title: Cardiometabolic changes and disparities among persons with spinal cord injury: a 17-year cohort study.
abstract: BACKGROUND
  Cardiometabolic syndrome in individuals who are aging with spinal cord injury (SCI) increases the risk of cardiovascular disease and diabetes. Longitudinal research is needed on the natural progression of cardiometabolic syndrome in SCI.
  
  
  OBJECTIVE
  To identify the magnitude of changes in biomarkers of cardiometabolic syndrome and diabetes over time in people aging with SCI, and to discern how these biomarkers relate to demographics of race/ethnicity and sex.
  
  
  METHODS
  This cohort study was a follow-up of a convenience sample of 150 participants (mean age, 51.3; duration of SCI, 27.3 years) from a full cohort of 845 who participated in research in which physiologic and serologic data on cardiovascular disease had been prospectively collected (1993-1997). Inclusion criteria were adults with traumatic-onset SCI. Average years to follow-up were 15.7 ± 0.9. Assessments were age, race, level and completeness of injury, duration of injury, blood pressure, body mass index, waist circumference, serum lipids, fasting glucose, hemoglobin A1c, and medications used. Primary outcome was meeting at least 3 of the criteria for cardiometabolic syndrome.
  
  
  RESULTS
  The frequency of cardiometabolic syndrome increased significantly from 6.7% to 20.8% or 38.2% according to 2 definitions. It was significantly higher in Hispanics and apparently higher in women. Diabetes increased significantly by a factor of 6.7.
  
  
  CONCLUSIONS
  Our data indicate clinically important increases in the frequency of cardiometabolic syndrome, especially among Hispanic and female participants, and a similar increase in diabetes among individuals aging with SCI. Clinical practice guidelines need to be customized for women and Hispanics with SCI.
authors.affiliation: Department of Medicine of Rancho Los Amigos National Rehabilitation Center , Downey, California ; Keck School of Medicine of the University of Southern California , Los Angeles, California ; Los Amigos Research and Educational Institute , Downey, California.
authors.forename: Yaga
authors.initials: Y
authors.lastname: Szlachcic
authors.affiliation: Los Amigos Research and Educational Institute , Downey, California.
authors.forename: Rodney H
authors.initials: RH
authors.lastname: Adkins
authors.affiliation: Keck School of Medicine of the University of Southern California , Los Angeles, California ; Department of Pathology, Rancho Los Amigos National Rehabilitation Center , Downey, California.
authors.forename: Sugantha
authors.initials: S
authors.lastname: Govindarajan
authors.affiliation: College of Health Professions, Medical University of South Carolina , Charleston, South Carolina.
authors.forename: Yue
authors.initials: Y
authors.lastname: Cao
authors.affiliation: College of Health Professions, Medical University of South Carolina , Charleston, South Carolina.
authors.forename: James S
authors.initials: JS
authors.lastname: Krause
keywords: aging; cardiovascular disease; diabetes; dyslipidemia; metabolic syndrome; risk factors