Validation of Capillary Blood for the Assessment of Disease Risk Factors in Children
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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-Navarro 1 ; 1 Health, Iberoamericana Universtiy, Mexico, Mexico, 2 Instituto 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 e- mailed to University employees (Mexico). From 143 subjects that answered, 30 resulted as having risk and 21 subjects agreed to participate (10 men, 11 women 18 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 (r0.571, p0.007), and with total cholesterol levels (CIREC r0.442, p0.04; FRAMIN r549, p0.010). 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; r0.612, p0.003); 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. 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 10.32.0 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; P0.001 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-RR- 00032, Clinical Nutrition Research Unit grant P30-DK56336 and the Department of Nutrition Sciences, University of Alabama at Birmingham. 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 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 Title: FOODSERVICES, NUTRITIONAL CARE AND STAFFING ARE ASSOCIATED WITH RISK OF MALNUTRITION IN LONG-TERM CARE Author(s): N. Carrier, 1 D. Ouellet, 2 G. E. West 3 ; 1 E ´ cole des sciences des aliments, de nutrition et d’e ´tudes familiales, Universite ´ de Moncton, Moncton, NB, Canada, 2 De ´partement des sciences des aliments et de nutrition, Universite ´ Laval, Que ´bec, PQ, Canada, 3 De ´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) SUNDAY, SEPTEMBER 30 POSTER SESSION: PROFESSIONAL SKILLS/NUTRITION ASSESSMENT/MEDICAL NUTRITION THERAPY A-32 / August 2007 Suppl 3—Abstracts Volume 107 Number 8
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Transcript of Validation of Capillary Blood for the Assessment of Disease Risk Factors in Children
Title: VALIDATION OF A QUESTIONNAIRE THAT IDENTIFIESTHE RISK OF DEVELOPING CARDIOVASCULAR DISEASE INMEXICAN ADULTS
Author(s): A.Suverza-Fernandez,1 O. Perichart-Perera,2
S. K. Loza- Hirishaka,1 A. Zarate-Collado,1 K. Haua-Navarro1;1Health, Iberoamericana Universtiy, Mexico, Mexico, 2InstitutoNacional de Perinatologıa, Mexico, Mexico
Learning Outcome: To validate a screening questionnaire thatidentifies mexican population in risk of cardiovascular disease
Text: Cardiovascular disease is an important public health problemall over the world. There are no validated questionnaires to identifyCVD risk in the Mexican population. The objective of this study wasto validate a questionnaire (CIREC) to identify risk factors fordeveloping CVD by measuring metabolic and clinical parameters thatare recognized as main risk factors for CVD. A questionnaire was e-mailed to University employees (Mexico). From 143 subjects thatanswered, 30 resulted as having risk and 21 subjects agreed toparticipate (10 men, 11 women �18 years old). We test the ability ofthe questionnaire to predict risk by relating it with metabolicparameters and with the Framingham criteria (FRAMIN).Cholesterol, LDL cholesterol, HDL cholesterol, triglycerides andglucose levels were analyzed. Blood pressure, body mass index (BMI),body fat percentage (%BF), and abdominal circumference weremeasured. CIREC classified 70% of men and 64% of women as havingCVD 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 clusteranalysis, subjects were classified as having risk or not having riskaccording to FRAMIN variables. With this classification we created acontingency table. CIREC correlated well with the new FRAMINgroups (chi-square; r�0.612, p�0.003); its sensitivity was 100% andspecificity was 58%. The evaluated questionnaire (CIREC) correlatedwell with total cholesterol levels. Even though the sample is verysmall, the sensitivity of the questionnaire appeared to be excellentand could be tested in a larger Mexican population.
Funding Disclosure: None
Title: VALIDATION OF CAPILLARY BLOOD FOR THE ASSESSMENTOF 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 willunderstand that use of capillary blood obtained with the finger-puncturemethod, for pediatric disease-risk screening, may be a useful alternative tovenipuncture that can be performed more easily in clinical or communityhealth settings.
Text: Research Outcome: Due to the rapid increase in childhood obesity,simple screening for obesity-related risk factors may be desirable for use inclinical or community health settings. Because children view venipuncture aspainful, stressful and invasive, less-invasive methods for outpatient screeningare needed. The primary objective of this study was to determine if measuresof insulin, glucose, triglyceride and total cholesterol obtained from capillaryblood correlated with those obtained from venous blood. A secondary objectivewas to determine if waist circumference was associated with serumconcentrations of obesity-related disease risk factors. Methods: 21 children(mean age 10.3�2.0 years) were evaluated at the General Clinical ResearchCenter outpatient clinic at the University of Alabama-Birmingham. Subjectswere evaluated in the fasted state. 5cc of blood was drawn by venipunctureand �0.5cc by finger puncture. Height, weight and waist circumference weremeasured. Sera were assayed for insulin, glucose, triglyceride and totalcholesterol concentrations. Statistical analysis included ANOVA, paired t-test,regression analysis and Bland-Altman plots. Results: Venous and capillarymeasures of each analyte were significantly correlated (correlation coefficientsof 0.74 - 0.96; P�0.001 for all). Capillary glucose and triglycerides averaged5.1% and 8.1% higher, respectively, than corresponding venous values; totalcholesterol and insulin did not differ. Waist circumference was significantlycorrelated with both venous and capillary insulin and with capillarycholesterol. Conclusions: Capillary blood obtained via finger-puncture methodmay be a useful alternative to venipuncture for pediatric disease-risk screeningthat can be performed more easily in clinical or community health settings.
