Influence of Puberty on Relationships Between Body Composition and Blood Pressure: A Cross-Sectional Study

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 (5.5-17y). 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=1,405; age: M=13.3±2.9y; 65.4% female; 53.2% racial/ethnic minority), FM/FFM were positively associated with SBPz and DBPz (ps≤.02). Pubertal development moderated the associations between FFM and BPz (ps≤.01), but not FM (ps>.43). For early/mid and late pubertal participants, there were positive associations between FFM and BP (DBPz: βs=.10-.18, ps≤.01; SBPz: βs=.33-.43, ps<.001); however, these relationships were attenuated, especially for prepubertal DBPz (DBPz: β=.01, p=.91; SBPz: β=.24, p=.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.