Anthropometric Measures of Adiposity and Their Associations with Blood Pressure among Malay Adolescents Aged 18 to 19 Years Old in Terengganu
Article Sidebar
Issue
Vol. 19 No. 3 (2024)
Accepted
15 November 2024
Published
29 November 2024
Keywords:
-
adiposity, adolescents, blood pressure
Abstract
This study aims to explore association of anthropometric adiposity measures with blood pressure among Malays aged 18 to 19 years. Participants comprised 309 university students of Malay ethnicity residing in Kuala Nerus, Terengganu. This cross-sectional research study was done in April 2021 to August 2023. A total of 40.7% of participants were overweight/obese, 42.1% normal weight, and 17.5% underweight based on World Health Organisation (WHO)-Asian Body Mass Index (BMI) classification. Among this population, 15.5% of the students was considered as Hypertension (HPT) and 21.4% had Elevated Blood Pressure (EBP). Proportions of male students with HPT (35.7%) and EBP (29.8%) were significantly higher compared to female students (18% and 18.2%, respectively). Linear regression analysis indicated that BMI was a significant factor that influenced Systolic Blood Pressure (SBP), especially among female participants. Obese adolescents had 7.0 times higher odds of developing EBP/HPT compared to those in other BMI categories (aOR=6.97; 95% CI: 2.92, 16.6; p<0.05). The high prevalence of HPT and EBP raises concern, as the study also confirmed an association between obesity and blood pressure. In conclusion, anthropometric measures of adiposity were associated with increased odds of HPT. Thus, early identification of individuals with high-risk anthropometric adiposity is crucial to facilitate timely intervention and mitigate associated risks.
References
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Kallioinen N, Hill A, Horswill MS, Ward HE, Watson MO.2017. Sources of inaccuracy in the measurement of adult patients’ resting blood pressure in clinical settings: A systematic review. J Hypertens 35(3):421−441. https://doi.org/10.1097/hjh.0000000000001197
Khair NAM, Wee BS. 2021. Association between pubertal status and body fat percentage among Malay adolescents in Kuala Nerus, Terengganu. Malaysian Appl Biol 50(2):81−88. https://doi.org/10.55230/mabjournal.v50i2.1982
Kim MS, Kim SY, Kim JH. 2018. Secular change in waist circumference and waist-height ratio and optimal cutoff of waist-height ratio for abdominal obesity among Korean children and adolescents over 10 years. Korean J Pediatr 62(7):261−268. https://doi.org/10.3345/kjp.2018.07038
Krejcie RV, Morgan DW. 1970. Sample size determination using Krejcie and Morgan table. Kenya Projects Organization (KENPRO) 38:607−610.
Kurnianto A, Kurniadi Sunjaya D, Ruluwedrata Rinawan F, Hilmanto D. 2020. Prevalence of hypertension and its associated factors among Indonesian Adolescents. Int J Hypertens 2020(1):4262034. https://doi.org/10.1155/2020/4262034
Li Y, Zou Z, Luo J, Ma J, Ma Y, Jing J, Zhang X, Luo C, Wang H, Zhao H et al. 2020. The predictive value of anthropometric indices for cardiometabolic risk factors in Chinese children and adolescents: A national multicenter school-based study. Plos One 15(1):e0227954. https://doi.org/10.1371/journal.pone.0227954
Martha Sari NKP, Sulistiawati S, Indarwati R. 2021. The Behavior prevention of obesity in adolescents with self efficacy: A systematic review. STRADA Jurnal Ilmiah Kesehatan 10(1):1160−1173.
