Search Results (256)

Androgens regulate skeletal muscle, bone, erythropoiesis, and male reproductive function via the androgen receptor (AR), a ligand-dependent transcription factor. Pharmacologic modulation of AR has been pursued for clinical and non-medical purposes. Anabolic androgenic steroids (AAS), synthetic testosterone derivatives, act as full AR agonists, broadly activating multiple tissues. While effective in promoting muscle growth and strength, AAS cause well-known adverse effects, including hypothalamic–pituitary–gonadal (HPG) axis suppression, dyslipidemia, hepatotoxicity, cardiovascular disease, tendon injury, and neuropsychiatric disturbances. Selective androgen receptor modulators (SARMs) aim to stimulate AR in muscle and bone while minimizing androgenic effects in prostate and skin. They induce ligand-specific AR conformations, altering coactivator and corepressor recruitment, and avoiding metabolism by 5α-reductase or aromatase. Preclinical studies show favorable anabolic-to-androgenic ratios, but clinical translation is limited. Early human trials report modest lean mass gains, variable functional outcomes, and dose-dependent testosterone suppression. Emerging evidence also suggests cardiotoxicity, tendon injury, and liver toxicity, though long-term effects are unclear. Pharmacokinetically, SARMs have predictable oral absorption and moderate half-lives, enabling once-daily dosing, unlike AAS. This review compares AAS and SARMs in molecular mechanisms, pharmacokinetics, and safety. While SARMs offer partial tissue selectivity and reduced adverse effects, risks remain, and long-term safety is uncertain. Regulatory oversight is limited, and non-medical use is rising. Preclinical and clinical studies are needed to clarify whether SARMs can separate anabolic benefits from androgenic toxicity and inform safe clinical application. Full article

Janus kinase (JAK) inhibitors have become an important therapeutic option for a wide range of immune-mediated inflammatory diseases. By targeting intracellular cytokine signaling through inhibition of the JAK–STAT pathway, these agents provide effective suppression of multiple inflammatory cascades. Alongside their growing clinical use, changes in body weight—particularly weight gain—have recently been reported in clinical practice. Although this phenomenon has not consistently emerged as a prominent adverse event in randomized clinical trials, observational studies and real-world data suggest that weight gain may occur in some of the treated patients. The mechanisms underlying these changes remain barely understood and are likely multifactorial. Effective suppression of systemic inflammation may reverse inflammation-driven catabolism and restore metabolic balance, contributing to increases in body weight and lean body mass. In addition, experimental evidence indicates that JAK–STAT signaling participates in adipocyte differentiation, lipid metabolism, and energy regulation. Pharmacologic inhibition of this pathway may therefore influence adipose tissue biology, thermogenic activity, and appetite regulation through leptin-dependent signaling pathways. This review summarizes current evidence regarding weight and body composition changes associated with JAK inhibitor therapy, integrating findings from experimental studies, clinical trials, and real-world observations. Potential biological mechanisms are discussed alongside patient-related and disease-related factors that may modify the risk of weight gain. A better understanding of these immune–metabolic interactions may help guide clinical monitoring and future research on the metabolic consequences of JAK inhibition. Full article

Background: Metabolic syndrome is associated with early impairments in cellular bioenergetics that are not fully captured by conventional body composition measures. Molecular hydrogen, produced endogenously through gut microbial fermentation and measurable in breath, has been implicated in redox and mitochondrial regulation. Whether breath hydrogen relates to preservation of intracellular, metabolically active tissue in metabolic syndrome remains unclear. Objectives: To examine the association between breath hydrogen concentration and an integrated cellular bioenergetic phenotype derived from intracellular body composition indices in sedentary adults with metabolic syndrome. Methods: Twenty-eight sedentary, middle-aged adults (51.2 ± 7.9 years, 19 females) with metabolic syndrome underwent fasting breath hydrogen assessment and multifrequency bioelectrical impedance analysis. A composite cellular bioenergetic phenotype was derived using principal component analysis of body cell mass, intracellular water, total body potassium, and glycogen. Associations between breath hydrogen and the composite phenotype were evaluated using Spearman correlation with bootstrapped confidence intervals, Theil-Sen regression, and Bayesian linear regression adjusted for age, sex, and waist circumference. Sensitivity analyses included fat-free mass. Results: A single principal component explained 98.6% of the variance across intracellular variables, indicating a highly coherent cellular bioenergetic phenotype. Breath hydrogen concentration was positively associated with this phenotype (ρ = 0.43, p = 0.021; BCa 95% CI 0.07–0.70). Theil-Sen regression confirmed a robust positive association (β = 0.017 per ppm hydrogen; 95% CI 0.002–0.046). Bayesian models showed posterior distributions centered on positive effect sizes, independent of central adiposity. In contrast, the association with fat-free mass alone was borderline. Conclusions: Breath hydrogen concentration reflects an integrated intracellular bioenergetic phenotype in sedentary adults with metabolic syndrome, tracking cellular quality rather than lean mass quantity. Breath hydrogen may serve as a non-invasive biomarker of cellular bioenergetic integrity and a potential tool for phenotype-guided metabolic interventions. Full article

