BIOMEDICAL MEASURES
The Australian Health Survey (AHS) biomedical measures component is a new collection, which forms the National Health Measures Survey (NHMS). The NHMS has been made possible by additional funding from the Australian Government Department of Health and Ageing as well as the National Heart Foundation of Australia. The NHMS measured specific biomarkers for chronic disease and nutrition status, derived from tests on blood and urine samples from volunteering participants selected in the AHS.
All people aged 5 years and over who participated in either the National Health Survey (NHS) or the National Nutrition and Physical Activity Survey (NNPAS) were invited to participate in the NHMS, which took place throughout Australia, from March 2011 to September 2012. Children aged 5–11 years were asked to provide a urine sample only, whereas people aged 12 years and over were asked to provide both a blood and urine sample, which were then analysed for specific biomarkers. In the NHMS, a biomarker generally refers to a measured characteristic, which may be used to indicate a health risk factor or condition.
The biomarkers included were selected based on the key policy objectives set out by the Department of Health and Ageing.1 A number of other tests were considered and discussed by the Department's biomedical expert group, and specific tests to measure chronic disease and nutrition status were selected based on the operational requirements and funding of the program, and the feasibility for a population health survey.
Ethics approval for the NHMS was granted by the Australian Government Department of Health and Ageing Departmental Ethics Committee (DEC) in February 2011.
The 2011–12 NHMS collected information about:
- chronic disease biomarkers, including tests for diabetes, cholesterol, triglycerides, kidney disease and liver function
- nutrient biomarkers, including tests for iron, folate, iodine and vitamin D levels.
Estimates of the prevalence of chronic disease risk factors such as cardiovascular disease, diabetes and chronic kidney disease have been collected in the NHS and NNPAS; and dietary behaviour and physical activity estimates have been collected in the NNPAS. These surveys are a good source of self reported data. Whilst self reported estimates are a good source of data, they may underestimate the true prevalence of these diseases. The NHMS data can be used together with the self reported data collected in the NHS and NNPAS to provide an objective measure of Australia's nutritional status and prevalence of chronic disease, whilst also providing data on undiagnosed cases of disease.
This chapter provides information about the following chronic disease and nutrient biomarkers that were collected for the National Health Measures Survey (NHMS).
SUMMARY OF CHRONIC DISEASE BIOMARKERS
|
 | Age | Test type | Fasting |
|
| Cardiovascular disease biomarkers | | | |
|
| Total cholesterol | 12+ | Blood | No |
| High Density Lipoprotein (HDL) cholesterol | 12+ | Blood | No |
| Low Density Lipoprotein (LDL) cholesterol | 12+ | Blood | Yes |
| Triglycerides | 12+ | Blood | Yes |
| Apolipoprotein B (Apo B) | 12+ | Blood | No |
Diabetes biomarkers
|
| Fasting plasma glucose | 12+ | Blood | Yes |
| Glycated Haemoglobin (HbA1c) | 12+ | Blood | No |
Kidney disease biomarkers
|
| Albumin creatinine ratio (ACR) | 5+ | Urine | No |
| Estimated glomerular filtration rate (eGFR) | 18+ | Blood | No |
Liver function biomarkers
|
| Alanine aminotransferase (ALT) | 12+ | Blood | No |
| Gamma glutamyl transferase (GGT) | 12+ | Blood | No |
Tobacco use
|
| Cotinine | 12+ | Blood | No |
SUMMARY OF NUTRIENT BIOMARKERS
|
| Age | Test type | Fasting |
|
| Folate & Vitamin B12 |
|
| Serum folate | 12+ | Blood | No |
| Red cell folate (RCF) | 12+ | Blood | No |
| Serum vitamin B12 | 12+ | Blood | No |
|
| Iron |
|
| Serum ferritin | 12+ | Blood | No |
| Inflammation marker (C-reactive Protein (CRP)) | 12+ | Blood | No |
| Soluble transferrin receptor (sTfR) | 12+ | Blood | No |
| Haemoglobin (Hb) | 12+ | Blood | No |
|
| Vitamin D |
|
| Serum 25-hydroxyvitamin D [25(OH)D] | 12+ | Blood | No |
|
| Iodine |
|
| Iodine concentration | 5+ | Urine | No |
|
| Sodium |
|
| Sodium concentration | 5+ | Urine | No |
|
| Potassium |
|
| Potassium concentration | 5+ | Urine | No |
|
More information regarding the biomedical tests can be found in the relevant subsections.
ENDNOTES
1 Department of Health and Ageing 2011,
Biomedical Component of the Australian Health Survey: Public health objectives, <
http://www.health.gov.au/internet/main/publishing.nsf/Content/health-pubhlth-strateg-food-monitoring.htm>, Last accessed 12/02/2015.
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