Sarcopenic Obesity in Adults With Spinal Cord Injury: A Cross-Sectional Study.
To describe (1) the frequency and utility of clinically relevant spinal cord injury (SCI)-specific and general population thresholds for obesity and sarcopenic obesity; and (2) the fat and lean soft tissue distributions based on the neurologic level of injury and the American Spinal Injury Association Impairment Scale.



Cross-sectional.



Tertiary SCI rehabilitation hospital.



Persons (N=136; men, n=100; women, n=36) with chronic (mean ± SD: 15.6±11.3y postinjury) tetraplegia (n=66) or paraplegia (n=70).



Not applicable.



Body composition was assessed with anthropometrics and whole-body dual-energy x-ray absorptiometry. Muscle atrophy was quantified using a sarcopenia threshold of appendicular lean mass index (ALMI) (men, ≤7.26kg/m2; women, ≤5.5kg/m2). Obesity was defined by percentage body fat (men, ≥25%; women, ≥35%), visceral adipose tissue (≥130cm2), and SCI-specific obesity thresholds (body mass index [BMI] ≥22kg/m2; waist circumference ≥94cm). Sarcopenic obesity was defined as the presence of both sarcopenia and obesity. Groups were compared based on impairment characteristics using an analysis of covariance.



Sarcopenic obesity was prevalent in 41.9% of the sample. ALMI was lower among participants with motor-complete (6.2±1.3kg/m2) versus motor-incomplete (7.5±1.6kg/m2) injuries (P<.01). Whole-body fat was greater among participants with tetraplegia (28.8±11.2kg) versus paraplegia (24.1±8.7kg; P<.05). Compared with general population guidelines (20.6%), SCI-specific BMI thresholds identified all the participants with obesity (77.9%) based on percentage body fat (72.1%).



The observed frequency of sarcopenic obesity in this sample of individuals with chronic SCI is very high, and identification of obesity is dissimilar when using SCI-specific versus general population criteria.
Toronto Rehabilitation Institute-University Health Network, Brain and Spinal Cord Rehabilitation Program, Toronto, Ontario, Canada. Electronic address: chelsea.pelletier@unbc.ca.
Chelsea A
CA
Pelletier
Toronto Rehabilitation Institute-University Health Network, Brain and Spinal Cord Rehabilitation Program, Toronto, Ontario, Canada.
Masae
M
Miyatani
Toronto Rehabilitation Institute-University Health Network, Brain and Spinal Cord Rehabilitation Program, Toronto, Ontario, Canada; Department of Kinesiology, University of Waterloo, Waterloo, Ontario, Canada.
Lora
L
Giangregorio
Toronto Rehabilitation Institute-University Health Network, Brain and Spinal Cord Rehabilitation Program, Toronto, Ontario, Canada; Department of Medicine, University of Toronto, Toronto, Ontario, Canada.
B Catharine
BC
Craven
D015502:Absorptiometry, Photon; D000328:Adult; D000368:Aged; D001823:Body Composition / Q000502:physiology*; D015992:Body Mass Index; D001835:Body Weight; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009133:Muscular Atrophy; D009765:Obesity / Q000453:epidemiology*; D010264:Paraplegia; D011782:Quadriplegia; D055948:Sarcopenia / Q000453:epidemiology*; D013119:Spinal Cord Injuries / Q000453:epidemiology* / Q000534:rehabilitation; D062606:Tertiary Care Centers
Adiposity; Body composition; Muscular atrophy; Obesity, abdominal; Rehabilitation; Spinal cord injuries