title: Relationship between Cardiovascular Risk Score and Traditional and Nontraditional Cardiometabolic Parameters in Obese Adolescent Girls.
abstract: 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.
authors.affiliation: Primary Health Care Center, Podgorica, Montenegro.
authors.forename: Aleksandra
authors.initials: A
authors.lastname: Klisic
authors.affiliation: Primary Health Care Center, Podgorica, Montenegro.
authors.forename: Nebojsa
authors.initials: N
authors.lastname: Kavaric
authors.affiliation: Institute of Biostatistics, Medical Informatics and Research in Medicine, Faculty of Medicine, University of Belgrade, Serbia.
authors.forename: Ivan
authors.initials: I
authors.lastname: Soldatovic
authors.affiliation: Clinic of Pediatrics, Clinical Center, Nis, Serbia.
authors.forename: Bojko
authors.initials: B
authors.lastname: Bjelakovic
authors.affiliation: Department of Medical Biochemistry, Faculty of Pharmacy, University of Belgrade, Belgrade, Serbia.
authors.forename: Jelena
authors.initials: J
authors.lastname: Kotur-Stevuljevic
keywords: adolescents; cardiovascular risk; inflammation; obesity; total bilirubin