Higher glucose uptake in paralysed spastic leg.
BACKGROUND
Insulin resistance and diabetes mellitus have been reported in the spinal cord injured (SCI). The group exhibits risk factors, as decreased physical activity, as well as episodes of stimulation of sympathetic nervous system below the level of lesion known to stimulate lipolysis, which in turn could induce insulin resistance. However, data are inconsistent, which might indicate the presence of protective mechanisms.


OBJECTIVE
To investigate the glucose uptake in spastic paralysed SCI legs compared to able-bodied. To investigate regional differences between glucose handling in the arm and leg.


METHODS
Experimental controlled study.


METHODS
Institution of Clinical Neuroscience and Physiology, Spinal Injures Unit, Sahlgrens University Hospital, Goteborg, Sweden.


METHODS
Nine SCI subjects (2 C7, 7 T1-T4 ASIA A: 8, ASIA B: 1) were compared to 10 weight- and age-matched controls. Plasma flow in arm and leg was analysed by venous occlusion strain gauge plethysmography, and plasma derived from artery and veins in the arm and leg was analysed for glucose, insulin and lactate during fasting resting conditions.


RESULTS
Glucose uptake was higher in SCI legs compared to controls. There was no difference in insulin uptake or lactate production. Plasma flow was higher in SCI legs compared to controls. Controls showed a higher glucose uptake and lactate production in arm than leg.


CONCLUSIONS
Spasticity may counteract the risk of diabetes by inducing an insulin-independent glucose uptake. The regional difference in metabolism in able-bodied make it hazardous to do generalizations to whole body metabolism from arm or leg measurements.
Bennegard
G-M
GM
Spinal Injuries Unit, Sahlgrenska University Hospital, Goteborg, Sweden. gun-marie.bennegard@vgregion.se
Karlsson
A-K
AK
D000328:Adult; D001132:Arm / Q000098:blood supply; D005947:Glucose / Q000378:metabolism*; D006801:Humans; D007328:Insulin / Q000378:metabolism; D019344:Lactic Acid / Q000378:metabolism; D007866:Leg / Q000098:blood supply; D009128:Muscle Spasticity / Q000503:physiopathology*; D010264:Paraplegia / Q000378:metabolism*; D010991:Plethysmography; D012039:Regional Blood Flow; D013119:Spinal Cord Injuries / Q000503:physiopathology*
D007328:Insulin; D019344:Lactic Acid; D005947:Glucose