Background: Roux-en-Y gastric bypass (RYGB) is a highly effective treatment for severe obesity, achieving substantial weight loss and metabolic improvement. Beyond weight, assessing body composition and functional markers is essential. Phase angle (PA), obtained through bioelectrical impedance, is a relevant indicator of cellular integrity and nutritional status. The rise of glucagon-like peptide-1 and glucose-dependent insulinotropic polypeptide (GLP-1 and GLP-1/GIP) agonists makes comparison with surgical outcomes increasingly important. This study aimed to evaluate changes in fat mass, lean mass, hydration, and PA after RYGB and compare these findings with evidence from pharmacological therapies. Methods: A retrospective observational study was conducted in 15 patients (18–50 years, BMI > 35 kg/m²) at Quirón Salud Hospital Torrevieja. Body composition was assessed using multifrequency bioelectrical impedance (TANITA BC-980) before surgery and at 3 and 12 months. All patients received structured nutritional follow-up. Repeated-measures ANOVA and the Friedman test were applied. Results: After 12 months, weight decreased by 40.06 ± 11.86 kg; fat mass by 30.43 ± 10.81 kg; and fat-free mass by 9.64 ± 5.31 kg. PA declined 11% during the first 3 months and then stabilized. Women lost more fat mass; men lost more lean mass. Conclusions: RYGB combined with nutritional support produces high-quality weight loss with relative preservation of lean tissue and stabilization of PA, which proves valuable for postoperative monitoring. Full article

Background: Body mass index (BMI) is commonly used to assess nutritional status; however, it cannot distinguish between fat and lean tissue. In young adults, this limitation may mask excess adiposity and distort diet–adiposity associations. Bioelectrical impedance analysis (BIA) provides more detailed measures, including percent of body fat (PBF), skeletal muscle mass (SMM), and the visceral fat level. Objectives: To examine how combining BMI with BIA-based classifications of adiposity influences the assessment of diet–body composition associations in young adults. Methods: This cross-sectional study of 285 young adults (median age 18 years, IQR: 18–20) used InBody BIA to classify participants by BMI and PBF. Dietary habits were assessed via food frequency questionnaire covering eight food groups. Group comparisons used Mann–Whitney U tests with Cohen’s d effect sizes; correlations used Spearman’s rank correlation. Results: Thirty-five participants (12.3%) were BMI-Normal but PBF-High (normal BMI with elevated body fat), a phenotype missed by BMI screening; overall BMI-PBF agreement was 75.4%. Physical activity (IPAQ) correlated significantly with body composition markers, PBF (rho = −0.177, p = 0.003) and SMM (rho = +0.186, p = 0.002), but not with BMI (rho = +0.060, p = 0.310). BMI showed an inverse association with self-reported sweets consumption (rho = −0.138, p = 0.020), likely reflecting a reporting bias rather than true intake, as this pattern disappeared when examining actual adiposity (PBF: rho = +0.032, p = 0.591). Conclusions: Combining BIA with BMI may improve the detection of elevated body fat (12.3% prevalence of normal BMI with elevated body fat); BMI-based screening may not identify all individuals with elevated body fat. Physical activity associations support the complementary value of BIA alongside BMI. Apparent diet–BMI associations may be confounded by adiposity misclassification and reporting bias. Full article

