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PP317 CHOLESTERYL ESTER TRANSFER PROTEIN LEVELS AND ITS RELATIONSHIP WITH CARDIOVASCULAR RISK OF ADOLESCENTS
Nutrition and chronic diseases II HPN is over-utilised in Denmark and Scotland compared to the service provided in New Zealand or whether there is ongoing inequality of access in NZ. Disclosure of Interest: None declared
PP316 ORAL HEALTH, DENTAL PROPHYLAXIS AND CATHETER RELATED BLOODSTREAM INFECTIONS IN HOME PARENTERAL NUTRITION PATIENTS: RESULTS OF A UK SURVEY AND COHORT STUDY A.M. Lee1 , S.M. Gabe2 , J.M. Nightingale3 , J. Fiske4 , M. Burke5 . 1 Clinical Fellow, North West London Hospitals NHS Trust, 2 Consultant Gastroenterologist & Co-Chair of the Lennard-Jones Intestinal Failure Unit, St Mark’s Hospital; Hon. Senior Lecturer, Imperial College, 3 Consultant Gastroenterologist & Co-Chair of the Lennard-Jones Intestinal Failure Unit, St Mark’s Hospital, 4 Senior Lecturer/Honorary Consultant in Special Care Dentistry, 5 Consultant in Special Care Dentistry, Guys and St Thomas’ NHS Foundation Trust, London, United Kingdom Rationale: There are concerns that catheter related bloodstream infections (CRBSIs) arise from poor oral health and there are no standard guidelines for antibiotic prophylaxis for dental treatment in home parenteral nutrition (HPN) patients. Methods: A. An email survey of the UK HPN group requesting provider’s opinions, observations and prescribing practices related to oral health and CRBSIs. B. Review of data from 52 HPN patients comparing oral health parameters and dental treatment in relation to CRBSI experience in the last 12 months; using Chisquare analysis to assess associations. Results: A. 68% responded. 89% linked dental health/treatment with a CRBSI and 61% recommended parenteral prophylactic antibiotics (82% IV, 18% IM). Streptococci, bacteroides and fuscobacteria caused most concern. Amoxicillin, metronidazole, co-amoxyclav and gentamycin are most prescribed. Many practitioners followed the historic infective endocarditis (IE) dental treatment guidelines, although regimes varied from current IE guidance. 36% may delay HPN if oral health was poor; 89% believe a new central venous catheter should not delay dental treatment; 89% could not recall dental treatment impacting on HPN and 79% had no recall of oral health impacting on HPN. 57% recommended dental examination or oral health screening, and 25% dental extractions, to prevent or treat CRBSIs. 71% believed patient care should be in a specialist setting. B. There was no significant link between dental plaque, the interval since last dental treatment or antibiotic prophylaxis and CRBSIs over the previous 12 months. Conclusion: Despite no evidence to support an association between dental health/treatment and CRBSIs, UK HPN providers tend to prescribe prophylactic antibiotics for dental treatment; a multicentre study would provide more robust evidence to help establish valid guidelines. Disclosure of Interest: None declared
147 PP317 CHOLESTERYL ESTER TRANSFER PROTEIN LEVELS AND ITS RELATIONSHIP WITH CARDIOVASCULAR RISK OF ADOLESCENTS A.P.D.Q. Mello1 , I. Silva1 , C. Sanibal1 , N. Damasceno1 . 1 Department of Nutrition, School of Public Health, University of Sao Paulo, Sao Paulo, Brazil Rationale: Cholesteryl ester transfer protein (CETP) promotes the transfer of cholesteryl esters from HDLs to apolipoprotein B containing lipoproteins and its deficiency is associated with a profile antiatherogenic. Our goal was to assess the level of CETP and investigate its possible relationship with cardiovascular risk factors of adolescents. Methods: 242 adolescents, aged 10 19 years, both sexes from public school (Sao Paulo, Brazil) were included BMI in this study. Anthropometric (body