Which body composition measures are associated with cardiovascular function and structure in adolescence?

• Adolescent adiposity is associated with some functional cardiovascular outcomes.
• Adolescent adiposity is not associated with structural cardiovascular outcomes.
• Therefore, detrimental effects of adiposity may not be evident until later life.
• Combined adiposity measures provide limited predictive advantage above BMI alone.

BackgroundQuantifying relationships between non-invasive body composition and comprehensive adolescent cardiovascular phenotypes could aid clinicians in identifying adolescents at increased cardiovascular risk.AimsTo assess (1) cross-sectional associations between body composition and cardiovascular function and structure, and (2) determine whether cardiovascular variation is better predicted by combined than individual body composition measures.MethodsParticipants- 202 adolescents (mean age 15.1 years, SD 0.6) from a community-based cohort. Measures- Body composition ‘exposures’: BMI/waist z-score, fat/lean mass indices. Cardiovascular ‘outcomes’: systolic/diastolic blood pressure, augmentation index, pulse wave velocity, carotid intima-media thickness, and arteriole-to-venule ratio. Analysis- Adjusted regression models to determine associations. R2 values to determine relative predictiveness of models.ResultsA one-unit increase in BMI/waist z-scores and fat/lean mass indices was associated with increased systolic blood pressure (2.5 mmHg (95%CI:0.9–4.0); 1.9 mmHg (95%CI:0.5–3.4); 0.5 mmHg (95%CI:0.0–1.1); 1.4 mmHg (95%CI:0.4–2.3)) and augmentation index (2.9% (95%CI:1.2–4.6); 2.0% (95%CI:0.4–3.6); 1.0% (95%CI:0.4–1.6); 1.9% (95%CI:0.9–2.9)). Statistically significant differences were not observed for other cardiovascular outcomes. The R2 value of combined models was marginally higher than individual models for all cardiovascular outcomes.ConclusionsIn adolescence, body composition was associated with some functional outcomes but not readily-measurable structural change, implying that associations may not be evident until at least young adulthood. Combined measurements provide limited additional advantage to the clinician above BMI alone.