Investigation of lipids in First Year Medical Residents

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Investigation of lipids in First Year Medical
Residents

• Baseline Data
• Susan DeLange, MD
• Michelle Zook, MD
• 8/21/08

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Introduction

• Every year students make the transition to
  residents signaling a significant change in
  lifestyle
• In 2008 56 Internal Medicine residents were
  assessed for CVD risk factors, 20 of these
  residents had / 2 or more risk factors
  including obesity, hypertension, hyperlipidemia
  or nicotine abuse
• However it has not been shown whether these risk
  factors worsen over the time devoted to residency

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CARDIA study

• CARDIA study which started recruitment of
  subjects in 1988, studied 5115 young adults
  between age 18-30 to monitor CVD risk factors
  over time
• This study demonstrated that a decline in
  physical fitness/activity over 7 years was
  associated with weight gain and hyperlipidemia
• This study provided several questionnaires that
  were used to elicit sleep pattern, stress level,
  exercise and nutrition level

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Goals

• To determine the effects of increased stress,
  decreased exercise, and diet changes over one
  year in first-year medical residents on lipids,
  waist circumference, and weight.
• Primary study endpoint lipid profile at 12
  months
• Primary objective To determine the difference,
  if any, between baseline and one-year lipid
  profiles.
• Secondary objectives To determine the
  difference, if any, between baseline and one-year
  weight and waist circumference.

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Study Population

• Participants were recruited at Georgetown
  Resident orientation and the only inclusion
  criteria was employment in the first year class
• Exclusion criteria include previous participation
  in a residency program, history of familial
  hyperlipidemia, pregnancy, previous treatment
  with a statin, pregnancy and diabetes mellitus
• Total of 57 residents were recruited to
  participate in the study

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Stress, Sleep, Exercise, Nutrition

• Participants provided self assesment of current
  exercise level, nutrition level, stress level and
  sleep using CARDIA study assessment tools
• Using the questionnaire answers participants were
  assigned an exercise score assessed in exercise
  units (EU)
• EU(mos infrequent activity 3mos frequent
  activity)difficulty rating

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Lipid Profile

• Overnight fasting blood samples were drawn, cells
  and plasma separated then plasma frozen until
  processing could occur
• Total and HDL Cholesterol and triglycerides were
  determined by enzymatic reaction, LDL-C was
  estimated by the Friedewald equation

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Baseline Lipids cont

• 57 residents were enrolled in the study at
  baseline 12 residents have total chol200
• At baseline 12 residents have LDL130
• 5 residents have LDL /160

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Weight and Waist Circumference

• Participants were weighed using a balance beam
  scale
• BMI calculated using the NIH BMI calculator
• Waist Circumference was measured using the two
  attempts, the iliac crest was palpated and the
  measuring tape placed directly above this line

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Number of participants by Department
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Supported by

• The study has been approved by the Georgetown IRB
• In addition supported by Georgetown Clinical
  Research Center (GCRC)
• GCRC provided all the nursing and laboratory
  support

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References

• Mihalopoulos, N Gerald, S. Cardiovascular Risk
  factors among Internal Medicine Residents.
  Preventative Cardiology. 11(2)76-81, 2008.
• Loria, C Liu, K. Early Adult Risk Factors Levels
  and Consequent Coronary Artery Calcification.
  Journal of the American College of Cardiology.
  49(20) 2007.
• Truesdale, KT Stevens, J. Changes in Risk
  Factors for Cardiovascular Disease by baseline
  weight status in young adults who gain or
  maintain weight over 15 years CARDIA study.
  International Journal of Obesity. 30 1397-1407,
  2006.
• Sternfeld, B Sydney, S. Seven Year Changes in
  Physical Fitness, Physical Activity, and Lipid
  Profile in the CARDIA study. Annals of
  Epidemiology. 925-33, 1999.

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Thank You!