Aerobic fitness, lipid ratio, visceral adiposity index and risk of hypertension in adolescents: An observational study

doi:10.5409/wjcp.v14.i3.105939

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Sep 9, 2025 (publication date) through Jun 17, 2025

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World Journal of Clinical Pediatrics

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2219-2808

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Baishideng Publishing Group Inc, 7041 Koll Center Parkway, Suite 160, Pleasanton, CA 94566, USA

Observational Study

World J Clin Pediatr. Sep 9, 2025; 14(3): 105939
Published online Sep 9, 2025. doi: 10.5409/wjcp.v14.i3.105939

Table 1 General characteristics of participants stratified by sex (n = 403)

Variable	Total (n = 403)	Girls (n = 201)	Boys (n = 202)	t-value	P value
Age (year)	14.7 ± 2.3	14.8 ± 2.3	14.7 ± 2.2	0.586	0.558
APHV (year)	13.3 ± 1.1	12.5 ± 0.8	14.1 ± 0.8	20.068	< 0.001
MO (year)	1.4 ± 1.3	2.3 ± 1.7	0.6 ± 1.0	10.029	< 0.001
Stature (cm)	160.2 ± 9.8	159.6 ± 7.1	160.9 ± 11.9	0.303	0.193
Weight (kg)	53.1 ± 12.5	55.5 ± 12.1	50.8 ± 12.5	3.784	0.016
BMI (kg/m²)	20.5 ± 3.5	21.7 ± 4.0	19.3 ± 2.6	6.929	< 0.001
WC (cm)	65.8 ± 8.8	67.2 ± 9.4	64.4 ± 8.0	2.273	0.001
20-MST (lap)	32.2 ± 16.8	24.9 ± 13.3	39.5 ± 16.8	9.697	< 0.001
Peak VO₂ (mL/kg/min)	40.4 ± 4.4	38.3 ± 4.0	42.5 ± 2.7	10.898	< 0.001
TG (mmol/L)	1.0 ± 0.9	1.1 ± 1.2	0.9 ± 0.4	1.653	0.100
HDL-C (mmol/L)	1.3 ± 0.4	1.3 ± 0.3	1.3 ± 0.4	1.090	0.276
TG/HDL-C	0.9 ± 0.6	1.0 ± 0.6	0.8 ± 0.5	1.697	0.091
VAI	1.2 ± 0.7	1.6 ± 0.8	0.8 ± 0.6	3.912	< 0.001
SBP (mmHg)	105.6 ± 16.7	107.8 ± 16.7	103.5 ± 16.2	2.587	0.010
DBP (mmHg)	69.9 ± 14.5	70.5 ± 15.3	69.5 ± 13.5	0.595	0.552

APHV: Age at peak height velocity; MO: Maturity off-set; BMI: Body mass index; WC: Waist circumference; HDL-C: High-density lipoprotein cholesterol; TG: Triglycerides; VAI: Visceral adiposity index; 20-MST: Multistage shuttle run test; Peak VO₂: Aerobic fitness; SBP: Systolic blood pressure; DBP: Diastolic blood pressure.

Table 2 Comparison of participants cardiometabolic health indicators according to their hypertension risk status

Variable	Girls			Boys
Variable	No risk (n = 187)	Risk (n = 14)	Total (n = 201)	No risk (n = 194)	Risk (n = 08)	Total (n = 202)
Age (year)	14.7 ± 2.3	16.6 ± 1.5	14.8 ± 2.3^a	14.6 ± 2.2	16.5 ± 1.9	14.7 ± 2.2^a
Body mass	54.9 ± 12.1	63.1 ± 10.3	55.4 ± 12.1^b	50.3 ± 11.8	63.4 ± 20.4	50.8 ± 12.5
BMI	21.4 ± 3.9	24.6 ± 3.2	21.7 ± 4.0^b	19.2 ± 2.4	22.7 ± 4.5	19.3 ± 2.6
Peak VO₂ (mL/kg/min)	38.6 ± 4.0	35.3 ± 2.5	38.3 ± 4.0^b	42.6 ± 3.6	39.5 ± 3.2	42.5 ± 3.7
WC	66.6 ± 8.9	75.1 ± 11.9	67.2 ± 9.4^b	64.1 ± 7.8	70.8 ± 10.6	64.4 ± 8.0
SBP	105.5 ± 15.3	135.7 ± 5.4	107.8 ± 6.7^a	101.8 ± 14.0	145.7 ± 5.1	103.5 ± 16.2^a
DBP	69.1 ± 15.0	86.9 ± 10.3	70.4 ± 15.3^a	68.3 ± 11.9	97.8 ± 20.2	69.5 ± 13.5^b
TG	1.0 ± 0.3	1.4 ± 0.8	1.2 ± 0.2	0.7 ± 0.1	0.7 ± 0.1	0.9 ± 0.4^a
HDL-C	1.3 ± 0.3	1.3 ± 0.3	1.3 ± 0.3	1.3 ± 0.4	1.3 ± 0.2	1.3 ± 0.4
TG/HDL	1.0 ± 0.7	1.2 ± 0.8	1.0 ± 0.7	0.5 ± 0.5	0.5 ± 0.1	0.8 ± 0.5
VAI	1.6 ± 0.8	1.2 ± 0.7	1.6 ± 0.8	0.9 ± 0.6	0.6 ± 0.1	0.8 ± 0.6

^aP < 0.001.