Background/Objectives: While sarcopenia has been implicated, we hypothesize that a distinct body composition phenotype, characterized by elevated visceral adiposity and reduced abdominal muscle mass, plays a more critical role in T2DM-related fracture pathogenesis. Methods: In a cross-sectional study of 99 female patients aged ≥65 years who underwent surgery for hip fracture, we compared body composition parameters derived from DXA scans between those with (n = 40) and without (n = 59) T2DM. Key measures included appendicular lean mass index (ALMI), visceral adipose tissue (VAT) mass, android-to-gynoid (A/G) fat ratio, and a derived measure of relative core lean mass (RCLM). Results: There were no significant differences in ALMI between T2DM and non-DM groups. In contrast, T2DM showed significantly higher central adiposity—A/G ratio (1.13 ± 0.15 vs. 1.05 ± 0.17; p = 0.0298) and TL fat ratio (1.31 ± 0.22 vs. 1.19 ± 0.23; p = 0.0071)—with VAT estimate numerically higher. Conclusions: In older hip-fracture patients, T2DM was characterized not by appendicular sarcopenia but by central adiposity without significant differences in LMI or RCLM—a phenotype that may contribute to fracture risk through bone-quality and fall-related pathways independent of ALMI. Full article

Background/Objectives: Metabolic Dysfunction-Associated Steatotic Liver Disease (MASLD) is a global health crisis, but current diagnostics are limited. Liver biopsy is invasive, magnetic resonance imaging-proton density fat fraction (MRI-PDFF) is expensive, and quantitative ultrasound methods are low-accuracy, especially in patients with a high body mass index (BMI). This study introduces a novel thermo-acoustic (TA) method that generates ultrasound signals based on tissue electrical conductivity, where lean tissue (high in water and electrolytes) absorbs more radio-frequency (RF) energy than fatty tissue, providing a direct molecular contrast for fat. Methods: A prospective, cross-sectional feasibility study compared a new thermo-acoustic fat fraction (TAFF) score with the reference standard MRI-PDFF in 40 subjects with suspected fatty liver disease. Bland–Altman analysis, Deming regression, and Binary classification performance were tested. To establish system stability, a dedicated Repeatability and Reproducibility (R&R) study (N = 14) evaluated inter-operator and intra-operator consistency using an Intraclass Correlation Coefficient (ICC) derived from a two-way random-effects ANOVA model. Results: TAFF estimates demonstrated a substantial correlation (r = 0.89) with MRI-PDFF and an average absolute error of 3.04% fat fraction. Classification performance was high, with an Area Under the Receiver Operating Characteristic Curve (AUROC) of 0.92 at the 12% fat fraction threshold and 0.99 at the 20% fat fraction threshold. The R&R study confirmed robust stability (intraclass correlation = 0.89) and a negligible mean inter-operator difference of 0.36%. Estimation errors showed no statistically significant correlation with BMI or other body habitus measurements. Conclusions: These findings support thermoacoustics’ potential as an accurate, non-invasive, point-of-care solution that can serve as a new imaging biomarker. By providing predictive values closely aligned with MRI-PDFF across the full MASLD spectrum, TAFF can complement currently available ultrasound methods to address the cost and access constraints of MRI for the assessment, diagnosis, and monitoring of MASLD. Full article

Objectives: Hormonal changes during the postmenopausal period of life predispose women to changes in fat tissue distribution and the risk of insulin resistance, and may lead to deterioration of bone metabolism. Physical activity plays a significant role in improving metabolic health and may inhibit bone mass decrease. The purpose of this study was to analyze the relationships between bone health, body composition, maximal oxygen uptake (VO₂max), and carbohydrate metabolic indices in non-diabetic postmenopausal women. Methods: Fifty-seven postmenopausal women were included in the study (64.9 ± 4.8 years). The areal bone mineral density (aBMD) of femoral neck and L1–L4, femur strength index (FSI), total fat (FM), lean body mass (LBM), VO₂max, serum insulin, and glucose concentrations were determined. The insulin resistance index (HOMA-IR) was also calculated. The main statistical analyses were performed using hierarchical multiple linear regression models. Results: Body mass index (BMI), FM and LBM positively correlated with aBMD results (p ≤ 0.01) and FM negatively with FSI levels (p < 0.05). VO₂max showed a positive association with FSI and this relationship was confirmed in hierarchical multiple regression analysis (p < 0.05). Regression analysis revealed that the base model including age and BMI explained the variance in the femoral neck aBMD (p ≤ 0.01) and L1–L4 aBMD (p ≤ 0.01), respectively. In the case of the femoral neck aBMD model, adjustment for VO₂max increased the explained variance. Alternative models with carbohydrate metabolic indicators did not increase the explained variance. Conclusion: Our results suggest that aerobic capacity may be related to the level of femur bone strength. Somatic characteristics and carbohydrate metabolic status appear to play a role in the correlations between femur bone health and VO₂max. Full article

