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(Circulation. 2002;105:1093.)
© 2002 American Heart Association, Inc.

Clinical Investigation and Reports

Trunk Fat and Blood Pressure in Children Through Puberty

Qing He, MD, PhD; Mary Horlick, MD; Barbara Fedun, RN; Jack Wang, MS; Richard N. Pierson, Jr, MD; Stanley Heshka, PhD; Dympna Gallagher, EdD

From the Obesity Research Center, St Luke’s-Roosevelt Hospital; Institute of Human Nutrition (Q.H., S.H., D.G.); and Children’s Hospital of New York (M.H.), College of Physicians & Surgeons, Columbia University, New York, NY.

Correspondence to Dr Dympna Gallagher, Obesity Research Center, 1090 Amsterdam Ave, New York, NY 10025. E-mail dg108{at}columbia.edu

Background— Fat distribution is well recognized as a cardiovascular risk factor in adults. The association between android fat distribution and cardiovascular risk factors, such as blood pressure (BP), was previously reported in an African-American and Caucasian pediatric population. The aim of the present study was to investigate the relationship between BP and body fat distribution in a large cross-sectional pediatric sample. The effects of race, sex, and puberty on this relationship were assessed.

Methods and Results— BP was measured in 920 healthy children and adolescents (African-American, Asian, and Caucasian, ages 5 to 18 years). Fat distribution was determined by skinfold thickness and dual-energy X-ray absorptiometry (DXA). Pubertal status was assessed by the criteria of Tanner. Regression analysis was used to explore the association between BP and fat distribution. Significant positive relationships between systolic and diastolic BP and trunk fat adjusted for total fat were seen in boys at all pubertal stages in all 3 races by both DXA and skinfold measurements. In girls, trunk fat was not a significant predictor of BP.

Conclusions— Our results demonstrate a sex difference in the relationship between BP and trunk fat in that a significant positive relationship was present in boys only. These findings, based on 2 independent measures of fat distribution, may help identify the specific features of individuals at risk, allow earlier intervention, and suggest sex-specific determinants for BP.

Key Words: fat distribution • blood pressure • pediatrics • puberty

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