waist circumference was the strongest significant adiposity predictor of hypertension risk among AA and EA children. Additional research is needed to determine which environmental and genetic factors contribute to pediatric hypertension, particularly among HA groups.

SUBMITTER: Willig AL

PROVIDER: S-EPMC2998040 | biostudies-other | 2010 Aug

REPOSITORIES: biostudies-other

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Adjusting adiposity and body weight measurements for height alters the relationship with blood pressure in children.

Willig Amanda L AL Casazza Krista K Dulin-Keita Akilah A Franklin Frank A FA Amaya Michelle M Fernandez Jose R JR

American journal of hypertension 20100422 8

<h4>Background</h4>Adiposity measures are associated with increased pediatric blood pressure (BP). However, this correlation can be confounded by the relationship of both variables to height. We evaluated whether adiposity and anthropometric measures were associated with pediatric BP before and after adjusting each value for height.<h4>Methods</h4>Participants included 281 African-American (AA), European-American (EA), and Hispanic-American (HA) children aged 7-12 years. BP percentiles were calc ...[more]

PMID: 20414190

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Project description:ImportanceWeight-for-height z score (WHZ) is a standard indicator of children's nutritional status even though it does not fully reflect body fat.ObjectiveTo examine the combined association of WHZ and body fat with early development in the East Asia and Pacific region.Design, setting, and participantsChildren from the East Asia-Pacific Early Child Development Scales validation study, with full data available regarding their nutritional status and outcomes, were included in this cross-sectional analysis. In brief, a multilevel stratified random sampling was used to select representative samples from each participating country in the study. WHZ and body fat were independently trichotomized using established references and were combined to form a 9-category exposure variable. Data collection was performed between 2012 and 2014, and the analyses were conducted in June 2021.Main outcomes and measuresThe binary outcome variable of not being developmentally on track (hereafter referred to as poor development) was defined as a score less than the 25th percentile in the following domains: cognitive, language, socioemotional, motor development, and total development score. Poisson regression models were used to analyze the associations between the combined categories and poor development, adjusted for sociodemographic factors.ResultsA total of 6815 children (mean [SD] age, 4.02 [0.8] years; 3434 girls [50.4%]) had full data available and were included in this study. Compared with children with normal weight and normal fat, those with wasting and low body fat had the highest likelihood of total poor development (prevalence ratio, 1.47; 95% CI, 1.28-1.70), followed by those with normal weight but low fat (prevalence ratio, 1.23; 95% CI, 1.11-1.36). Similar associations were found in language, cognitive, and socioemotional development, but not in motor development.Conclusions and relevancePoor development was more commonly found in children with low body fat independent of WHZ (wasted or normal weight). Early public health strategies may consider using a combination of WHZ and body fat as an indicator of poor development.

Project description:BACKGROUND:Children with acute lymphoblastic leukemia (ALL) have an increased risk of obesity and short stature. To the authors' knowledge, data regarding patients treated on contemporary protocols without cranial irradiation are limited. METHODS:Changes in z scores for body mass index (BMI), height, and weight from the time of diagnosis to 5 years off therapy were evaluated using multivariable analysis in 372 children with ALL who were aged 2 to 18 years at the time of diagnosis and were enrolled on the St. Jude Children's Research Hospital Total XV protocol from 2000 through 2007. RESULTS:The percentage of overweight/obese patients increased from 25.5% at the time of diagnosis to approximately 50% during the off-therapy period. Median BMI z scores increased significantly during glucocorticoid therapy (induction: ?0.56; 95% confidence interval [95% CI], 0.29-0.64 [P<.001]; and reinduction II: ?0.22; 95% CI, 0.13-0.49 [P=.001]) and during the first year after therapy (?0.18; 95% CI, 0.08-0.46 [P=.006]). Among patients who were of healthy weight/underweight at the time of diagnosis, those aged 2 to <10 years at diagnosis had a significantly higher risk of becoming overweight/obese during or after therapy compared with those aged ?10 years (P=.001). Height z scores declined during treatment and improved after therapy. Being aged 2 to <10 years at the time of diagnosis, being of low-risk status, having a white blood cell count?<?50×109 /L at the time of diagnosis, and having negative central nervous system disease were associated with significantly better improvements in z scores for height during the off-therapy period compared with being aged ?10 years, being of standard-risk/high-risk status, having a white blood cell count ???50×109 /L, and having positive central nervous system disease, respectively. CONCLUSIONS:The results of the current study demonstrate that obesity is prevalent, and height growth, especially in patients with identified risk factors, appears compromised. Multidisciplinary intervention should begin during induction therapy and continue during the off-therapy period.

Project description:Normalizing cardiovascular measurements for body size allows for comparison among children of different ages and for distinguishing pathologic changes from normal physiologic growth. Because of growing interest to use height for normalization, the aim of this study was to develop height-based normalization models and compare them to body surface area (BSA)-based normalization for aortic and left ventricular (LV) measurements. The study population consisted of healthy, non-obese children between 2 and 18 years of age enrolled in the Pediatric Heart Network Echo Z-Score Project. The echocardiographic study parameters included proximal aortic diameters at 3 locations, LV end-diastolic volume, and LV mass. Using the statistical methodology described in the original project, Z-scores based on height and BSA were determined for the study parameters and tested for any clinically significant relationships with age, sex, race, ethnicity, and body mass index (BMI). Normalization models based on height versus BSA were compared among underweight, normal weight, and overweight (but not obese) children in the study population. Z-scores based on height and BSA were calculated for the 5 study parameters and revealed no clinically significant relationships with age, sex, race, and ethnicity. Normalization based on height resulted in lower Z-scores in the underweight group compared to the overweight group, whereas normalization based on BSA resulted in higher Z-scores in the underweight group compared to the overweight group. In other words, increasing BMI had an opposite effect on height-based Z-scores compared to BSA-based Z-scores. Allometric normalization based on height and BSA for aortic and LV sizes is feasible. However, height-based normalization results in higher cardiovascular Z-scores in heavier children, and BSA-based normalization results in higher cardiovascular Z-scores in lighter children. Further studies are needed to assess the performance of these approaches in obese children with or without cardiac disease.

Dataset Information

Adjusting adiposity and body weight measurements for height alters the relationship with blood pressure in children.

Publications

Adjusting adiposity and body weight measurements for height alters the relationship with blood pressure in children.

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