Mohammed Nawi A, Mohammad Z, Jetly K, Abd Razak MA, Ramli NS, Wan Ibadullah WAH, Ahmad N. 2021. The prevalence and risk factors of hypertension among the urban population in Southeast Asian Countries: A Systematic review and metaanalysis. Int J Hypertens 2021:6657003. https://doi.org/10.1155/2021/6657003
Mohan B, Verma A, Singh K, Singh K, Sharma S, Bansal R, Tandon R, Goyal A, Singh B, Chhabra ST. 2019. Prevalence of sustained hypertension and obesity among urban and rural adolescents: a school-based, crosssectional study in North India. BMJ Open 9(9):e027134. https://doi.org/10.1136/bmjopen-2018-027134
Omar MA, Irfan NI, Yi KY, Muksan N, MajidNLA, Yusoff M FM. 2016. Prevalence of young adult hypertension in Malaysia and its associated factors: Findings from National Health and Morbidity Survey 2011.
Pazin DC, da Luz Kaestner TL, Olandoski M, Baena CP, de Azevedo Abreu G, Kuschnir MCC, Bloch KV, Faria-Neto JR. 2020. Association between abdominal waist circumference and blood pressure in Brazilian Adolescents with normal body mass index: Waist circumference and blood pressure in Adolescents. Glob Heart 15(1):27. https://doi.org/10.5334/gh.779
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Rampal L, Ng KC, Izzati IN, Izzati ZF, Nazrul IM, Faisal I, Zainiyah SS. 2011. Prevalence of hypertension among Malay adolescents in Putrajaya secondary schools, Malaysia, 2010. MJMHS 7(2):53−60.
Saha S, Pandya AK, Kandre Y, Raval D, Saxena D. 2021. Cross-Sectional Analysis of Nutritional Status, Knowledge and Uptake of Nutritional Services Among Adolescent Girls in Western India. Adolesc Health Med Ther 12:117−125. https://doi.org/10.2147/AHMT.S336071
Song JJ, Ma Z, Wang J, Chen LX, Zhong JC. 2020. Gender Differences in Hypertension. J Journal of Cardiovascular Translational Research 13(1):47−54. https://doi.org/10.1007/s12265-019-09888-z
Soo J, Chow ZY, Ching SM, Tan CH, Lee KW, Devaraj NK, Salim HS, Ramachandran V, Lim PY, Sivaratnam D et al. 2020. Prevalence, awareness and control of hypertension in Malaysia from 1980−2018: A systematic review and meta-analysis. World J Meta-Anal 8(4):320−344. https://doi.org/10.1007/s12265-019-09888-z
Sukmasari V, Dieny FF, Panunggal B. 2019.Metabolic syndrome and bone density in obese adolescents. J Gizi Pangan 14(1):9−16. https://doi.org/10.25182/jgp.2019.14.1.9-16
Taxová Braunerová R, Kunešová M, HeinenMM, Rutter H, Hassapidou M, Duleva V, Pudule I, Petrauskienė A, Sjöberg A, Lissner L, Spiroski I. 2021. Waist circumference and waist-to-height ratio in 7-year-old children—WHO Childhood obesity surveillance initiative. Obes Rev 22(S6):e13208. https://doi.org/10.1111/obr.13208
Tebar WR, Ritti-Dias RM, Farah BQ, Zanuto EF, Vanderlei LCM, Christofaro DGD. 2018. High blood pressure and its relationship to adiposity in a school-aged population: Body mass index vs waist circumference. Hypertens Res 41(2):135−140. https://doi.org/10.1038/hr.2017.93
Trandafir LM, Russu G, Moscalu M, Miron I, Lupu VV, Leon Constantin MM, Cojocaru E, Lupu A, Frasinariu OE. 2020. Waist circumference a clinical criterion for prediction of cardio-vascular complications in children and adolescences with overweight and obesity. Medicine99(30):e20923. https://doi.org/10.1097/md.0000000000020923
Verma M, Rajput M, Kishore K, Kathirvel S. 2019. Asian BMI criteria are better than WHO criteria in predicting Hypertension: A crosssectional study from rural India. J Family Med Prim Care 8(6):2095−2100. https://doi.org/10.4103/jfmpc.jfmpc_257_19
[WHO Regional Office for the Western Pacific] World Health Organization Regional Office for the Western Pacific. 2000. The Asia-Pacific perspective: Redefining obesity and its treatment. Sydney (AUS): Health Communactions Australia.
