Adiposity measures and blood pressure in Chinese children and adolescents

Hongjian Wang ¹, Jonathan Necheles ¹, Mercedes Carnethon ², Binyan Wang ¹, Zhiping Li ³, Liuliu Wang ³, Xue Liu ³, Jianhua Yang ³, Genfu Tang ³, Houxun Xing ³, Xiping Xu ⁴ and Xiaobin Wang ^1*

¹ Mary Ann and J. Milburn Smith Child Health Research Program, United States
² Department of Preventive Medicine, United States
³ Biomedicine, China
⁴ Center for Population Genetics, United States

^* To whom correspondence should be addressed. E-mail: xbwang{at}childrensmemorial.org.

Accepted 9 March 2008

Abstract

Objective: To investigate the association of adiposity measures with blood pressure (BP) in Chinese children and adolescents.

Design: A cross - sectional study.

Participants: A total of 1330 males and 1170 females aged 6-18 years from a rural population based cohort of twins studied between 1998-2000 in Anhui, China.

Outcome Measures: Adiposity measures included body mass index (BMI), total body fat and trunk fat assessed by dual energy x-ray absorptiometry. BMI was divided into fat mass index (FMI) and lean mass index (LMI) in the analysis.

Major outcomes included: systolic (S) and diastolic (D) BP. Both linear and logistic regressions were performed to assess gender specific associations between various adiposity measures and BP, while adjusting for age and height. Generalized estimating equations were used to account for intra-twin pair correlations.

Results: Average BMI and percent body fat in children aged 6 C 11 years were 14.9 kg/m2 and 9.7%; corresponding measures in 12 C 18 years were 17.8 kg/m2 and 14.2%. Adiposity measures were more strongly associated with SBP (p<0.05 in all age strata) than DBP (p<0.05 only in children aged 6-11 years). Both FMI (¦Â=1.26-2.37) and LMI (¦Â=1.00-1.71) are associated with SBP across age and gender strata after adjusting for age and height (p<0.05).

Conclusions: Our results indicate that in this relatively lean population of Chinese children and adolescents, BP, particularly SBP, is positively associated with measures of adiposity. Among all the adiposity measures, BMI is the strongest predictor of BP.