title: Metabolic syndrome in adolescents with spinal cord dysfunction.
abstract: OBJECTIVE
  The purpose of this study was to determine the prevalence of components of the metabolic syndrome in adolescents with spinal cord injury (SCI) and spina bifida (SB), and their associations with obesity in subjects with and without SCI and SB.
  
  
  METHODS
  Fifty-four subjects (20 SCI and 34 SB) age 11 to 20 years with mobility impairments from lower extremity paraparesis were recruited from a hospital-based clinic. Sixty able-bodied subjects who were oversampled for obesity served as controls (CTRL). Subjects were categorized as obese if their percent trunk fat measured by dual x-ray absorptiometry (DXA) was > 30.0% for males and > 35.0% for females. Ten SCI, 24 SB, and 19 CTRL subjects were classified as obese. Fasting serum samples were collected to determine serum glucose, insulin, and lipid concentrations. Metabolic syndrome was defined as having > or =3 of the following components: (a) obesity; (b) high-density lipoprotein (HDL) <45 mg/dL for males; <50 mg/dL for females; (c) triglycerides 2100 mg/dL; (d) systolic or diastolic blood pressure > or =95th percentile for age/ height/gender, and (e) insulin resistance determined by either fasting serum glucose 100-125 mg/dL; fasting insulin > or =20 microU /mL; or homeostasis model assessment of insulin resistance > or = 4.0.
  
  
  RESULTS
  Metabolic syndrome was identified in 32.4% of the SB group and 55% of the SCI group. Metabolic syndrome occurred at a significantly higher frequency in obese subjects (SB = 45.8%, SCI = 100%, CTRL = 63.2%) than nonobese subjects (SB = 0%, SCI = 10%, CTRL = 2.4%).
  
  
  CONCLUSIONS
  The prevalence of metabolic syndrome in adolescents with SB/SCI is quite high, particularly in obese individuals. These findings have important implications due to the known risks of cardiovascular diseases and diabetes mellitus associated with metabolic syndrome in adults, particularly those with spinal cord dysfunction.
authors.affiliation: University of California Department of Nutrition, Davis, California, USA.
authors.forename: Mindy Dopler
authors.initials: MD
authors.lastname: Nelson
authors.forename: Lana M
authors.initials: LM
authors.lastname: Widman
authors.forename: Richard Ted
authors.initials: RT
authors.lastname: Abresch
authors.forename: Kimber
authors.initials: K
authors.lastname: Stanhope
authors.forename: Peter J
authors.initials: PJ
authors.lastname: Havel
authors.forename: Dennis M
authors.initials: DM
authors.lastname: Styne
authors.forename: Craig M
authors.initials: CM
authors.lastname: McDonald
mesh_terms: D015502:Absorptiometry, Photon; D000293:Adolescent; D000328:Adult; D000704:Analysis of Variance; D000886:Anthropometry; D001786:Blood Glucose; D001794:Blood Pressure; D002648:Child; D005260:Female; D006801:Humans; D007333:Insulin Resistance; D008075:Lipoproteins, HDL / Q000378:metabolism; D008297:Male; D008659:Metabolic Diseases / Q000453:epidemiology / Q000209:etiology* / Q000378:metabolism; D009765:Obesity; D015995:Prevalence; D012737:Sex Factors; D013119:Spinal Cord Injuries / Q000150:complications* / Q000453:epidemiology / Q000378:metabolism; D016135:Spinal Dysraphism / Q000150:complications* / Q000453:epidemiology / Q000378:metabolism; D014280:Triglycerides / Q000097:blood
chemical_list: D001786:Blood Glucose; D008075:Lipoproteins, HDL; D014280:Triglycerides