Background: Since the cardiovascular (CV) risk score in the young population, children and adolescents, is underestimated, especially in developing countries such as Montenegro, where a strong interaction exists between the genetically conditioned CV risk and environmental factors, the purpose of this study was to estimate CV risk in apparently healthy adolescent girls. Moreover, we aimed to test some new, emerging CV risk factors and their interaction with the traditional ones, such as obesity. Precisely, we aimed to assess the impact of low bilirubin levels, as a routine biochemical parameter, as an additional risk factor for atherosclerotic disease in the adult phase.
Methods: Forty-five obese adolescent girls (mean age 17.8±1.22 years) and forty-five age- and sex-matched normal weight controls, all nonsmokers, were included. Anthropometric and biochemical parameters were measured. Cardiovascular Risk Score (CVRS) was calculated by adding the points for each risk factor (e.g. sex, HDL-c, non-HDL-c, blood pressure and fasting glycemia).
Results: A significant positive relationship between CVRS and ALT, hsCRP and TG/HDL-c, but an opposite relationship between CVRS and total bilirubin were found (P<0.001). Multiple linear regression analysis showed that higher waist circumference (WC) and LDL-c, but lower HDL-c were independent predictors of lower bilirubin values (adjusted R2=0.603, P<0.001).
Conclusions: Obese adolescent girls are at an increased risk of cardiovascular disease late in life. In addition to the traditional risk factors, total bilirubin may have the potential to discriminate between low and higher risk for cardiovascular disturbances in healthy adolescent girls.
Uvod: Kako je skor kardiovaskularnog (KV) rizika često potcenjen kod dece i adolescenata, naročito u zemljama u razvoju, kakva je Crna Gora, gde postoji jaka interakcija između genetski uslovljenog KV rizika i sredine, cilj ove studije je bio da se proceni KV rizik kod zdravih adolescentkinja. Takođe, cilj je bio i da se ispitaju neki novi KV faktori rizika u interakciji sa tradicionalnim, kao što je gojaznost. Preciznije, imali smo za cilj da ispitamo uticaj niskih vrednosti bilirubina, rutinskog biohemijskog parametra, kao dodatnog faktora rizika za aterosklerozu u adultnom dobu.
Metode: Ukupno 45 gojaznih adolescentkinja, srednje starosne dobi 17,8±1,22 godina, i 45 normalno uhranjenih adolescentkinja, uparenih po godinama starosti, nepušača, uključeno je u studiju. Mereni su antropometrijski i biohemijski parametri. Skor kardiovaskularnog rizika (CVRS) računat je dodavanjem poena za svaki faktor rizika (pol, HDL-holesterol, non-HDL-holesterol, krvni pritisak i glikemija našte).
Rezultati: Utvrđena je statistički značajna pozitivna povezanost između CVRS i ALT, hsCRP i TG/HDL-holesterola (P<0,001). Višestruka linearna regresiona analiza je pokazala da su veći obim struka i viši LDL-holesterol, a niži HDL-holesterol nezavisni prediktori nižih vrednosti bilirubina (R2=0,603, P<0,001).
Zaključak: Gojazne adolescentkinje imaju povećan rizik za KV bolesti u kasnijem dobu. Pored tradicionalnih faktora rizika, ukupni bilirubin može imati potencijal da diskriminiše između niskog i većeg rizika za KV promene kod zdravih adolescentkinja.
Keywords: adolescents; cardiovascular risk; inflammation; obesity; total bilirubin.