Implications of pubertal stage in cardiometabolic risk factors in obese adolescents: a network analysis

Despite the existence of numerous studies describing the early stages of sexual maturation in overweight children, there is still a gap in understanding the consequences of obesity at each level of pubertal development and its association with cardiometabolic diseases. Network analysis thus proves to be a promising approach for understanding the complexity of obesity in adolescence. This study aimed to analyze the associations of cardiometabolic risk factors at the expense of the pubertal stage in overweight adolescents. This cross-sectional study analyzed 97 adolescents (54.6% females, mean age 12.87 ± 2.48 years old). Sociodemographic information, anthropometr, body composition, and biochemical data [fasting glucose, cholesterol, high-density lipoprotein (HDL-c), low-density lipoprotein (LDL-c), and triglycerides] were collected. Adolescents were classified according to pubertal stage (SP, n = 59) or postpubertal stage (SPP, n = 38). The study employed an unpaired t test to compare the variables based on pubertal stage, with a significance level of 5%. In addition, Bayesian network analysis was used to investigate the associations between cardiometabolic risk factors and puberty. The analysis revealed the indicator of expected influence centrality, highlighting the network's key factors. The network configuration had a more significant influence on the fat mass (FM) (1.863), high-density lipoprotein (HDL-c) (-1.137), and fat-free mass (FFM) (1.392) parameters in the SP group and on the SPP - HDL-c (-1.389), lean mass (LM) (1.269), and fat-free mass (FFM) (1.220) parameters. The analysis also revealed the indicator of expected influence centrality, highlighting the network's key factors. When the stages in the SSP group were compared, the values of body mass, height, body mass index, abdominal circumference, FFM, LM, FM, and visceral fat were measured. These findings suggest the need for tailored strategies and programs to prevent excess weight and improve cardiometabolic health in adolescents, regardless of pubertal stage, to mitigate the long-term damage caused by obesity.