Klisic Aleksandra, Kavaric Nebojsa, Soldatovic Ivan, Bjelakovic Bojko, Kotur-Stevuljevic Jelena
Primary Health Care Center, Podgorica, Montenegro.
Institute of Biostatistics, Medical Informatics and Research in Medicine, Faculty of Medicine, University of Belgrade, Serbia.
J Med Biochem. 2016 Sep;35(3):282-292. doi: 10.1515/jomb-2016-0005. Epub 2016 Jul 6.
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.
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).
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 R=0.603, P<0.001).
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.
由于年轻人群(儿童和青少年)的心血管(CV)风险评分被低估,尤其是在黑山等发展中国家,在这些国家,遗传条件所致的CV风险与环境因素之间存在强烈相互作用,本研究的目的是评估表面健康的青春期女孩的CV风险。此外,我们旨在测试一些新出现的CV风险因素及其与传统风险因素(如肥胖)的相互作用。具体而言,我们旨在评估低胆红素水平作为常规生化参数,作为成年期动脉粥样硬化疾病额外风险因素的影响。
纳入45名肥胖青春期女孩(平均年龄17.8±1.22岁)和45名年龄及性别匹配的正常体重对照者,所有受试者均不吸烟。测量人体测量学和生化参数。通过将每个风险因素(如性别、高密度脂蛋白胆固醇、非高密度脂蛋白胆固醇、血压和空腹血糖)的分数相加来计算心血管风险评分(CVRS)。
发现CVRS与谷丙转氨酶、超敏C反应蛋白和甘油三酯/高密度脂蛋白胆固醇之间存在显著正相关,但与总胆红素之间存在相反关系(P<0.001)。多元线性回归分析表明,较高的腰围(WC)和低密度脂蛋白胆固醇,但较低的高密度脂蛋白胆固醇是较低胆红素值的独立预测因素(调整R=0.603,P<0.001)。
肥胖青春期女孩在晚年患心血管疾病的风险增加。除了传统风险因素外,总胆红素可能有潜力区分健康青春期女孩心血管紊乱的低风险和高风险。