Publications (3)3.84 Total impact
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Article: Costs of managing conditions associated with obesity among Australian teenagers.
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ABSTRACT: To determine the health-care charges associated with monitoring and managing, over 1 year, the cases of elevated insulin concentration, elevated alanine aminotransferase concentration and dyslipidaemia due to overweight or obesity among 15-19-year-old Australian males and females. Fasting blood samples (n= 500) were collected in 2004 from a representative population sample of adolescents (n= 496; mean age 15.3 years) attending schools in Sydney, Australia. Full service charges and Medicare expenditures for specialist medical and dietary consultations, pathology tests and radiological investigations, over 1 year, under efficient and inefficient health-care delivery models, including and excluding participants in the healthy body mass index (BMI) category. Under an inefficient delivery model and including all participants with elevated risk factors, the Medicare expenditure was $A305.1 million per annum (M pa). Exclusion of participants in the healthy BMI category resulted in an annual Medicare expenditure of $A170.0M pa. Under an efficient delivery model and including all participants with elevated risk factors, the Medicare expenditure was $A295.5M pa. Exclusion of participants in the healthy BMI category reduced annual Medicare expenditure to $A164.8M pa. Medicare expenditure for 15-19-year-olds would increase by 48% if only cases among overweight and obese adolescents were treated and by 85% if all cases were identified and treated. Short-term management of the health consequences of overweight and obesity among adolescents will increase Medicare expenditure on this group by at least 48%. Failure to treat will delay, but compound, health-care expenditure.Journal of Paediatrics and Child Health 07/2009; 45(7-8):448-56. · 1.28 Impact Factor -
Article: The population prevalence of adverse concentrations and associations with adiposity of liver tests among Australian adolescents.
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ABSTRACT: Paediatric overweight has a high incidence and has serious consequences for health, including non-alcoholic fatty liver disease (NAFLD). However, very little is known about NAFLD among young people, particularly from a population perspective. This paper reports the prevalence of elevated concentrations of four liver enzymes and their associations with adiposity in a representative population sample of Australian adolescents. Overnight fasting blood samples were collected from a representative population sample of 500 Grade 10 students (15-years-old) attending schools in Sydney, Australia, between February and May, 2004. Weight, height and waist girth were measured. The prevalence of adverse concentrations of the enzymes alanine aminotransferase (ALT), gamma-glutamyltransferase (GGT), aspartate aminotransferase (AST) and alkaline phosphatase (ALP) were described for all boys and girls and by body mass index (BMI) categories. The nature of the associations between the enzyme concentrations and indices of adiposity were characterised, and regression equations for estimating enzyme concentrations from BMI were prepared. The prevalence of adverse concentrations of ALT (most likely as a result of NAFLD) and GGT were approximately 10%, while the prevalence of adverse concentrations of AST and ALP were approximately 7% and 5% respectively. The prevalence of adverse concentrations of ALT, GGT and AST increased across BMI categories, while the prevalence of adverse concentrations of ALP declined across BMI categories. The high prevalence of NAFLD in a population sample of healthy Australian adolescents represents a significant burden of disease.Journal of Paediatrics and Child Health 12/2008; 44(12):686-91. · 1.28 Impact Factor -
Article: The population distributions, upper normal limits and correlations between liver tests among Australian adolescents.
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ABSTRACT: Relatively little is known about the results of liver tests among adolescents. The purpose of this study was to describe the distributions of liver tests, to identify the upper normal limits (UNLs) and to describe the correlations among liver tests. Overnight fasting blood samples were collected from a representative population sample of 500 Grade 10 students (15 years old) attending schools in Sydney, Australia. Weight, height and waist girth were measured. UNLs were calculated for each enzyme as the 95th percentiles of the healthy body mass index category, after excluding those with high blood pressure, elevated low-density lipoprotein cholesterol (>or=3.4 mmol/L) or triglyceride concentration (>or=2.25 mmol/L) (n = 246). The distributions of alanine aminotransferase (ALT), gamma-glutamyltransferase (GGT), aspartate aminotransferase (AST) and alkaline phosphatase (ALP) were described, UNLs were identified and the correlations between enzyme concentrations were described. The UNLs for ALT were 32 and 20 U/L; for GGT, 24 and 19 U/L; for AST, 33 and 26 U/L; and for ALP, 385 and 183 U/L, for boys and girls, respectively. ALT concentration was strongly correlated with GGT and AST (r = 0.5-0.6). Neither ALT nor GGT concentrations were correlated with ALP concentration, but AST concentration was moderately correlated with ALP concentration. These data are valuable in defining the distributions of liver tests, normal liver test ranges and relationships between liver tests among adolescents.Journal of Paediatrics and Child Health 10/2008; 44(10):579-85. · 1.28 Impact Factor
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2008
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Westmead Millennium Institute
Paramatta, New South Wales, Australia
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