Objective To analyze the association between different body composition indicators and elevated blood pressure among school-age children and adolescents, in order to provide evidence for early prevention of hypertension in adulthood. Methods From September to November 2023, a stratified cluster random sampling method was used to select 3 444 school-age children and adolescents aged 7 - 17 from 12 schools in Suzhou.Measurements included height, weight, waist circumference, blood pressure, and body composition.Elevated blood pressure was used as the dependent variable.Logistic regression and restricted cubic spline (RCS) models were applied to analyze the relationship between different body composition indicators and elevated blood pressure. Results The detection rate of elevated blood pressure among children and adolescents aged 7 - 17 in Suzhou was 11.61% (400/3 444).The whole-body percentage body fat (PBF) was (23.25±8.82)%, fat mass index (FMI) was (4.81±2.73) kg/m2, muscle mass index (MMI) was (13.84±2.06) kg/m2, and body mass index (BMI) was (19.55±4.18) kg/m2.All these indices were higher in the elevated blood pressure group compared to the normal blood pressure group (P<0.05).The whole-body percentage of muscle mass (PBM) was (72.06±8.36)%, which was lower in the elevated blood pressure group (P<0.05).RCS analysis revealed a nonlinear association of increasing PBF and PBM levels with elevated blood pressure (P for nonlinearity<0.05), while FMI, MMI, and BMI showed a linear relationship with elevated blood pressure (Pfor nonlinearity>0.05).Logistic regression analysis indicated that the associations of FMI, MMI, and PBF with elevated blood pressure were stronger in girls than in boys (P<0.05).Using the group with normal BMI and normal PBF as the reference, the group with normal BMI and overweight/obesity based on PBF (OR =3.467) and the group with overweight/obesity based on both BMI and PBF (OR=4.177) had an increased risk of elevated blood pressure (P<0.05), while no increased risk was observed in the group with overweight/obesity based on BMI and normal PBF (P=0.266). Conclusions Higher body fat percentage is positively associated with elevated blood pressure, while muscle mass percentage may have a protective effect.It is recommended to strengthen body composition monitoring, promote physical exercise, increase muscle mass percentage, and prevent elevated blood pressure in children and adolescents.
Key words
body composition /
blood pressure /
percent body fat /
children
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