The relationships among serum lipid levels, adiposity, and depressive symptomatology in persons aging with spinal cord injury.
BACKGROUND
Cardiovascular disease (CVD) appears to occur prematurely in persons with spinal cord injury (SCI). Stress may play a significant role in the development of CVD. Depression is the most common form of stress complicating the care of persons with SCI.


METHODS
In 188 persons with SCI, 46% with tetraplegia and 54% with paraplegia, the relationship between depression and the serum lipid profile was studied. Depression was measured by the Older Adult Health and Mood Questionnaire (OAHMQ) for persons with disability. Total cholesterol, high density lipoprotein (HDL) and low density lipoprotein (LDL) cholesterol and triglycerides were measured; body mass index (BMI) was computed and percent body fat was determined by dual-energy x-ray absorptiometry (DXA).


RESULTS
Depression and level of SCI were found to have significant interactive effects on serum lipid levels. Serum total and LDL cholesterol, as well as triglycerides, were all higher among persons with paraplegia who were depressed compared to those who were not depressed. This was not found in persons with tetraplegia. Inverse relationships were evident between serum triglycerides and HDL cholesterol levels. Persons with paraplegia who were depressed had significantly more adiposity than those not depressed. BMI correlated directly with serum triglycerides and indirectly with serum HDL cholesterol.


CONCLUSIONS
Depression appears to be a strong determinant of adverse lipid profiles in patients with paraplegia. association between depression and adiposity in these patients compounds the risk for cardiovascular disease.
Kemp
B J
BJ
Rehabilitation Research and Training Center on Aging with Spinal Cord Injury, Rancho Los Amigos National Rehabilitation Center, Downey, California, USA.
Spungen
A M
AM
Adkins
R H
RH
Krause
J S
JS
Bauman
W A
WA
D050154:Adiposity / Q000502:physiology*; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000375:Aging / Q000502:physiology; D002318:Cardiovascular Diseases / Q000209:etiology; D003866:Depressive Disorder / Q000097:blood* / Q000453:epidemiology*; D005260:Female; D006801:Humans; D008055:Lipids / Q000097:blood*; D008297:Male; D008875:Middle Aged; D010264:Paraplegia / Q000097:blood / Q000209:etiology / Q000523:psychology; D011782:Quadriplegia / Q000097:blood / Q000209:etiology / Q000523:psychology; D012307:Risk Factors; D012720:Severity of Illness Index; D013119:Spinal Cord Injuries / Q000097:blood* / Q000150:complications / Q000523:psychology*
D008055:Lipids