Wang L, Song L, Liu B, Zhang L, Wu M, Cao Z, Wang Y. 2019. Trends and status of the prevalence of elevated blood pressure in children and adolescents in China: a systematic review and meta-analysis. Curr Hypertens Rep 21(11):1−12 https://doi.org/10.1007/s11906-019-0992-1
Widjaja NA, Arifani R, Irawan R. 2023. Cut-off value of waist-to-hip ratio as a predictor of metabolic syndrome in adolescents with obesity. Acta Biomed 94(3):e2023076. https://doi.org/10.23750/abm.v94i3.13755
Xiao J, Purcell SA, Prado CM, Gonzalez MC. 2018. Fat mass to fat-free mass ratio reference values from NHANES III using bioelectrical impedance analysis. Clin Nutr 37(6):2284−2287. https://doi.org/10.1016/j.clnu.2017.09.021
Yao W, Luo J, Ao L, Cheng H, Lu S, Liu J, Lu K, Mi J, Yang Y, Liu L. 2023. Association of total body fat and fat distribution with bone mineral density among children and adolescents aged 6–17 years from Guangzhou, China. Eur J Pediatr 182(3):1115−1126. https://doi.org/10.1007/s00431-022-04727-x
Zimmet P, Alberti K, Kaufman F, Tajima N, Silink M, Arslanian S, Wong G, Bennett P, Shaw J, Caprio S. 2007. The metabolic syndrome in children and adolescents–an IDF consensus report. Pediatric Diabetes 8(5):299−306. https://doi.org/10.1111/j.1399-5448.2007.00271.x
Alhawari HH, Al-Shelleh S, Alhawari HH, Al-Saudi A, Aljbour Al-Majali D, Al- Faris L, AlRyalat SA. 2018. Blood pressure and its association with gender, body mass index, smoking, and family history among University Students. Int J Hypertens 2018(1):4186496. https://doi.org/10.1155/2018/4186496
Azegami T, Uchida K, Tokumura M, Mori M. 2021. Blood pressure tracking from childhood to adulthood. Front Pediatr 9:785356. https://doi.org/10.3389/fped.2021.785356
Bennett JP. 2023 Emerging Applications in the Measurement of Body Composition and Their Relationships to Disease Risk. [Dissertation]: Mānoa: University of Hawai'i at Mānoa.
Chandrashekarappa S, Malhotra S, Nagendraswamy C, Gopi A, Murthy MN, Upadhyay K, Goel S.2022. Hypertension as a silent epidemic among late adolescent girls, its associated demographic factors, and pregnancy outcome: A report from national family health survey (NFHS) IV data. J Family Med Prim Care 11(9):849−5856. https://doi.org/10.4103/jfmpc.jfmpc_169_22
Cheah WL, Chang CT, Hazmi H, Kho GWF. 2018. Using anthropometric indicator to identify hypertension in adolescents: A Study in Sarawak, Malaysia. Int J Hypertens 2018:6736251. https://doi.org/10.1155/2018/6736251
Chen M, Liu J, Ma Y, Li Y, Gao D, Chen L, Ma T Dong Y, Ma J. 2021. Association between body fat and elevated blood pressure among children and adolescents aged 7–17 years: Using Dual-Energy X-ray Absorptiometry (DEXA) and Bioelectrical Impedance Analysis (BIA) from a crosssectional study in China. Int J Environ Res Public Health 18(17):9254. https://doi.org/10.3390/ijerph18179254
Dangardt F, Charakida M, Georgiopoulos G, Chiesa ST, Rapala A, Wade KH, Hughes A. D, Timpson NJ, Pateras K, Finer NE et al. 2019. Association between fat mass through adolescence and arterial stiffness: A population-based study from the avon longitudinal study of parents and children. Lancet Child Adolesc Health 3(7):474−481. https://doi.org/10.1016/S2352-4642(19)30105-1
Daniel RA, Haldar P, Prasad M, Kant S, Krishnan A, Gupta SK, Kumar R. 2020. Prevalence of hypertension among adolescents (10−19 years) in India: A systematic review and meta-analysis of cross-sectional studies. Plos One 15(10):e0239929. https://doi.org/10.1371/journal.pone.0239929
