BIOMEDICAL MEASURES
The Australian Aboriginal and Torres Strait Islander Health Survey (AATSIHS) biomedical measures component is a new collection, which forms the National Aboriginal and Torres Strait Islander Health Measures Survey (NATSIHMS). The NATSIHMS has been made possible by additional funding from the Australian Government Department of Health and Ageing (DoHA) as well as the National Heart Foundation of Australia. The NATSIHMS measured specific biomarkers for chronic disease and nutrition status, derived from tests on blood and urine samples from volunteering participants selected in the AATSIHS.
All people aged 18 years and over who participated in either the National Aboriginal and Torres Strait Islander Health Survey (NATSIHS) or the National Aboriginal and Torres Strait Islander Nutrition and Physical Activity Survey (NATSINPAS) were invited to participate in the NATSIHMS, which took place throughout Australia, from April 2012 to July 2013. Participants aged 18 years and over were asked to provide both a blood and urine sample, which were then analysed for specific biomarkers. In the NATSIHMS, a biomarker generally refers to a measured characteristic, which may be used to indicate a health risk factor or condition. These biomarkers are the same as those that were collected in the general population for the National Health Measures Survey (NHMS).
The biomarkers included were selected based on the key policy objectives set out by DoHA. 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 NATSIHMS was granted at the national level by the Australian Government Department of Health and Ageing Departmental Ethics Committee (DEC) in February 2011. Ethics approval was also required at the jurisdictional level for New South Wales, South Australia, Western Australia, Northern Territory and for Queensland Health Service Districts. Ethics approval was sought and gained (for the NATSIHMS component only) from the following Ethics Committees:
- Aboriginal Health and Medical Research Council Ethics Committee in New South Wales
- Aboriginal Health Research Ethics Committee in South Australia
- Western Australian Aboriginal Health Ethics Committee in Western Australia
- Western Australia Country Health Service (WACHS) Research Ethics Committee in Western Australia
- Central Australian Human Research Ethics Committee in Northern Territory
- Human Research Ethics Committee of the Northern Territory Department of Health and Menzies School of Health Research in Northern Territory
- several Human Research Ethics Committees of Queensland Government Hospital and Health Services districts.
The 2012–13 NATSIHMS 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, sodium, potassium 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 NATSIHS and NATSINPAS; and dietary behaviour and physical activity estimates have been collected in the NATSINPAS. 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 NATSIHMS data can be used together with the self reported data collected in the NATSIHS and NATSINPAS to provide an objective measure of Aboriginal and Torres Strait Islander peoples’ 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 NATSIHMS.
SUMMARY OF CHRONIC DISEASE BIOMARKERS
|
 | Age | Test type | Fasting |
|
| Cardiovascular disease biomarkers | | | |
|
| Total cholesterol | 18+ | Blood | No |
| High Density Lipoprotein (HDL) cholesterol | 18+ | Blood | No |
| Low Density Lipoprotein (LDL) cholesterol | 18+ | Blood | Yes |
| Triglycerides | 18+ | Blood | Yes |
| Apolipoprotein B (Apo B) | 18+ | Blood | No |
Diabetes biomarkers
|
| Fasting plasma glucose | 18+ | Blood | Yes |
| Glycated Haemoglobin (HbA1c) | 18+ | Blood | No |
Kidney disease biomarkers
|
| Albumin creatinine ratio (ACR) | 18+ | Urine | No |
| Estimated glomerular filtration rate (eGFR) | 18+ | Blood | No |
Liver function biomarkers
|
| Alanine aminotransferase (ALT) | 18+ | Blood | No |
| Gamma glutamyl transferase (GGT) | 18+ | Blood | No |
Tobacco use
|
| Cotinine | 18+ | Blood | No |
SUMMARY OF NUTRIENT BIOMARKERS
|
| Age | Test type | Fasting |
|
| Folate & Vitamin B12 |
|
| Serum folate | 18+ | Blood | No |
| Red cell folate (RCF) | 18+ | Blood | No |
| Serum vitamin B12 | 18+ | Blood | No |
|
| Iron |
|
| Serum ferritin | 18+ | Blood | No |
| Inflammation marker (C-reactive Protein (CRP)) | 18+ | Blood | No |
| Soluble transferrin receptor (sTfR) | 18+ | Blood | No |
| Haemoglobin (Hb) | 18+ | Blood | No |
|
| Vitamin D |
|
| Serum 25-hydroxyvitamin D [25(OH)D] | 18+ | Blood | No |
|
| Iodine |
|
| Iodine concentration | 18+ | Urine | No |
|
| Sodium |
|
| Sodium concentration | 18+ | Urine | No |
|
| Potassium |
|
| Potassium concentration | 18+ | Urine | No |
|
The ABS provides data to the Council of Australian Governments (COAG) in line with the COAG indicators as part of the National Partnership Agreement on Closing the Gap in Indigenous Health Outcomes. COAG has committed to closing the gap in life expectancy between Aboriginal and Torres Strait Islander peoples and other Australians within a generation. Chronic disease is a major area of focus in reducing the gap because many of these diseases occur at higher rates in the Aboriginal and Torres Strait Islander population than in the general population.
1
More information regarding the biomedical tests can be found in the relevant subsections of this Users' Guide.
ENDNOTES
1 Department of Health,
Closing the Gap: Tackling Chronic Disease,
<http://www.health.gov.au/>, Last accessed 28/04/2014.
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