Funding Disclosure: General Clinical Research Center grant MO1-RR-00032, Clinical Nutrition Research Unit grant P30-DK56336 and theDepartment of Nutrition Sciences, University of Alabama at Birmingham.
Title: TYPE 2 DIABETES AMONG YOUTH: PREVALENCE ANDAWARENESS
Author(s): E. C. K. Lasley, R. E. Litchfield; Iowa State University,Ames, IA
Learning Outcome: To identify the prevalence of youth at high riskfor type 2 diabetes and healthcare provider awareness and knowledgeof ADA screening guidelines.
Text: Prevalence of overweight among youth continues to rise with aconsequent rise in type 2 diabetes. Yet, the exact prevalence of type 2diabetes in the youth population is not well understood. AmericanDiabetes Association (ADA) guidelines to screen youth for type 2diabetes were used to: 1. examine prevalence of youth meeting ADAcriteria; and 2. examine awareness and knowledge of ADA criteriaamong healthcare providers. Heights and weights were measured in509 fourth and fifth grade children to determine overweight statusaccording to BMI-for-age growth charts. A parent survey queried forfamily history related to ADA screening guidelines to determineyouth considered high risk. Interviews were conducted withhealthcare providers to examine awareness and knowledge of ADAscreening guidelines. Overweight (BMI � 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 fortype 2 diabetes by ADA guidelines, 12 (24.5%) had been screened.Interviews revealed a lack of confidence regarding awareness of ADAscreening guidelines and thirst, overweight and family history werethe most common signs that elicit screening of youth. Healthcareproviders identified insurance, lifestyle, and lack of public awarenessas barriers to screening and treatment. Nearly 10% of youth in thispopulation were considered high risk for type 2 diabetes indicatingthe need for increased awareness and screening; however, currenthealthcare practices are not conducive to implementation of the ADAguidelines.
Funding Disclosure: The Wellmark Foundation, Iowans Fit ForLife funded through CDC Nutrition and Physical Activity Program
Title: FOODSERVICES, NUTRITIONAL CARE AND STAFFING AREASSOCIATED WITH RISK OF MALNUTRITION IN LONG-TERMCAREAuthor(s): N. Carrier,1 D. Ouellet,2 G. E. West3; 1Ecole des sciences desaliments, de nutrition et d’etudes familiales, Universite de Moncton,Moncton, NB, Canada, 2Departement des sciences des aliments et denutrition, Universite Laval, Quebec, PQ, Canada, 3Departementd’economie agroalimentaire et des sciences de la consommation, UniversiteLaval, Quebec, PQ, Canada
Learning Outcome: Recognize that risk of malnutrition is quite commonin LTC and that institutional factors such as those related to foodservices,nutritional care, and staffing, can impact risk of malnutrition in bothcognitively intact and cognitively impaired residents
Text: This cross-sectional, population-based study investigates institutionaldeterminants of risk of malnutrition among nursing home residents. The 132cognitively intact and 263 cognitively impaired residents aged 65 or older whoparticipated in this study came from 38 public long-term care (LTC) facilities.Participants were screened for risk of malnutrition, and demographic andmedical data were gathered from their medical charts. Information onparticipants’ dining experience, as well as foodservices, nutritional care andother institutional factors were also gathered. Ordered logistic regressionswere used to separately examine relationships between risk of malnutritionand institutional factors for cognitively intact and cognitively impairedresidents. Findings indicated that 39% of participants were highly ormoderately at risk of malnutrition. Risk was significantly higher incognitively impaired participants (49.2%) compared to cognitively intactparticipants (17.6%). Menu cycle length (28-days vs 21-days), difficultymanipulating dishes, lids and food packages, type of food delivery system(bulk vs tray), and oral supplementation were significantly associated withrisk of malnutrition in both groups of residents. Therapeutic diets, nutritionalscreening, and ratio of residents per resident assistant were also significantlyassociated with risk among cognitively impaired residents. Risk ofmalnutrition is quite common among LTC residents, especially among thosewho are cognitively impaired. Several institutional factors were found to havedifferential impacts on risk depending on cognitive status. These differencesshould be considered when determining which institutional factors should bemodified to reduce the risk of malnutrition in LTC.
Funding Disclosure: Medical Research Funds of New Brunswick(MRFNB)
SUNDAY, SEPTEMBER 30
POSTER SESSION: PROFESSIONAL SKILLS/NUTRITION ASSESSMENT/MEDICAL NUTRITION THERAPY
A-32 / August 2007 Suppl 3—Abstracts Volume 107 Number 8