Drury ER, Wu J, Gigliotti JC, Le T. H. 2024. Sex differences in blood pressure regulation and hypertension: renal, hemodynamic, and hormonal mechanisms. Physiol Rev 104(1):199−251. https://doi.org/10.1152/physrev.00041.2022
Egg S, Wakolbinger M, Reisser A, Schätzer M, Wild B, Rust P. 2020. Relationship between nutrition knowledge, education and other determinants of food intake and lifestyle habits among adolescents from urban and rural secondary schools in Tyrol, Western Austria. Public Health Nutr 23(17):3136−3147. https://doi.org/10.1017/S1368980020000488
Eslami M, Pourghazi F, Khazdouz M, Tian J, Pourrostami K, Esmaeili-Abdar Z, Ejtahed HS, Qorbani M. 2023. Optimal cut-off value of waist circumference-to-height ratio to predict central obesity in children and adolescents: A systematic review and meta-analysis of diagnostic studies. Front Nutr 9:985319. https://doi.org/10.3389/fnut.2022.985319
Fedewa MV, Nickerson BS, Esco MR. 2019. Associations of body adiposity index, waist circumference, and body mass index in young adults. Clin Nutr 38(2):715−720. https://doi.org/10.1016/j.clnu.2018.03.014
Flynn JT, Kaelber DC, Baker-Smith CM, Blowey D, Carroll AE, Daniels SR, De Ferranti SD, Dionne JM, Falkner B, Flinn SK et al. 2017. Clinical practice guideline for screening and management of high blood pressure in children and adolescents. Pediatr 140(3). https://doi.org/10.1542/peds.2017-1904
Fowler GC. 2019. Pfenninger and Fowler's Procedures for Primary Care. 4th edition. Amsterdam (NL): Elsevier Health Sciences.
Froon-Torenstra D, Renting L, Kok DE, Vermeij WP, Tissing WJE. 2024. Comparison of two bioelectrical impedance analyzers for estimating body composition in a cohort of pediatric oncology patients Clin Nutr Open Sci 57:1−9. https://doi.org/10.1016/j.nutos.2024.07.006
Ganapathy S, Jawahir S, Tan L. 2020. Penemuan Utama NHMS 2019. Malaysia (KL): Kemenyterian Kesihatan Malaysia. Ganapathy SS, Aris TH, Ahmad NA, Shauki NIHA, Krishnan M, Kaundan NA, Yusoff MFM, Jawahir S, Perialathan K, Kassim MSA et al. 2019. National Health and Morbidity Survey 2019: Non- Communicable Diseases, Healthcare Demand and Health Literacy.
Guimarães Filho GC, Silva LT, Silva LT. 2022. Correlação entre a Circunferência de Cintura e Medidas Centrais da Pressão Arterial. Arquivos Brasileiros de Cardiologia 119:257. https://doi.org/10.36660/abc.20210432
Kallioinen N, Hill A, Horswill MS, Ward HE, Watson MO.2017. Sources of inaccuracy in the measurement of adult patients’ resting blood pressure in clinical settings: A systematic review. J Hypertens 35(3):421−441. https://doi.org/10.1097/hjh.0000000000001197
Khair NAM, Wee BS. 2021. Association between pubertal status and body fat percentage among Malay adolescents in Kuala Nerus, Terengganu. Malaysian Appl Biol 50(2):81−88. https://doi.org/10.55230/mabjournal.v50i2.1982
Kim MS, Kim SY, Kim JH. 2018. Secular change in waist circumference and waist-height ratio and optimal cutoff of waist-height ratio for abdominal obesity among Korean children and adolescents over 10 years. Korean J Pediatr 62(7):261−268. https://doi.org/10.3345/kjp.2018.07038
Krejcie RV, Morgan DW. 1970. Sample size determination using Krejcie and Morgan table. Kenya Projects Organization (KENPRO) 38:607−610.
