title: Mild stunting is associated with higher blood pressure in overweight adolescents.
abstract: BACKGROUND
  Studies have shown that pre/postnatal undernutrition leads to higher risk of non communicable diseases such as diabetes, hypertension and obesity in adulthood.
  
  
  OBJECTIVE
  To determine whether overweight adolescents with mild stunting [height-for-age Z scores (HAZ) in the range <-1 to ≥ -2] have higher blood pressure than overweight individuals with normal stature (HAZ ≥ -1).
  
  
  METHODS
  Participants were classified as mildly stunted or of normal stature, and further stratified according to body mass index-for-age percentiles as overweight, normal or underweight. Systolic (SBP) and diastolic (DPB) blood pressures were determined according to guidelines, and abdominal fat was analyzed by dual energy X-ray absorptiometry.
  
  
  RESULTS
  Mild stunted overweight individuals showed higher DBP values (p=0.001) than their underweight counterparts (69.75 ± 12.03 and 54.46 ± 11.24 mmHg, respectively), but similar to those of normal BMI. No differences were found in DBP values of normal, overweight and underweight individuals among the normal stature groups. An increase in SBP (p=0.01) among mild stunted individuals was found when those with overweight were compared to their underweight and normal BMI counterparts (114.70 ± 15.46, 97.38 ± 10.87 and 104.72 ± 12.24 mmHg, respectively). Although no differences were observed in the means of SBP between mild stunting and normal stature groups, a significant intercept was found (p=0.01), revealing higher SBP among stunted individuals. There was a correlation between SBP and abdominal fat (r=0.42, ρ=0.02) in the stunted group.
  
  
  CONCLUSIONS
  Stunted individuals with overweight showed higher SBP than those of normal stature and overweight. These findings confirm that mild stunting increase the risk of future hypertension and alterations are evident at early age.
authors.affiliation: Departamento de Fisiologia, Universidade Federal de São Paulo, Brazil. ana.clemente@unifesp.br
authors.forename: Ana Paula Grotti
authors.initials: AP
authors.lastname: Clemente
authors.forename: Carla Danusa
authors.initials: CD
authors.lastname: Santos
authors.forename: Ana Amelia Benedito
authors.initials: AA
authors.lastname: Silva
authors.forename: Vinicius Jose
authors.initials: VJ
authors.lastname: Martins
authors.forename: Anna Carolina
authors.initials: AC
authors.lastname: Marchesano
authors.forename: Mariana Belluca
authors.initials: MB
authors.lastname: Fernandes
authors.forename: Maria Paula
authors.initials: MP
authors.lastname: Albuquerque
authors.forename: Ana Lydia
authors.initials: AL
authors.lastname: Sawaya
mesh_terms: D050153:Abdominal Fat / Q000503:physiopathology; D000293:Adolescent; D001794:Blood Pressure / Q000502:physiology; D015992:Body Mass Index; D016022:Case-Control Studies; D002648:Child; D003430:Cross-Sectional Studies; D005260:Female; D006130:Growth Disorders / Q000145:classification / Q000209:etiology / Q000503:physiopathology*; D006801:Humans; D006973:Hypertension / Q000209:etiology* / Q000503:physiopathology; D007223:Infant; D007228:Infant Nutrition Disorders / Q000145:classification / Q000150:complications*; D008297:Male; D050177:Overweight / Q000209:etiology / Q000503:physiopathology*; D012016:Reference Values; D012307:Risk Factors; D055815:Young Adult