mass index and waist circumference WC), body composition (percentage of fat BIA) parameters and sexual maturation (Tanner method) were monitored. Lipid profile (total cholesterol, LDL-C, HDL-C, triglycerides) and CETP concentration were analyzed in plasma. Statistical analysis was performed by SPSS 15.0. Results: Adolescents were distributed in tertiles of CETP. It was not observed differences in sex, sexual maturation, total cholesterol and LDL-C in function of tertiles of CETP. However, body fat percentage (p = 0.012), BMI (p 0.005), WC (p = 0.001) and total cholesterol/HDL-C ratio (p = 0.039) were significantly higher in adolescents in the highest tertile compared to those in the lowest tertile. In opposite, HDL-C showed lower values in adolescents in the highest tertile compared to those in the lowest tertile (p = 0.011). The negative impact of CETP on cardiovascular risk factors was confirmed by positive correlation with body fat percentage (r = 0.24, p 0.005), BMI (r = 0.28, p 0.005), WC (r = 0.28, p 0.005), LDL-C (r = 0.15, p = 0.025), non-HDL-C (r = 0.15, p = 0.022) and total cholesterol/HDL-C ratio (r = 0.21, p 0.005). Negative correlation were found between CETP and body mass percentage (r = 0.20, p 0.005) and HDL-C (r = 0.22, p 0.005). Conclusion: Elevated CETP level is associated with obesity and dyslipidemia in adolescents. Disclosure of Interest: None declared
PP318 RISK FACTORS OF HEPATIC CYTOLYSIS AND EVOLUTION OF TRANSAMINASES DURING RENUTRITION IN ANOREXIA NERVOSA M. Guidoum1 , N. Courn` ede1 , P. De Truchis1 , e de Nutrition Clinique, J.C. Melchior1 , P. Crenn1 . 1 Unit´ Hˆ opital Raymond Poincar´ e, Garches, France Rationale: Hepatic cytolysis is often observed in malnourished patients with anorexia nervosa (AN). The aim of this study was to identify the risk factors of elevated transaminases and to observe their evolution during nutritional rehabilitation. Methods: Comprehensive study of AN patients (BMI < 18), hospitalized for nutritional rehabilitation (enteral and/or oral, including vitamins and trace elements) between
PP316 ORAL HEALTH, DENTAL PROPHYLAXIS AND CATHETER RELATED BLOODSTREAM INFECTIONS IN HOME PARENTERAL NUTRITION PATIENTS: RESULTS OF A UK SURVEY AND COHORT STUDY A.M. Lee1 , S.M. Gabe2 , J.M. Nightingale3 , J. Fiske4 , M. Burke5 . 1 Clinical Fellow, North West London Hospitals NHS Trust, 2 Consultant Gastroenterologist & Co-Chair of the Lennard-Jones Intestinal Failure Unit, St Mark’s Hospital; Hon. Senior Lecturer, Imperial College, 3 Consultant Gastroenterologist & Co-Chair of the Lennard-Jones Intestinal Failure Unit, St Mark’s Hospital, 4 Senior Lecturer/Honorary Consultant in Special Care Dentistry, 5 Consultant in Special Care Dentistry, Guys and St Thomas’ NHS Foundation Trust, London, United Kingdom Rationale: There are concerns that catheter related bloodstream infections (CRBSIs) arise from poor oral health and there are no standard guidelines for antibiotic prophylaxis for dental treatment in home parenteral nutrition (HPN) patients. Methods: A. An email survey of the UK HPN group requesting provider’s opinions, observations and prescribing practices related to oral health and CRBSIs. B. Review of data from 52 HPN patients comparing oral health parameters and dental treatment in relation to CRBSI experience in the last 12 months; using Chisquare analysis to assess associations. Results: A. 68% responded. 89% linked dental health/treatment with a CRBSI and 61% recommended parenteral prophylactic antibiotics (82% IV, 18% IM). Streptococci, bacteroides and fuscobacteria caused most concern. Amoxicillin, metronidazole, co-amoxyclav and gentamycin are most prescribed. Many practitioners followed the historic infective endocarditis (IE) dental treatment guidelines, although regimes varied from current IE guidance. 