Social class-related gradient in the association of skeletal growth with blood pressure among adolescent boys in India.

OBJECTIVE In view of the fact that height differences between socio-economic groups are apparent early in childhood, it is of interest to examine whether skeletal growth is reflective of the social class gradient in CVD risk. The present study examined blood pressure levels, adiposity and growth of adolescent boys from high and low social classes. DESIGN In a cross-sectional study, skeletal growth (height and sitting height), adiposity (weight, BMI and body fat) and blood pressure levels of the adolescents were measured. SETTING Pune, India. SUBJECTS Adolescent schoolboys (9-16 years) from high socio-economic (HSE; n 1146) and low socio-economic (LSE; n 932) class. RESULTS LSE boys were thin, short and undernourished (mean BMI: 15.5 kg/m2 v. 19.3 kg/m2 in HSE boys, P = 0.00). Social gradient was revealed in differing health risks. The prevalence of high systolic blood pressure (HSBP) was high in HSE class (10.5 % v. 2.7 % in LSE class, P = 0.00) and was associated with adiposity, while the prevalence of high diastolic blood pressure (HDBP) was high in LSE class (9.8 % v. 7.0 % in HSE class, P = 0.00) and had only a weak association with adiposity. Despite this, lower ratio of leg length to height was associated with significantly higher respective health risks, i.e. for HDBP in LSE class (OR = 1.99, 95 % CI 1.14, 3.47) and for HSBP in HSE class (OR = 1.69, 95 % CI 1.02, 2.77). CONCLUSIONS As stunting in childhood is a major problem in India and Asia, the leg length to height indicator needs to be validated in different populations to understand CVD risks.