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Comparison of Nutritional Status, Lung Functions Between Amish and Non Amish Children with Cystic Fibrosis
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A3674 - Comparison of Nutritional Status, Lung Functions Between Amish and Non Amish Children with Cystic Fibrosis
Author Block: R. Padman, D. Gilham, T. Laturner; Pulmonary Div, Lutheran childrens hospital, Fort Wayne, IN, United States.
Introduction: The Amish population in North America with Cystic Fibrosis (CF) is understudied and underreported. Same genetic mutation have variable disease expression depending on psychosocial, culture, economic, and environmental variables. Amish live on farms, and hold different philosophies for healthcare, wellness, insurance, and religion. Little has been published on clinical characteristics of CF in this population. Amish clinical outcomes were studied in respect to nutrition, BMI, FEV1, and FEF 25-75 compared to non-Amish population. Higher rates of CF exist in the Amish. Our clinic has 40 CF patients, 25% are Amish. The 2014 population of Indiana Amish was approximately 50,000. Estimating the number of Amish effected by CF is difficult.
Methods: 40 patients between the ages of 0 and 18 and in port-CF were eligible for study. A retrospective, open, non-interventional, single site, comparative study of CF therapy in the Amish and non-Amish population accounting for social, economic, physical, environmental, and nutritional differences was conducted. Data collection compared outcomes for; age, height, weight, BMI, weight for length, FEV1, and FEF 25-75. Data was collected for 3 months. A questionnaire for non-Port CF data was used for supplementary information. Statistical tests used for categorical data were chi square or fishers exact test and student TTest for numeric data.
Results: 9 Amish and 16 non-Amish patients participated. 64% male and 36% female. Average age was 6 and 7.6 years. Amish were 100% homozygous for DeltaF508. Non-Amish, 40% heterozygous for 12% homozygous, and 8% did no DeltaF508 mutation. Electricity access 1/9 vs 16/16 p=0.001 odds ratio 0.0053 or 189/1. Well water 9 vs 5 p=0.001, odds ratio of 40/1. Insurance/financial assistance was 55% compared to 100%. Home electricity was 44% and 100%. Numeric data for FEV1 and FEF 25-75 were not statistically significant due to limited data. Raw numbers showed tendency toward lower FEV1 and FEF 25-75. FEV1 mean was 83.6 vs 102.5 19.5% difference and FEF 25-75 mean 58 vs 86 32.9% difference. BMI percentiles were 51.25 and 61.25 16% difference p = 0.31. Activity level was 4.12 to 3.4. Despite BMI being lower, supplements were prescribed at 89% vs 50% p= 0.087.
Conclusion: This study is a first examining utilization of services, access to care, and clinical outcomes in the Amish population. Significant differences were noted in; financial services, electricity, well water, transportation, homozygosity for DeltaF508. Lower FEV1, FEF 25-75, BMI, weight for length and higher activity levels were noted.
Author Block: R. Padman, D. Gilham, T. Laturner; Pulmonary Div, Lutheran childrens hospital, Fort Wayne, IN, United States.
Introduction: The Amish population in North America with Cystic Fibrosis (CF) is understudied and underreported. Same genetic mutation have variable disease expression depending on psychosocial, culture, economic, and environmental variables. Amish live on farms, and hold different philosophies for healthcare, wellness, insurance, and religion. Little has been published on clinical characteristics of CF in this population. Amish clinical outcomes were studied in respect to nutrition, BMI, FEV1, and FEF 25-75 compared to non-Amish population. Higher rates of CF exist in the Amish. Our clinic has 40 CF patients, 25% are Amish. The 2014 population of Indiana Amish was approximately 50,000. Estimating the number of Amish effected by CF is difficult.
Methods: 40 patients between the ages of 0 and 18 and in port-CF were eligible for study. A retrospective, open, non-interventional, single site, comparative study of CF therapy in the Amish and non-Amish population accounting for social, economic, physical, environmental, and nutritional differences was conducted. Data collection compared outcomes for; age, height, weight, BMI, weight for length, FEV1, and FEF 25-75. Data was collected for 3 months. A questionnaire for non-Port CF data was used for supplementary information. Statistical tests used for categorical data were chi square or fishers exact test and student TTest for numeric data.
Results: 9 Amish and 16 non-Amish patients participated. 64% male and 36% female. Average age was 6 and 7.6 years. Amish were 100% homozygous for DeltaF508. Non-Amish, 40% heterozygous for 12% homozygous, and 8% did no DeltaF508 mutation. Electricity access 1/9 vs 16/16 p=0.001 odds ratio 0.0053 or 189/1. Well water 9 vs 5 p=0.001, odds ratio of 40/1. Insurance/financial assistance was 55% compared to 100%. Home electricity was 44% and 100%. Numeric data for FEV1 and FEF 25-75 were not statistically significant due to limited data. Raw numbers showed tendency toward lower FEV1 and FEF 25-75. FEV1 mean was 83.6 vs 102.5 19.5% difference and FEF 25-75 mean 58 vs 86 32.9% difference. BMI percentiles were 51.25 and 61.25 16% difference p = 0.31. Activity level was 4.12 to 3.4. Despite BMI being lower, supplements were prescribed at 89% vs 50% p= 0.087.
Conclusion: This study is a first examining utilization of services, access to care, and clinical outcomes in the Amish population. Significant differences were noted in; financial services, electricity, well water, transportation, homozygosity for DeltaF508. Lower FEV1, FEF 25-75, BMI, weight for length and higher activity levels were noted.
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