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Validation of Capillary Blood for the Assessment of Disease Risk Factors in Children
SUNDAY, SEPTEMBER 30
POSTER SESSION: PROFESSIONAL SKILLS/NUTRITION ASSESSMENT/MEDICAL NUTRITION THERAPY Title: VALIDATION OF A QUESTIONNAIRE THAT IDENTIFIES THE RISK OF DEVELOPING CARDIOVASCULAR DISEASE IN MEXICAN ADULTS Author(s): A.Suverza-Fernandez,1 O. Perichart-Perera,2 S. K. Loza- Hirishaka,1 A. Zarate-Collado,1 K. Haua-Navarro1; 1 Health, Iberoamericana Universtiy, Mexico, Mexico, 2Instituto Nacional de Perinatologı´a, Mexico, Mexico Learning Outcome: To validate a screening questionnaire that identifies mexican population in risk of cardiovascular disease Text: Cardiovascular disease is an important public health problem all over the world. There are no validated questionnaires to identify CVD risk in the Mexican population. The objective of this study was to validate a questionnaire (CIREC) to identify risk factors for developing CVD by measuring metabolic and clinical parameters that are recognized as main risk factors for CVD. A questionnaire was emailed to University employees (Mexico). From 143 subjects that answered, 30 resulted as having risk and 21 subjects agreed to participate (10 men, 11 women ⱖ18 years old). We test the ability of the questionnaire to predict risk by relating it with metabolic parameters and with the Framingham criteria (FRAMIN). Cholesterol, LDL cholesterol, HDL cholesterol, triglycerides and glucose levels were analyzed. Blood pressure, body mass index (BMI), body fat percentage (%BF), and abdominal circumference were measured. CIREC classified 70% of men and 64% of women as having CVD risk. Positive and significant correlations (CIREC-FRAMIN) were found (r⫽0.571, p⫽0.007), and with total cholesterol levels (CIREC r⫽0.442, p⫽0.04; FRAMIN r⫽549, p⫽0.010). Using cluster analysis, subjects were classified as having risk or not having risk according to FRAMIN variables. With this classification we created a contingency table. CIREC correlated well with the new FRAMIN groups (chi-square; r⫽0.612, p⫽0.003); its sensitivity was 100% and specificity was 58%. The evaluated questionnaire (CIREC) correlated well with total cholesterol levels. Even though the sample is very small, the sensitivity of the questionnaire appeared to be excellent and could be tested in a larger Mexican population.
Title: TYPE 2 DIABETES AMONG YOUTH: PREVALENCE AND AWARENESS Author(s): E. C. K. Lasley, R. E. Litchfield; Iowa State University, Ames, IA Learning Outcome: To identify the prevalence of youth at high risk for type 2 diabetes and healthcare provider awareness and knowledge of ADA screening guidelines. Text: Prevalence of overweight among youth continues to rise with a consequent rise in type 2 diabetes. Yet, the exact prevalence of type 2 diabetes in the youth population is not well understood. American Diabetes Association (ADA) guidelines to screen youth for type 2 diabetes were used to: 1. examine prevalence of youth meeting ADA criteria; and 2. examine awareness and knowledge of ADA criteria among healthcare providers. Heights and weights were measured in 509 fourth and fifth grade children to determine overweight status according to BMI-for-age growth charts. A parent survey queried for family history related to ADA screening guidelines to determine youth considered high risk. Interviews were conducted with healthcare providers to examine awareness and knowledge of ADA screening guidelines. Overweight (BMI ⱖ 85%) was observed in 198 (38.9%) of the youth, but was not different between boys and girls (39.7% vs. 38.1% respectively). Of 49 youth considered high risk for type 2 diabetes by ADA guidelines, 12 (24.5%) had been screened. Interviews revealed a lack of confidence regarding awareness of ADA screening guidelines and thirst, overweight and family history were the most common signs that elicit screening of youth. Healthcare providers identified insurance, lifestyle, and lack of public awareness as barriers to screening and treatment. Nearly 10% of youth in this population were considered high risk for type 2 diabetes indicating the need for increased awareness and screening; however, current healthcare practices are not conducive to implementation of the ADA guidelines. Funding Disclosure: The Wellmark Foundation, Iowans Fit For Life funded through CDC Nutrition and Physical Activity Program
Funding Disclosure: None
