Cardiometabolic risk in community-dwelling persons with chronic spinal cord injury.
OBJECTIVE
The purpose of this study was to describe cardiometabolic risk factors and risk clustering in people with spinal cord injury (SCI).


METHODS
This was a cross-sectional study of 121 subjects aged 18 to 73 years (mean, 37 ± 12 years) with chronic, motor complete SCI between C5 and T12. Assessments included demographic, social, and medical history; physical, anthropometric, and blood pressure assessments; fasting serum assays including total cholesterol (TC), high-density lipoprotein cholesterol (HDL-C), triglycerides, and hemoglobin A1c; calculated low-density lipoprotein cholesterol (LDL-C); and an oral glucose tolerance test. Framingham risk scores (FRSs) for each subject were calculated on the basis of Third National Cholesterol Education Program Adult Treatment Panel algorithm.


RESULTS
According to FRSs, 90.1%, 8.3%, and 1.7% were classified in the low-, medium-, and high-risk groups, respectively. The most prevalent cardiometabolic risk factors were overweight/obesity (74%), elevated LDL-C (64%), low HDL-C (53%), elevated systolic blood pressure (SBP, 33%), and elevated TC (30%). Stratification by level of injury demonstrated significant differences between paraplegic and tetraplegic participants in SBP (120 vs 99 mm Hg, P = .0001), 2-hour glucose (101.37 vs 137.93 mg/dL, P = .0001), and 2-hour insulin (47.45 vs 94.36 μIU/mL, P = .024). In addition, triglycerides, fasting insulin, body mass index, LDL-C, hemoglobin A1c, and insulin resistance were significantly associated with FRS.


CONCLUSIONS
Ten percent of young people with SCI are at moderate to high risk for long-term hard cardiac events. Overweight/obesity, LDL-C, HDL-C, SBP, and TC were the most prevalent risk factors. Carbohydrate metabolism is preferentially affected in persons suffering from tetraplegia, indicating a need for impairment-specific risk assessment.
National Rehabilitation Hospital, Washington, DC 20010, USA. suzanne.l.groah@medstar.net
Suzanne L
SL
Groah
Mark S
MS
Nash
Emily A
EA
Ward
Alexander
A
Libin
Armando J
AJ
Mendez
Patricia
P
Burns
Matt
M
Elrod
Larry F
LF
Hamm
D000293:Adolescent; D000328:Adult; D000368:Aged; D002318:Cardiovascular Diseases / Q000453:epidemiology* / Q000209:etiology; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D012111:Residence Characteristics; D018570:Risk Assessment; D012307:Risk Factors; D013119:Spinal Cord Injuries / Q000150:complications* / Q000503:physiopathology; D055815:Young Adult