Androgens and androgen receptor (AR) signaling influence many aspects of female physiology, including reproduction, musculoskeletal health, metabolism, and neurological regulation, yet are less studied than in males. Selective androgen receptor modulators (SARMs) were developed to provide tissue-selective anabolic effects with reduced androgenic side effects, but their effects in women are not well defined. This narrative review summarizes preclinical and clinical evidence on SARM use in female rodents and women, focusing on AR biology, tissue selectivity, therapeutic potential, and safety. A literature search of PubMed, Scopus, and Google Scholar identified relevant experimental and clinical studies addressing sex-specific AR signaling and SARM effects in females. Preclinical data indicate that SARMs can enhance sexual motivation and improve muscle and bone outcomes in ovariectomized models, with compound-dependent effects on reproductive tissues. Clinical studies in postmenopausal women demonstrate increases in lean body mass with generally limited androgenic effects, although functional benefits are inconsistent and alterations in lipid profiles and liver enzymes have been reported. Evidence also supports antitumor activity of AR-targeted SARMs in selected breast cancer subtypes. Overall, while SARMs show therapeutic potential in women, long-term safety and efficacy remain insufficiently characterized, warranting further sex-specific clinical investigation. Full article

Obesity is recognized as a causal risk factor for the development of multiple cancers, with risk magnitude varying by tumor site, sex, life stage, and adipose tissue distribution. This narrative review synthesizes recent epidemiological evidence linking excess body fatness with cancer incidence and mortality and integrates the biological mechanisms that explain this association. Chronic low-grade inflammation, insulin resistance with compensatory hyperinsulinemia, dysregulation of adipose-derived hormones and sex steroids, impairment of anti-tumor immune responses, alterations in the gut microbiota, and remodeling of the tumor microenvironment collectively create conditions that favor tumor initiation and progression. Bariatric surgery is the most effective clinical intervention for achieving substantial and sustained weight loss in individuals with severe obesity, and growing evidence indicates that it is associated with a reduction in overall cancer risk and cancer-related mortality, particularly for malignancies strongly linked to obesity. However, the extent of this benefit differs by surgical technique and remains less consistent for colorectal cancer. Beyond metabolic improvements, bariatric surgery produces long-term changes in nutritional physiology that may also influence oncologic outcomes. Persistent deficiencies of micronutrients such as iron, folate, vitamin B12, vitamin D, and calcium can affect DNA synthesis, methylation, oxidative balance, and cellular repair. Altered protein and energy intake may contribute to loss of lean mass and reduced metabolic resilience, while changes in alcohol absorption and metabolism can increase systemic exposure to ethanol and its carcinogenic metabolites. In addition, bariatric surgery induces sustained remodeling of the gut microbiome and bile acid metabolism, which may further modulate tumorigenic signaling. Overall, the oncological impact of bariatric surgery reflects a balance between metabolic improvement and long-term nutritional management, underscoring the need for structured follow-up and targeted nutritional strategies to optimize cancer risk reduction. Full article

Background and Objectives: Semaglutide is a glucagon-like peptide-1 receptor agonist (GLP-1RA) that has demonstrated metabolic and weight benefits in diabetic and obese patients with chronic kidney disease (CKD) who are not on dialysis; however, evidence in the hemodialysis (HD) population is scarce. Weight control and body composition optimization are particularly challenging in HD because of fluid shifts and the risk of protein-energy wasting. Materials and Methods: This prospective, multicenter, real-world, uncontrolled observational pilot study explored the short-term safety and changes in anthropometric and body-composition parameters after semaglutide initiation in obese adults with type 2 diabetes mellitus (T2DM) undergoing chronic HD. Patients were assessed at baseline and at 3 and 6 months. The primary endpoint was the change in body mass index (BMI), dry weight, and fat mass assessed by bioimpedance spectroscopy (BIS). Results: Thirteen patients were included (10 male, 77%), with a median age of 61.9 years (IQR 55–69). Semaglutide was started at 0.25 mg/week and titrated up to 1 mg/week according to tolerance. Three patients (23.1%) experienced transient nausea that was resolved over time or after dose adjustment, without discontinuation. From baseline to month +6, BMI decreased by a median of 1.5 kg/m² and dry weight by 5.0 kg, mainly driven by a median reduction in fat mass of 9 kg; lean tissue mass and serum albumin did not change significantly. Conclusions: In this small, uncontrolled exploratory study, semaglutide was generally well tolerated and was associated with short-term reductions in body weight and fat mass in obese patients with T2DM on HD. These findings are hypothesis-generating and require confirmation in larger controlled prospective studies to define safety and clinical benefit in this population. Full article