^bP < 0.05.

VAI: Visceral adiposity index; Peak VO₂: Aerobic fitness; BMI: Body mass index; TG/HDL-C: Triglycerides-to-High-density lipoprotein cholesterol; SBP: Systolic blood pressure; DBP: Diastolic blood pressure; WC: Waist circumference.

Table 3 Partial correlation coefficients assessing the relationships among aerobic fitness, atherogenic index of the plasma, visceral adiposity index, and blood pressure

Sex	SBP			DBP
Sex	Peak VO₂	VAI	AIP	Peak VO₂	VAI	AIP
Girls	-0.284^a	0.120^b	0.084	0.061	0.127^b	0.085
Boys	-0.230^a	0.094	0.069	-0.169^b	0.205^b	0.150^b

^aP < 0.001.

^bP < 0.05.

Peak VO₂: Aerobic fitness; VAI: Visceral adiposity index; AIP: Atherogenic index of the plasma; SBP: Systolic blood pressure; DBP: Diastolic blood pressure.

Table 4 Standardized regression coefficients assessing the relationships among Aerobic fitness, Atherogenic index of the plasma, Visceral adiposity index, and Systolic blood pressure

Sex	Predictor	R²	R² change	Model 1		Model 2
Sex	Predictor	R²	R² change	β	P value	β	P value
Girls	Age	0.356	0.116	0.111	0.650	0.700	0.008
	MO	-	-	0.383	0.118	-0.264	0.323
	Peak VO₂	-	-	-	-	0.328	< 0.001
	AIP	-	-	-	-	-0.391	< 0.001
	VAI	-	-	-	-	1.439	< 0.001
Boys	Age	0.362	0.096	0.799	< 0.001	2.046	< 0.001
	MO	-	-	-0.304	0.142	-0.772	< 0.001
	Peak VO₂	-	-	-	-	0.548	< 0.001
	AIP	-	-	-	-	-0.802	0.029
	VAI	-	-	-	-	0.704	0.063

MO: Maturity off-set; Peak VO₂: Aerobic fitness; VAI: Visceral adiposity index; AIP: Atherogenic index of the plasma.

Table 5 Standardized regression coefficients assessing the relationships among Aerobic fitness, Atherogenic index of the plasma, visceral adiposity index, and diastolic blood pressure

Sex	Predictor	R²	R² change	Model 1		Model 2
Sex	Predictor	R²	R² change	β	P	β	P
Girls	Age	0.306	0.064	0.620	0.012	0.791	0.004
	MO	-	-	-0.133	0.585	-0.346	0.212
	Peak VO₂	-	-	-	-	0.116	0.099
	AIP	-	-	-	-	-1.528	< 0.001
	VAI	-	-	-	-	1.585	< 0.001
Boys	Age	0.208	0.095	1.129	< 0.001	1.407	< 0.001
	MO	-	-	-1.103	< 0.001	-1.524	< 0.001
	Peak VO₂	-	-	-	-	0.293	0.025
	AIP	-	-	-	-	-1.4849	< 0.001
	VAI	-	-	-	-	1.984	< 0.001

MO: Maturity off-set; Peak VO₂: Aerobic fitness; VAI: Visceral adiposity index; AIP: Atherogenic index of the plasma.

Table 6 Receiver operating characteristics curve analysis for hypertension risk among participants

Outcome variable	Group	Independent variable	AUC	95%CI	Cut-point	Se	Spe	P value
SBP	Girls	AF	0.616	0.462-0.769	37.1	0.571	0.433	0.149
		AIP	0.620	0.436-0.805	0.544	0.571	0.599	0.133
		VAI	0.597	0.402-0.793	0.764	0.571	0.701	0.224
	Boys	AF	0.597	0.415-0.725	41.169	0.750	0.397	0.130
		AIP	0.280	0.143-0.416	0.725	0.250	0.412	0.135
		VAI	0.330	0.172-0.488	0.822	0.250	0.340	0.103
DBP	Girls	AF	0.503	0.381-0.625	38.9	0.529	0.313	0.956
		AIP	0.696	0.610-0.782	0.556	0.706	0.503	< 0.001
		VAI	0.698	0.608-0.787	0.954	0.706	0.413	< 0.001
	Boys	AF	0.595	0.448-0.743	41.2	0.529	0.605	0.194
		AIP	0.464	0.248-0.649	0.726	0.471	0.400	0.625
		VAI	0.507	0.331-0.684	0.823	0.471	0.324	0.919

SBP: Systolic blood pressure; DBP: Diastolic blood pressure; AF: Aerobic fitness; VAI: Visceral adiposity index; AIP: Atherogenic index of the plasma.

Citation: Musa DI, Goon DT, Omachi S, Jonathan SU. Aerobic fitness, lipid ratio, visceral adiposity index and risk of hypertension in adolescents: An observational study. World J Clin Pediatr 2025; 14(3): 105939
URL: https://www.wjgnet.com/2219-2808/full/v14/i3/105939.htm
DOI: https://dx.doi.org/10.5409/wjcp.v14.i3.105939