Title: VALIDATION OF CAPILLARY BLOOD FOR THE ASSESSMENT OF DISEASE RISK FACTORS IN CHILDREN Author(s): J. C. Lawrence, E. D. McAuley, M. S. Johnson, J. Munoz, B. A. Gower; Nutrition Sciences, University of Alabama at Birmingham, Birmingham, AL Learning Outcome: After reading this presentation, participants will understand that use of capillary blood obtained with the finger-puncture method, for pediatric disease-risk screening, may be a useful alternative to venipuncture that can be performed more easily in clinical or community health settings. Text: Research Outcome: Due to the rapid increase in childhood obesity, simple screening for obesity-related risk factors may be desirable for use in clinical or community health settings. Because children view venipuncture as painful, stressful and invasive, less-invasive methods for outpatient screening are needed. The primary objective of this study was to determine if measures of insulin, glucose, triglyceride and total cholesterol obtained from capillary blood correlated with those obtained from venous blood. A secondary objective was to determine if waist circumference was associated with serum concentrations of obesity-related disease risk factors. Methods: 21 children (mean age 10.3⫾2.0 years) were evaluated at the General Clinical Research Center outpatient clinic at the University of Alabama-Birmingham. Subjects were evaluated in the fasted state. 5cc of blood was drawn by venipuncture and ⬃0.5cc by finger puncture. Height, weight and waist circumference were measured. Sera were assayed for insulin, glucose, triglyceride and total cholesterol concentrations. Statistical analysis included ANOVA, paired t-test, regression analysis and Bland-Altman plots. Results: Venous and capillary measures of each analyte were significantly correlated (correlation coefficients of 0.74 - 0.96; P⬍0.001 for all). Capillary glucose and triglycerides averaged 5.1% and 8.1% higher, respectively, than corresponding venous values; total cholesterol and insulin did not differ. Waist circumference was significantly correlated with both venous and capillary insulin and with capillary cholesterol. Conclusions: Capillary blood obtained via finger-puncture method may be a useful alternative to venipuncture for pediatric disease-risk screening that can be performed more easily in clinical or community health settings. Funding Disclosure: General Clinical Research Center grant MO1-RR00032, Clinical Nutrition Research Unit grant P30-DK56336 and the Department of Nutrition Sciences, University of Alabama at Birmingham.
A-32 / August 2007 Suppl 3—Abstracts Volume 107 Number 8
Title: FOODSERVICES, NUTRITIONAL CARE AND STAFFING ARE ASSOCIATED WITH RISK OF MALNUTRITION IN LONG-TERM CARE ´ cole des sciences des Author(s): N. Carrier,1 D. Ouellet,2 G. E. West3; 1E aliments, de nutrition et d’e´tudes familiales, Universite´ de Moncton, 2 Moncton, NB, Canada, De´partement des sciences des aliments et de nutrition, Universite´ Laval, Que´bec, PQ, Canada, 3De´partement d’e´conomie agroalimentaire et des sciences de la consommation, Universite´ Laval, Que´bec, PQ, Canada Learning Outcome: Recognize that risk of malnutrition is quite common in LTC and that institutional factors such as those related to foodservices, nutritional care, and staffing, can impact risk of malnutrition in both cognitively intact and cognitively impaired residents Text: This cross-sectional, population-based study investigates institutional determinants of risk of malnutrition among nursing home residents. The 132 cognitively intact and 263 cognitively impaired residents aged 65 or older who participated in this study came from 38 public long-term care (LTC) facilities. Participants were screened for risk of malnutrition, and demographic and medical data were gathered from their medical charts. Information on participants’ dining experience, as well as foodservices, nutritional care and other institutional factors were also gathered. Ordered logistic regressions were used to separately examine relationships between risk of malnutrition and institutional factors for cognitively intact and cognitively impaired residents. Findings indicated that 39% of participants were highly or moderately at risk of malnutrition. Risk was significantly higher in cognitively impaired participants (49.2%) compared to cognitively intact participants (17.6%). Menu cycle length (28-days vs 21-days), difficulty manipulating dishes, lids and food packages, type of food delivery system (bulk vs tray), and oral supplementation were significantly associated with risk of malnutrition in both groups of residents. Therapeutic diets, nutritional screening, and ratio of residents per resident assistant were also significantly associated with risk among cognitively impaired residents. Risk of malnutrition is quite common among LTC residents, especially among those who are cognitively impaired. Several institutional factors were found to have differential impacts on risk depending on cognitive status. These differences should be considered when determining which institutional factors should be modified to reduce the risk of malnutrition in LTC. Funding Disclosure: Medical Research Funds of New Brunswick (MRFNB)
