title: Cardiometabolic risk clustering in spinal cord injury: results of exploratory factor analysis.
abstract: BACKGROUND
  Evidence suggests an elevated prevalence of cardiometabolic risks among persons with spinal cord injury (SCI); however, the unique clustering of risk factors in this population has not been fully explored.
  
  
  OBJECTIVE
  The purpose of this study was to describe unique clustering of cardiometabolic risk factors differentiated by level of injury.
  
  
  METHODS
  One hundred twenty-one subjects (mean 37 ± 12 years; range, 18-73) with chronic C5 to T12 motor complete SCI were studied. Assessments included medical histories, anthropometrics and blood pressure, and fasting serum lipids, glucose, insulin, and hemoglobin A1c (HbA1c).
  
  
  RESULTS
  The most common cardiometabolic risk factors were overweight/obesity, high levels of low-density lipoprotein (LDL-C), and low levels of high-density lipoprotein (HDL-C). Risk clustering was found in 76.9% of the population. Exploratory principal component factor analysis using varimax rotation revealed a 3-factor model in persons with paraplegia (65.4% variance) and a 4-factor solution in persons with tetraplegia (73.3% variance). The differences between groups were emphasized by the varied composition of the extracted factors: Lipid Profile A (total cholesterol [TC] and LDL-C), Body Mass-Hypertension Profile (body mass index [BMI], systolic blood pressure [SBP], and fasting insulin [FI]); Glycemic Profile (fasting glucose and HbA1c), and Lipid Profile B (TG and HDL-C). BMI and SBP formed a separate factor only in persons with tetraplegia.
  
  
  CONCLUSIONS
  Although the majority of the population with SCI has risk clustering, the composition of the risk clusters may be dependent on level of injury, based on a factor analysis group comparison. This is clinically plausible and relevant as tetraplegics tend to be hypo- to normotensive and more sedentary, resulting in lower HDL-C and a greater propensity toward impaired carbohydrate metabolism.
authors: MedStar National Rehabilitation Hospital , Washington DC.
authors: Alexander
authors: A
authors: Libin
authors: Emily A
authors: EA
authors: Tinsley
authors: Mark S
authors: MS
authors: Nash
authors: Armando J
authors: AJ
authors: Mendez
authors: Patricia
authors: P
authors: Burns
authors: Matt
authors: M
authors: Elrod
authors: Larry F
authors: LF
authors: Hamm
authors: Suzanne L
authors: SL
authors: Groah
keywords: body composition; cardiometabolic syndrome; cardiovascular disease; diabetes; dyslipidemia; factor analysis; spinal cord injury
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