Autosomal dominant polycystic kidney disease (ADPKD) is the most frequent monogenic kidney disease (≈4 cases per 10.000 inhabitants) and a major cause of end-stage kidney disease (ESKD). Beyond progressive cystic enlargement of the kidneys and frequent extrarenal involvement, adults with ADPKD often exhibit a distinctive “body phenotype” with central adiposity and marked abdominal distension due to renal and hepatic organomegaly. In this setting, conventional anthropometric indices such as body mass index (BMI) and crude body weight are of limited value, as they cannot distinguish nutritional tissues (muscle, subcutaneous fat) from non-nutritional mass (cyst fluid, fibrotic tissue, or expanded extracellular water). This review summarizes the current evidence on malnutrition and sarcopenia in adult ADPKD, with a focus on the impact of organomegaly and adiposity. Cross-sectional work using the modified Subjective Global Assessment (SGA) has shown that approximately one-third of ambulatory ADPKD patients are at risk of becoming, or have become, malnourished, and that height-adjusted total kidney and liver volume (htTKLV) is the strongest clinical predictor of malnutrition, whereas eGFR plays a secondary role. Bioelectrical impedance analysis (BIA) further demonstrates a disease-specific body composition phenotype, with increased total and extracellular body water, particularly in the trunk, a reduced phase angle and reduced lean mass, consistent with early malnutrition and sarcopenia. These alterations are present even at relatively preserved kidney function and, in matched analyses, distinguish ADPKD from non-ADPKD CKD. Prospective data from a multicenter cohort indicate that the baseline SGA-defined nutritional status independently predicts short-term eGFR decline in typical ADPKD, supporting malnutrition as a potential modifier of renal trajectory rather than a mere correlate of advanced disease. In parallel, narrative syntheses on adiposity highlight that a higher BMI, waist circumference and visceral fat are associated with larger total kidney volume, faster eGFR loss and greater symptom burden, and raise concern for a sarcopenic obesity phenotype in which excess fat and cystic mass coexist with low muscle mass. Collectively, these findings support a pathophysiological model in which organomegaly-driven mechanical effects (early satiety, gastrointestinal discomfort), systemic inflammation, insulin resistance and cyst-related metabolic reprogramming converge to produce “hidden malnutrition” in ADPKD, masked by apparent overweight. From a clinical perspective, malnutrition and sarcopenia should be regarded as central, disease-modifying components of the ADPKD phenotype. Routine nutritional screening (e.g., SGA/PG-SGA) and BIA-based body composition assessment, particularly in patients with severe organomegaly or symptomatic polycystic liver disease, should be integrated into ADPKD care pathways, and individualized, muscle-preserving nutritional strategies should be tested in future prospective studies. Full article

MASH is a progressive liver disease closely associated with cellular senescence, which is present in more than 80% of hepatocytes in patients who develop hepatocellular carcinoma (HCC). Although MASH affects both sexes, the incidence of MASH-related HCC is two to four times higher in males. Our group has previously described two apoptotic switches during MASH progression and HCC development, implicating the ATP1A1 signalosome in the late switch. Here, we investigated the role of ATP1A1 and sex-specific differences in the early apoptotic switch during preclinical MASH progression. Male and female C57BL/6J mice (7 weeks old) were fed normal mouse chow (NMC) or a high-fat diet (HFD) for 12, 24, or 48 weeks (n = 5/sex/group). Total body weight (TBW) and body composition were assessed by serial measurement and echo-MRI. Plasma was analyzed by non-targeted metabolomics and glutathione profiling using LC-MS/MS. NAFLD activity scores (NAS), hepatic senescence, and apoptosis were quantified in liver tissue. Statistical analyses were performed using GraphPad Prism and R. Males gained greater TBW and lean and fat mass than females (p < 0.05). At 24 W, males demonstrated higher GSH:GSSG ratios and lower ophthalmate levels than females (p < 0.05), consistent with altered redox balance. HFD-fed females showed increased succinic and deoxycholic acid levels, whereas males exhibited higher butyric acid levels across all time points (p < 0.05). Males had a higher mTOR 1 expression at 24 W and P53 at 12 W compared to females on HFD, but a lower Grb2 expression at 24 W (p < 0.05). By 24 W, males had lower fibrosis scores and reduced apoptotic activity compared with females (p < 0.05), despite similar levels of cellular senescence. The expression of ATP1A1, survivin, and SMAC did not differ by sex or diet, although an upregulation trend in both ATP1A1 and survivin was noted in the male-HFD group. There is sexual dimorphism in the response to HFD during the transition from senescence to the apoptosis-first apoptotic switch in MASH progression. Full article

