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  • Population Study Article
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Influence of puberty on relationships between body composition and blood pressure: a cross-sectional study

Pediatric Research volume 94, pages 781–788 (2023)Cite this article

Abstract

Background

Fat mass (FM) and fat-free mass (FFM) are positively associated with blood pressure (BP) in youth. Yet, how puberty, independent of age, affects these relationships remains unclear. Given puberty may be a crucial period for cardiometabolic health, we examined how pubertal development moderates the associations of FM/FFM with BP.

Methods

Pubertal development, resting BP, and body composition were assessed in a convenience sample of youth (5.5–17 years). General linear models were conducted to assess if pubertal development moderated the relationships between FM/FFM and systolic/diastolic BP standardized for age, sex, and height (SBPz/DBPz).

Results

Among participants (N = 1405; age: M = 13.3 ± 2.9 years; 65.4% female; 53.2% racial/ethnic minority), FM/FFM were positively associated with SBPz and DBPz (ps ≤ 0.02). Pubertal development moderated the associations between FFM and BPz (ps ≤ 0.01), but not FM (ps > 0.43). For early/mid and late pubertal participants, there were positive associations between FFM and BP (DBPz: βs = 0.10–0.18, ps ≤ 0.01; SBPz: βs = 0.33–0.43, ps < 0.001); however, these relationships were attenuated, especially for prepubertal DBPz (DBPz: β = 0.01, p = 0.91; SBPz: β = 0.24, p = 0.001).

Conclusions

Puberty moderated the relationships between FFM and SBPz/DBPz in analyses that separately modeled the contributions of age and sex. These data suggest that the FFM-DBPz association may potentially be impacted by increasing sex hormone concentrations during puberty.

Impact

  • Fat mass (FM) and blood pressure (BP) were positively associated throughout puberty.

  • Fat-free mass (FFM) and BP were positively associated throughout puberty; however, puberty moderated the FFM-BP relationship, such that there was a positive relationship in early/mid and late puberty, but the relationship was attenuated for prepubertal children.

  • These findings contribute further insight into physiological and cardiometabolic changes occurring during puberty.

  • Changes in hormone concentrations may explain the impact puberty has on the FFM-BP relationship.

  • Understanding predictors of BP are important as childhood BP is associated with future cardiometabolic outcomes.

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Fig. 1: Associations between body composition and standardized systolic and diastolic blood pressure.
Fig. 2: Relationship between fat-free mass and standardized systolic and diastolic blood pressure model within each pubertal stage.

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Data availability

The datasets generated during and/or analyzed during the current study are available from the corresponding author on reasonable request. The underlying data for the analyses are available at: https://doi.org/10.17632/vgzbgcxkvh.1.77

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Acknowledgements

Special thanks to the study participants and their families for volunteering their time to participate in the research studies used for analyses.

Funding

This work was supported by the Intramural Research Program of the Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD) Grant number ZIA-HD00641; J.A.Y., with supplemental funding from the Division of Nutrition Research Coordination, the National Institute of Minority Health and Health Disparities, and the Office of Behavioral and Social Sciences Research (to J.A.Y.). Additional monetary support was derived from the NICHD National Research Service Award 1F32HD056762; NICHD Grant K99-R00HD069516; Uniformed Services University of the Health Sciences Grant R072IC); and National Institute of Kidney Diabetes and Digestive and Kidney Diseases Grant R01DK080906-04.

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Authors and Affiliations

  1. Section on Growth and Obesity, Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD), Division of Intramural Research, National Institutes of Health (NIH), Bethesda, MD, USA

    Esther A. Kwarteng, Loie M. Faulkner, Lucy K. Loch, Syeda Fatima, Suryaa Gupta, Hannah E. Haynes, Kaitlin L. Ballenger, Megan N. Parker, Sheila M. Brady, Anna Zenno, Marian Tanofsky-Kraff & Jack A. Yanovski

  2. Department of Medical and Clinical Psychology, Uniformed Services University of the Health Sciences (USU), Bethesda, MD, USA

    Lisa M. Shank, Hannah E. Haynes, Megan N. Parker & Marian Tanofsky-Kraff

  3. Department of Medicine, Military Cardiovascular Outcomes Research (MiCOR) Program, USU, Bethesda, MD, USA

    Lisa M. Shank & Marian Tanofsky-Kraff

  4. Metis Foundation, San Antonio, TX, USA

    Lisa M. Shank & Hannah E. Haynes

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  1. Esther A. Kwarteng
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Contributions

J.A.Y. and M.T.-K. designed the parent studies used. E.A.K., L.M.S., L.M.F., L.K.L., S.F., S.G., H.E.H., K.L.B., M.N.P., S.M.B., A.Z., and J.A.Y. collected data. E.A.K. managed the dataset. E.A.K., J.A.Y., and L.M.S. conducted statistical analyses. E.A.K. wrote the first draft of the manuscript. L.M.S. supervised the project and provided substantial editing of the manuscript. J.A.Y. had primary responsibility for final content. All authors edited the manuscript and approved the final draft submitted.

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Correspondence to Jack A. Yanovski.

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The authors declare no conflict of interest for this research. J.A.Y. reports unrelated grant funds to NICHD supporting his research from Soleno Therapeutics, Rhythm Pharmaceuticals, and Hikma Pharmaceuticals. The opinions and assertions expressed herein are those of the authors and are not to be construed as reflecting the views of the National Institutes of Health or the United States Department of Defense.

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Kwarteng, E.A., Shank, L.M., Faulkner, L.M. et al. Influence of puberty on relationships between body composition and blood pressure: a cross-sectional study. Pediatr Res 94, 781–788 (2023). https://doi.org/10.1038/s41390-023-02503-7

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