Kurnianto A, Kurniadi Sunjaya D, Ruluwedrata Rinawan F, Hilmanto D. 2020. Prevalence of hypertension and its associated factors among Indonesian Adolescents. Int J Hypertens 2020(1):4262034. https://doi.org/10.1155/2020/4262034
Li Y, Zou Z, Luo J, Ma J, Ma Y, Jing J, Zhang X, Luo C, Wang H, Zhao H et al. 2020. The predictive value of anthropometric indices for cardiometabolic risk factors in Chinese children and adolescents: A national multicenter school-based study. Plos One 15(1):e0227954. https://doi.org/10.1371/journal.pone.0227954
Martha Sari NKP, Sulistiawati S, Indarwati R. 2021. The Behavior prevention of obesity in adolescents with self efficacy: A systematic review. STRADA Jurnal Ilmiah Kesehatan 10(1):1160−1173.
Mohammed Nawi A, Mohammad Z, Jetly K, Abd Razak MA, Ramli NS, Wan Ibadullah WAH, Ahmad N. 2021. The prevalence and risk factors of hypertension among the urban population in Southeast Asian Countries: A Systematic review and metaanalysis. Int J Hypertens 2021:6657003. https://doi.org/10.1155/2021/6657003
Mohan B, Verma A, Singh K, Singh K, Sharma S, Bansal R, Tandon R, Goyal A, Singh B, Chhabra ST. 2019. Prevalence of sustained hypertension and obesity among urban and rural adolescents: a school-based, crosssectional study in North India. BMJ Open 9(9):e027134. https://doi.org/10.1136/bmjopen-2018-027134
Omar MA, Irfan NI, Yi KY, Muksan N, MajidNLA, Yusoff M FM. 2016. Prevalence of young adult hypertension in Malaysia and its associated factors: Findings from National Health and Morbidity Survey 2011.
Pazin DC, da Luz Kaestner TL, Olandoski M, Baena CP, de Azevedo Abreu G, Kuschnir MCC, Bloch KV, Faria-Neto JR. 2020. Association between abdominal waist circumference and blood pressure in Brazilian Adolescents with normal body mass index: Waist circumference and blood pressure in Adolescents. Glob Heart 15(1):27. https://doi.org/10.5334/gh.779
Poh BK, Ang YN, Yeo GS, Lee YZ, Lee ST, Chia JSM, Wee BS. 2022. Anthropometric indices, but not birth weight, are associated with high blood pressure risk among Malay adolescents in Kuala Lumpur. Dialogues in Health 1:100006. https://doi.org/10.1016/j.dialog.2022.100006
Rampal L, Ng KC, Izzati IN, Izzati ZF, Nazrul IM, Faisal I, Zainiyah SS. 2011. Prevalence of hypertension among Malay adolescents in Putrajaya secondary schools, Malaysia, 2010. MJMHS 7(2):53−60.
