Blackett Piers, Farrell Kerry, Truong Minh, George Minu, Turner Peggy, Less Joane, Baldwin Jonathan D, Knehans Allen W
Department of Pediatrics, The Harold Hamm Diabetes Center, University of Oklahoma Health Sciences Center, 1200 Children's Ave, Suite 4500, Oklahoma City, Oklahoma 73104, USA.
Department of Nutritional Sciences, College of Allied Health, University of Oklahoma Health Sciences Center, 1200 N Stonewall, Suite 3057, Oklahoma City, Oklahoma 73104, USA.
Adv Prev Med. 2018 Jun 12;2018:5474838. doi: 10.1155/2018/5474838. eCollection 2018.
The feasibility of "point-of-care" screening for ideal cardiovascular health was explored in a pediatric specialty clinic setting. Children and adolescents aged 9-18 years (n=91) with treated and stabilized diseases were recruited at a pediatric endocrinology clinic. A table-top device was used to assay fingerstick samples for non-HDL cholesterol (non-HDL-C), which was used to divide participants into two groups based on the non-HDL-C threshold for comparison of the remaining metrics between groups. A significant number of children had low scores, and score frequency distribution was similar to larger retrospective studies, with few participants achieving none or all of the health metrics. Healthy diet was the metric least often achieved. Those with a non-HDL-C above the ideal threshold of 3.1 mmol/L (120 mg/dl) had a higher BMI percentile (p<0.01) and diastolic blood pressure percentile (p<0.05). We conclude that pediatric risk factor screening and scoring can be performed in a specialty clinic with meaningful cardiovascular health scores for patients and providers. Association of abnormal "point-of care" non-HDL-C levels with elevated BMI and blood pressure supports evidence for risk factor clustering and use of the ideal health construct in pediatric clinic settings.
在儿科专科门诊环境中探讨了“即时护理”筛查理想心血管健康状况的可行性。在一家儿科内分泌诊所招募了9至18岁（n = 91）患有已治疗且病情稳定疾病的儿童和青少年。使用台式设备检测手指采血样本中的非高密度脂蛋白胆固醇（non-HDL-C），并根据非高密度脂蛋白胆固醇阈值将参与者分为两组，以比较两组之间其余指标。相当数量的儿童得分较低，得分频率分布与较大规模的回顾性研究相似，很少有参与者实现所有或没有任何一项健康指标。健康饮食是最不容易实现的指标。非高密度脂蛋白胆固醇高于理想阈值3.1 mmol/L（120 mg/dl）的参与者，其BMI百分位数较高（p<0.01），舒张压百分位数也较高（p<0.05）。我们得出结论，儿科风险因素筛查和评分可以在专科门诊进行，为患者和医护人员提供有意义的心血管健康评分。“即时护理”非高密度脂蛋白胆固醇水平异常与BMI升高和血压升高之间的关联，支持了儿科门诊环境中风险因素聚集和使用理想健康指标的证据。