36% may delay HPN if oral health was poor; 89% believe a new central venous catheter should not delay dental treatment; 89% could not recall dental treatment impacting on HPN and 79% had no recall of oral health impacting on HPN. 57% recommended dental examination or oral health screening, and 25% dental extractions, to prevent or treat CRBSIs. 71% believed patient care should be in a specialist setting. B. There was no significant link between dental plaque, the interval since last dental treatment or antibiotic prophylaxis and CRBSIs over the previous 12 months. Conclusion: Despite no evidence to support an association between dental health/treatment and CRBSIs, UK HPN providers tend to prescribe prophylactic antibiotics for dental treatment; a multicentre study would provide more robust evidence to help establish valid guidelines. Disclosure of Interest: None declared
147 PP317 CHOLESTERYL ESTER TRANSFER PROTEIN LEVELS AND ITS RELATIONSHIP WITH CARDIOVASCULAR RISK OF ADOLESCENTS A.P.D.Q. Mello1 , I. Silva1 , C. Sanibal1 , N. Damasceno1 . 1 Department of Nutrition, School of Public Health, University of Sao Paulo, Sao Paulo, Brazil Rationale: Cholesteryl ester transfer protein (CETP) promotes the transfer of cholesteryl esters from HDLs to apolipoprotein B containing lipoproteins and its deficiency is associated with a profile antiatherogenic. Our goal was to assess the level of CETP and investigate its possible relationship with cardiovascular risk factors of adolescents. Methods: 242 adolescents, aged 10 19 years, both sexes from public school (Sao Paulo, Brazil) were included BMI in this study. Anthropometric (body mass index and waist circumference WC), body composition (percentage of fat BIA) parameters and sexual maturation (Tanner method) were monitored. Lipid profile (total cholesterol, LDL-C, HDL-C, triglycerides) and CETP concentration were analyzed in plasma. Statistical analysis was performed by SPSS 15.0. Results: Adolescents were distributed in tertiles of CETP. It was not observed differences in sex, sexual maturation, total cholesterol and LDL-C in function of tertiles of CETP. However, body fat percentage (p = 0.012), BMI (p 0.005), WC (p = 0.001) and total cholesterol/HDL-C ratio (p = 0.039) were significantly higher in adolescents in the highest tertile compared to those in the lowest tertile. In opposite, HDL-C showed lower values in adolescents in the highest tertile compared to those in the lowest tertile (p = 0.011). The negative impact of CETP on cardiovascular risk factors was confirmed by positive correlation with body fat percentage (r = 0.24, p 0.005), BMI (r = 0.28, p 0.005), WC (r = 0.28, p 0.005), LDL-C (r = 0.15, p = 0.025), non-HDL-C (r = 0.15, p = 0.022) and total cholesterol/HDL-C ratio (r = 0.21, p 0.005). Negative correlation were found between CETP and body mass percentage (r = 0.20, p 0.005) and HDL-C (r = 0.22, p 0.005). Conclusion: Elevated CETP level is associated with obesity and dyslipidemia in adolescents. Disclosure of Interest: None declared
PP318 RISK FACTORS OF HEPATIC CYTOLYSIS AND EVOLUTION OF TRANSAMINASES DURING RENUTRITION IN ANOREXIA NERVOSA M. Guidoum1 , N. Courn` ede1 , P. De Truchis1 , e de Nutrition Clinique, J.C. Melchior1 , P. Crenn1 . 1 Unit´ Hˆ opital Raymond Poincar´ e, Garches, France Rationale: Hepatic cytolysis is often observed in malnourished patients with anorexia nervosa (AN). The aim of this study was to identify the risk factors of elevated transaminases and to observe their evolution during nutritional rehabilitation. Methods: Comprehensive study of AN patients (BMI < 18), hospitalized for nutritional rehabilitation (enteral and/or oral, including vitamins and trace elements) between