Saha S, Pandya AK, Kandre Y, Raval D, Saxena D. 2021. Cross-Sectional Analysis of Nutritional Status, Knowledge and Uptake of Nutritional Services Among Adolescent Girls in Western India. Adolesc Health Med Ther 12:117−125. https://doi.org/10.2147/AHMT.S336071
Song JJ, Ma Z, Wang J, Chen LX, Zhong JC. 2020. Gender Differences in Hypertension. J Journal of Cardiovascular Translational Research 13(1):47−54. https://doi.org/10.1007/s12265-019-09888-z
Soo J, Chow ZY, Ching SM, Tan CH, Lee KW, Devaraj NK, Salim HS, Ramachandran V, Lim PY, Sivaratnam D et al. 2020. Prevalence, awareness and control of hypertension in Malaysia from 1980−2018: A systematic review and meta-analysis. World J Meta-Anal 8(4):320−344. https://doi.org/10.1007/s12265-019-09888-z
Sukmasari V, Dieny FF, Panunggal B. 2019.Metabolic syndrome and bone density in obese adolescents. J Gizi Pangan 14(1):9−16. https://doi.org/10.25182/jgp.2019.14.1.9-16
Taxová Braunerová R, Kunešová M, HeinenMM, Rutter H, Hassapidou M, Duleva V, Pudule I, Petrauskienė A, Sjöberg A, Lissner L, Spiroski I. 2021. Waist circumference and waist-to-height ratio in 7-year-old children—WHO Childhood obesity surveillance initiative. Obes Rev 22(S6):e13208. https://doi.org/10.1111/obr.13208
Tebar WR, Ritti-Dias RM, Farah BQ, Zanuto EF, Vanderlei LCM, Christofaro DGD. 2018. High blood pressure and its relationship to adiposity in a school-aged population: Body mass index vs waist circumference. Hypertens Res 41(2):135−140. https://doi.org/10.1038/hr.2017.93
Trandafir LM, Russu G, Moscalu M, Miron I, Lupu VV, Leon Constantin MM, Cojocaru E, Lupu A, Frasinariu OE. 2020. Waist circumference a clinical criterion for prediction of cardio-vascular complications in children and adolescences with overweight and obesity. Medicine99(30):e20923. https://doi.org/10.1097/md.0000000000020923
Verma M, Rajput M, Kishore K, Kathirvel S. 2019. Asian BMI criteria are better than WHO criteria in predicting Hypertension: A crosssectional study from rural India. J Family Med Prim Care 8(6):2095−2100. https://doi.org/10.4103/jfmpc.jfmpc_257_19
[WHO Regional Office for the Western Pacific] World Health Organization Regional Office for the Western Pacific. 2000. The Asia-Pacific perspective: Redefining obesity and its treatment. Sydney (AUS): Health Communactions Australia.
Wang L, Song L, Liu B, Zhang L, Wu M, Cao Z, Wang Y. 2019. Trends and status of the prevalence of elevated blood pressure in children and adolescents in China: a systematic review and meta-analysis. Curr Hypertens Rep 21(11):1−12 https://doi.org/10.1007/s11906-019-0992-1
Widjaja NA, Arifani R, Irawan R. 2023. Cut-off value of waist-to-hip ratio as a predictor of metabolic syndrome in adolescents with obesity. Acta Biomed 94(3):e2023076. https://doi.org/10.23750/abm.v94i3.13755
Xiao J, Purcell SA, Prado CM, Gonzalez MC. 2018. Fat mass to fat-free mass ratio reference values from NHANES III using bioelectrical impedance analysis. Clin Nutr 37(6):2284−2287. https://doi.org/10.1016/j.clnu.2017.09.021
Yao W, Luo J, Ao L, Cheng H, Lu S, Liu J, Lu K, Mi J, Yang Y, Liu L. 2023. Association of total body fat and fat distribution with bone mineral density among children and adolescents aged 6–17 years from Guangzhou, China. Eur J Pediatr 182(3):1115−1126. https://doi.org/10.1007/s00431-022-04727-x
Zimmet P, Alberti K, Kaufman F, Tajima N, Silink M, Arslanian S, Wong G, Bennett P, Shaw J, Caprio S. 2007. The metabolic syndrome in children and adolescents–an IDF consensus report. Pediatric Diabetes 8(5):299−306. https://doi.org/10.1111/j.1399-5448.2007.00271.x
Authors
BaharunN. A. N., WeeB. S., ShahrilM. R., & PohB. K. (2024). Anthropometric Measures of Adiposity and Their Associations with Blood Pressure among Malay Adolescents Aged 18 to 19 Years Old in Terengganu. Jurnal Gizi Dan Pangan, 19(3), 197-206. https://doi.org/10.25182/jgp.2024.19.3.197-206
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