L35 Resident involvement in clinical research

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1997-VOL. 10, NO. 4, PART 2

POSTERS: Epidemiology

L33 LOW

L34 DIETARY

MAGNESIUM

IS

ASSOCIATED

WITH

INSULIN RESISTANCE IN A SAMPLE OF YOUNG, NON-DIABETIC, AFRICAN AMERICANS. SuzanneHumt)bries, Harvey Ku.shnm,and FtonitaFalkmr*. Allegheny UniversityMCP f)ivision,Philadelphia,PA. In both humans and experimentalnnimals, dietnry induced magnesium (Mg) deficiency is correlated with insulin resistance. The purpose of this study was to determine if dietary Mg intake is associatedwith insulinsensitivityin a sample of non-diahetic, young AfricanAmericans. We also examineddietmyCa, K, and Na intake, The study was conductedin a sample(n=179)of young adults ages 30,7 +/- 3,5 yrs, that ha been followed longitudinally, Nutrient intakewas assessed by obtaininga 24 hour recall interviewofdiehuy intake, Intake data were entered in a nutrient analysis program(Nutritionist 111), which quarditat.d mioronutrients, macronutrientsand minerals. Data was analyzed by ANOVA and Pearson’sCorrelationAnalysisto examinediet~ and metaholicdata i.e. glucose tolerance, insulin clamp, and blood pressure (BP) measurements. We classified the study sample of 90 males and 89 females into insulin sensitive and insulin resistant. There is a significantnegativecorrelationof total dietary Mg intake with the sum of insulin levels mes?mredduring an oral glucose tolerancetest 1=-.I296 p=O.041, When cases were categoricallyclassified insulin sensitive vs. insulinresistant, the Mg intie was significantly lower in femalescomparedto males in both 1Sand IR(Pz0,00I). To correct for sex differencesin adiposemass, Mg intake was computed as Mg intake in mgikg of fat free mass (MgiFFM). With this adjustmentfor bndysize and fat, there were no sex differencesin Mg intake. Mg/FFM was significantly lower in IR(2,97+/-l.4) than 1S(3,68+/-2.2)with P=.022. Insulinstimulatedglucoseutilization(M) measuredby insulinclampcorrelatedpositivelywith Mf#FFMfor the entire population~.1489 p=.047. This correlation was stronger in males (F.2500! ~.017), Analysis of Na, K and Ca also resulted in significantlyhigher intakes of each minernl in IS compared to IR when adjusted for fat-free mass. Conclusion: In this sample of African Americans, IR subjects demonstrated lower dietary Mg intakes. This is consistent with previous reports, and supports a possible ml. of Mg in insulin resistance. No relationship of Mg intakeand BP was detected. The concurrentgreater intake of Na, K and Ca (when adjusted for body size) in 1S cases with concomitant lower intakesreportedin obese individualsraises the possibilityof an underreportingartifact in dietary assessment methnds. Key words

Magnesium,Insulin, African American, Diet

HYPERTENS1ON IN NURSINGHOMEPATIENTS J,S, Trilling.-, 1.H. Gomalitt,S.S.Yeh,A.M.Filkin, R,C.Crimson,S. Nevitt, StateUniversityof NewYorkat StonyBrook,StonyBrook,N.Y. Littleis knownabouthypertensionin nursinghumepatients and whethertreatmentbenefitspersonsoverageeightyand thosewithsignificantcmnorbidity.Medicalchartsof 804 residentsof threenursinghomeswerereviewedfor demographicd.ta, medicalconditions,recentbloodpressure readings,activitiesof dailyliving,antihypsrtensivssandall othermedications.Of the total population,355(44.2%)were hypertensiveand30.S%ageeighty-fiveyearsandolder, 24.2%wereuntreated.Of thosetakingantihypertensives, 58.7%tookonlya singledrug,the mostcommonof whichwar a calciumchannel hlcxkm (30.3%). The averqe number of tmal medications was 8.68 dailyper patient. Hypertensive patientstookmorecardiacdrugs(P= OIMO),hypoglycemic (P= ().ftfM))andanalgesicdrngs(P= 0.004)thanthokewhoam normmensive.An increasedprevalenceof diabetes,renal disease,vasculardisease,neoplasms,gastrointestinaldisease, andpsychiatricdisorderswas associatedwithbypertensinn. Bloodpressuresequalto less than 140/90wereachievedin 89.0%but bloodpressurecnntmlwas significantlypnnrerin females,P=W306,in patientswitbdementia,P=O.COO, osteofmrosis,P= 0.0Q3,andcentralnervnussystemconditions. We concludethattbe mattagementnfhyp’tensinn in nursing bnmepatientsiscomplexandthat the associationwithsome comorbidconditionsunexplained.Amihypenensivetherapy maybe suboptimu.1 in thispatientpopulation,sincedietetics anddatablockersare less tiequemlyusedthancalcium channelblockers. The largenumkm.r of dailymedicationsalso requiresreevaluationof individualtherapeuticregimens. Additiomdresearchis needed.