POSTER SESSION: PROFESSIONAL SKILLS/NUTRITION ASSESSMENT/MEDICAL NUTRITION THERAPY Title: VALIDATION OF A QUESTIONNAIRE THAT IDENTIFIES THE RISK OF DEVELOPING CARDIOVASCULAR DISEASE IN MEXICAN ADULTS Author(s): A.Suverza-Fernandez,1 O. Perichart-Perera,2 S. K. Loza- Hirishaka,1 A. Zarate-Collado,1 K. Haua-Navarro1; 1 Health, Iberoamericana Universtiy, Mexico, Mexico, 2Instituto Nacional de Perinatologı´a, Mexico, Mexico Learning Outcome: To validate a screening questionnaire that identifies mexican population in risk of cardiovascular disease Text: Cardiovascular disease is an important public health problem all over the world. There are no validated questionnaires to identify CVD risk in the Mexican population. The objective of this study was to validate a questionnaire (CIREC) to identify risk factors for developing CVD by measuring metabolic and clinical parameters that are recognized as main risk factors for CVD. A questionnaire was emailed to University employees (Mexico). From 143 subjects that answered, 30 resulted as having risk and 21 subjects agreed to participate (10 men, 11 women ⱖ18 years old). We test the ability of the questionnaire to predict risk by relating it with metabolic parameters and with the Framingham criteria (FRAMIN). Cholesterol, LDL cholesterol, HDL cholesterol, triglycerides and glucose levels were analyzed. Blood pressure, body mass index (BMI), body fat percentage (%BF), and abdominal circumference were measured. CIREC classified 70% of men and 64% of women as having CVD risk. Positive and significant correlations (CIREC-FRAMIN) were found (r⫽0.571, p⫽0.007), and with total cholesterol levels (CIREC r⫽0.442, p⫽0.04; FRAMIN r⫽549, p⫽0.010). Using cluster analysis, subjects were classified as having risk or not having risk according to FRAMIN variables. With this classification we created a contingency table. CIREC correlated well with the new FRAMIN groups (chi-square; r⫽0.612, p⫽0.003); its sensitivity was 100% and specificity was 58%. The evaluated questionnaire (CIREC) correlated well with total cholesterol levels. Even though the sample is very small, the sensitivity of the questionnaire appeared to be excellent and could be tested in a larger Mexican population.
Title: TYPE 2 DIABETES AMONG YOUTH: PREVALENCE AND AWARENESS Author(s): E. C. K. Lasley, R. E. Litchfield; Iowa State University, Ames, IA Learning Outcome: To identify the prevalence of youth at high risk for type 2 diabetes and healthcare provider awareness and knowledge of ADA screening guidelines. Text: Prevalence of overweight among youth continues to rise with a consequent rise in type 2 diabetes. Yet, the exact prevalence of type 2 diabetes in the youth population is not well understood. American Diabetes Association (ADA) guidelines to screen youth for type 2 diabetes were used to: 1. examine prevalence of youth meeting ADA criteria; and 2. examine awareness and knowledge of ADA criteria among healthcare providers. Heights and weights were measured in 509 fourth and fifth grade children to determine overweight status according to BMI-for-age growth charts. A parent survey queried for family history related to ADA screening guidelines to determine youth considered high risk. Interviews were conducted with healthcare providers to examine awareness and knowledge of ADA screening guidelines. Overweight (BMI ⱖ 85%) was observed in 198 (38.9%) of the youth, but was not different between boys and girls (39.7% vs. 38.1% respectively). Of 49 youth considered high risk for type 2 diabetes by ADA guidelines, 12 (24.5%) had been screened. Interviews revealed a lack of confidence regarding awareness of ADA screening guidelines and thirst, overweight and family history were the most common signs that elicit screening of youth. Healthcare providers identified insurance, lifestyle, and lack of public awareness as barriers to screening and treatment. Nearly 10% of youth in this population were considered high risk for type 2 diabetes indicating the need for increased awareness and screening; however, current healthcare practices are not conducive to implementation of the ADA guidelines. Funding Disclosure: The Wellmark Foundation, Iowans Fit For Life funded through CDC Nutrition and Physical Activity Program
Funding Disclosure: None