Growth differentiation factor-15 (GDF-15) is an established marker of oxidative stress and a general stress-response mitokines. In this study, we aim to investigate the association of GDF-15 with the metabolic signature of gut and mitochondrial activity in HF and ageing population. A total of 25 HF (67.9 ± 10.0 years) and 29 age-matched healthy participants (HPs) (67.8 ± 11.1 years) were recruited and underwent detailed body composition assessment via dual X-ray absorptiometry; total fat mass and appendicular lean soft tissue index (ALSTI/body mass index (BMI)) were calculated. Utilizing semi-targeted Gas Chromatography–Mass Spectrometry on fasting plasma, a panel of gut microbial-derived (e.g., hippuric acid, indole derivatives, and sarcosine) and tricarboxylic acid cycle metabolites was identified. Results showed higher GDF-15 tertiles were associated with greater HF prevalence, fat mass, NT-proBNP, and TNF-α (p < 0.05). Gut-derived metabolites exhibited phenotype-specific patterns; 3-hydroxyindole predicted higher fat mass in HP; hippuric acid was inversely related in HF; and sarcosine correlated with GDF-15 only in HP. In HF, GDF-15 was strongly driven by pyruvic and fumaric acid, indicating disease-specific mitochondrial stress. In conclusion, these observed associations could be evaluated in future mechanistic studies as sensitive biomarkers of systemic oxidative stress markers, informing potential microbiome-targeted therapeutic avenues. Full article

Background/Objectives: Children and adolescents with intellectual disabilities (ID) have an elevated burden of obesity and cardiometabolic risk, yet factors associated with high blood pressure (BP) in this group remain insufficiently described. This study assessed the prevalence of hypertension (HTN) and isolated systolic hypertension (ISH) at a single visit and examined anthropometric and body composition correlates of elevated BP in children with ID. Methods: A cross-sectional study was conducted among 461 children and adolescents with ID aged 7–18 y attending special education schools in southeastern Poland. Anthropometric indicators (BMI, waist circumference [WC], hip circumference [HC], and waist-to-height ratio [WHtR]) and body composition parameters (BF%, MM%, FFM%, TBW%) were measured using standardized procedures. BP was assessed three times during one visit, and the average of the second and third readings was used. Receiver operating characteristic (ROC) analyses were used for exploratory assessment of discriminatory performance of anthropometric and body composition parameters, and multivariable logistic regression examined associations with elevated BP (HTN + ISH). Results: Overall, 13.9% of participants had HTN and 10.4% had ISH (combined prevalence: 24.3%). Abdominal obesity was present in 39.5% of participants, and elevated HC in 28.2%, both more common in girls. Higher BP categories were associated with greater WC, HC, BMI, and BF%, and lower MM%, FFM%, and TBW% (p < 0.0001). HC showed the highest discriminatory accuracy for HTN + ISH (AUC = 0.844), followed by MM%, BF%, and FFM%, whereas WHtR demonstrated limited discriminatory performance in ROC analyses. In multivariable models, WHtR ≥ 0.5 was associated with increased odds of elevated BP (OR = 4.25), whereas higher TBW% (≥55.38%) was inversely associated with elevated BP (OR = 0.17) in the total sample; similar patterns were observed in sex- and age-stratified analyses. Conclusions: Children with ID show a high prevalence of elevated BP at a single visit, including HTN-range and ISH-range values. Anthropometric indicators, particularly HC and WHtR, and BIA-derived body composition parameters reflecting higher fat mass and lower lean tissue proportion were associated with elevated BP. These exploratory findings suggest that simple anthropometric and body composition measures may help identify individuals who warrant further BP assessment, although longitudinal studies with repeated measurements are required before clinical application. Full article