Key

words

Cnmorbidity,NursingHome,Hypertension

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RESIDENT INVOLVEMENT IN CLINICAL RESEARCH. CMBr@S@, JJ Holland’. Northport VA Medical Center and SUNY at Stony Bronk School of Medicine, Stony

RACE (BLACK-WHfJE)AND GENDER DJFFBRENCBS IN BRACHLAL ARTSRY Compliance AND CARDSAC CONTRACTILITY R4 HEALTHYYOUNC3 ADULTS:THE

Brook

NY.

The role of medical trainees in clinical research is continually evolving. Medical professionals often wait until their careers are established before engaging in reaesrch. Introducing research earlier in their careers may broaden the trainee’s experience. Potential benefits for the trainee include advsnced education and improved clinical skills. Graduates may be more likely to incorporate clinical research into tbeir medical careers. The potential benefits of research to medical reaidents are reflected in the American Counsel of Graduate Medical Education recommendation that all trainees pstticipate in research resulting in publications or presentation.’ Tbe National Heart Lung and Blood Institute is currently sponsoring five large antibypertensive trials, Among the largest is the ALLHAT, or Antihypertensive and Lipid Lowering Treatment to Prevent Heart Attact Trial, underway at bundreds of clinical sites nationally. MmIy of these sitea are affiliated with university medical centers and training programs. Randomizing hundreds of patients at each site, cooperative studies provide a unique opportunity for medical residents to participate in research, The current role of residents in clinical antihypertensive trials is undefined. Researchers at tbe Northport VA Medical Center are conducting a study that will determine the extent of resident involvement in the ALLHAT study. The data obtsined will ‘ The GraduateMedical EducationDirectoW,Chicago: American MedicalAssociation,1995:66-67 KSYWords: clinical research, residency, hypertension

BOOALUSAHEARTSTUDY EM_WhiM,* A. EfkMkuy,T. Brinton,D. Waffa,A.S. Picknff, G.S. Be.mmnn,*TufursCeaterfor CV Heafth,NewOdMIM,M Arteriafcmmpfiance (cp) cfscraawswithage awl HTN. Reduced Cp la-d tn increasedSBP,puke prmsure(W) rmdgrastarLV wnrk resultingm LVH,a riskfactorfor camfiovawufw (CV)mmbidityawl in Cp exist mortafity.It innntkmnwnifmce awl gemderditT— whichmayinfluexwe tiedirbihrimr of CV disaasm.Ths currant ramad gamfarditTe— illbrscfdafacteryCpin a studyexamined do. sampleof 775 besfthyyoungadultswithpmvinusCV risk ktordnta cnffwtd forthe BogafusaHStudy(4c3%mafe,70% white, 18-3gyeara).BP,HR ad bmchiafarterypuksecurvedataInc., San obtainedusingthe DyMPufse2000instmmant(TtdsaMa4ric, Diego,CA). Wavefotmaof.acluafattwiafpress.. tbmughnutthe cmdiaccycleare recontadusinganodko-meiric technique.3%s cafibmtedarteriafpdss waveis incorporatedintoa physicafmcdelof the Cv systemto cakuhtabracbidarteryCp(mfAMdfg)d resistaaw(BAPR,mmHg/’Lhdn),anddP/dTLVIMX periphemf (mndfgkc), a non-invasiveeatimsteof cardiacccm4mctifity valicMad withcardiaccatkterizationdata. AcrnsssOage rsagad,bfacksN higherSBP SIXIDBPtJrm whitedwbansnsfyzsdby gsndsr. Femnfea hadhigbsrHRthanmrdw. ItIthinage range, Cpdecraamdin feznafas Onfy(p
refatrdto atfwnsclernsis. Key Words:

Compliance,Race,Gemder,Contmctifity

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