Introduction Normative blood pressure (BP) percentiles in children recommended by the current guidelines vary with body size. Separating the effect of fat mass from that of total body size on BP is important but challenging because fat mass and body size are strongly correlated. The objective of this study is to assess the relationship of relative body fat and BP in children.
Methods Chinese children who had a high skinfold thickness were individually matched by age, sex, weight and height to an equal number of children with a low skinfold. Systolic and diastolic BP levels were compared between the high and low body fat groups.
Results 7066 pairs of children aged 7–18 years were obtained, including 3042 pairs of boys and 4024 pairs of girls. As a result of matching, the two groups had identical distributions of height, weight and body mass index. The difference between the high and low fat groups in systolic BP was small (0.03, 95% CI −0.29 to 0.36 mm Hg) and not statistically significant. Diastolic BP in the high body fat group was 0.68 (95% CI 0.40 to 0.96) mm Hg higher than that in the low body fat group.
Conclusion For a given body size as measured by height and weight, relative body fat has little impact on systolic BP levels in children. Systolic BP is driven by overall body size. The same amount of fat mass and lean mass may have a similar impact on blood pressure in children.
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