Title: VALIDATION OF CAPILLARY BLOOD FOR THE ASSESSMENT OF DISEASE RISK FACTORS IN CHILDREN Author(s): J. C. Lawrence, E. D. McAuley, M. S. Johnson, J. Munoz, B. A. Gower; Nutrition Sciences, University of Alabama at Birmingham, Birmingham, AL Learning Outcome: After reading this presentation, participants will understand that use of capillary blood obtained with the finger-puncture method, for pediatric disease-risk screening, may be a useful alternative to venipuncture that can be performed more easily in clinical or community health settings. Text: Research Outcome: Due to the rapid increase in childhood obesity, simple screening for obesity-related risk factors may be desirable for use in clinical or community health settings. Because children view venipuncture as painful, stressful and invasive, less-invasive methods for outpatient screening are needed. The primary objective of this study was to determine if measures of insulin, glucose, triglyceride and total cholesterol obtained from capillary blood correlated with those obtained from venous blood. A secondary objective was to determine if waist circumference was associated with serum concentrations of obesity-related disease risk factors. Methods: 21 children (mean age 10.3⫾2.0 years) were evaluated at the General Clinical Research Center outpatient clinic at the University of Alabama-Birmingham. Subjects were evaluated in the fasted state. 5cc of blood was drawn by venipuncture and ⬃0.5cc by finger puncture. Height, weight and waist circumference were measured. Sera were assayed for insulin, glucose, triglyceride and total cholesterol concentrations. Statistical analysis included ANOVA, paired t-test, regression analysis and Bland-Altman plots. Results: Venous and capillary measures of each analyte were significantly correlated (correlation coefficients of 0.74 - 0.96; P⬍0.001 for all). Capillary glucose and triglycerides averaged 5.1% and 8.1% higher, respectively, than corresponding venous values; total cholesterol and insulin did not differ. Waist circumference was significantly correlated with both venous and capillary insulin and with capillary cholesterol. Conclusions: Capillary blood obtained via finger-puncture method may be a useful alternative to venipuncture for pediatric disease-risk screening that can be performed more easily in clinical or community health settings. Funding Disclosure: General Clinical Research Center grant MO1-RR00032, Clinical Nutrition Research Unit grant P30-DK56336 and the Department of Nutrition Sciences, University of Alabama at Birmingham.
A-32 / August 2007 Suppl 3—Abstracts Volume 107 Number 8
Title: FOODSERVICES, NUTRITIONAL CARE AND STAFFING ARE ASSOCIATED WITH RISK OF MALNUTRITION IN LONG-TERM CARE ´ cole des sciences des Author(s): N. Carrier,1 D. Ouellet,2 G. E. West3; 1E aliments, de nutrition et d’e´tudes familiales, Universite´ de Moncton, 2 Moncton, NB, Canada, De´partement des sciences des aliments et de nutrition, Universite´ Laval, Que´bec, PQ, Canada, 3De´partement d’e´conomie agroalimentaire et des sciences de la consommation, Universite´ Laval, Que´bec, PQ, Canada Learning Outcome: Recognize that risk of malnutrition is quite common in LTC and that institutional factors such as those related to foodservices, nutritional care, and staffing, can impact risk of malnutrition in both cognitively intact and cognitively impaired residents Text: This cross-sectional, population-based study investigates institutional determinants of risk of malnutrition among nursing home residents. The 132 cognitively intact and 263 cognitively impaired residents aged 65 or older who participated in this study came from 38 public long-term care (LTC) facilities. Participants were screened for risk of malnutrition, and demographic and medical data were gathered from their medical charts. Information on participants’ dining experience, as well as foodservices, nutritional care and other institutional factors were also gathered. Ordered logistic regressions were used to separately examine relationships between risk of malnutrition and institutional factors for cognitively intact and cognitively impaired residents. Findings indicated that 39% of participants were highly or moderately at risk of malnutrition. Risk was significantly higher in cognitively impaired participants (49.2%) compared to cognitively intact participants (17.6%). Menu cycle length (28-days vs 21-days), difficulty manipulating dishes, lids and food packages, type of food delivery system (bulk vs tray), and oral supplementation were significantly associated with risk of malnutrition in both groups of residents. Therapeutic diets, nutritional screening, and ratio of residents per resident assistant were also significantly associated with risk among cognitively impaired residents. Risk of malnutrition is quite common among LTC residents, especially among those who are cognitively impaired. Several institutional factors were found to have differential impacts on risk depending on cognitive status. These differences should be considered when determining which institutional factors should be modified to reduce the risk of malnutrition in LTC. Funding Disclosure: Medical Research Funds of New Brunswick (MRFNB)