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.
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: W A Bauman; R H Adkins; A M Spungen; R Herbert; C Schechter; D Smith; B J Kemp; R Gambino; P Maloney; R L Waters Journal: Spinal Cord Date: 1999-07 Impact factor: 2.772
Authors: W A Bauman; A M Spungen; M Raza; J Rothstein; R L Zhang; Y G Zhong; M Tsuruta; R Shahidi; R N Pierson; J Wang Journal: Mt Sinai J Med Date: 1992-03
Authors: Aram V Chobanian; George L Bakris; Henry R Black; William C Cushman; Lee A Green; Joseph L Izzo; Daniel W Jones; Barry J Materson; Suzanne Oparil; Jackson T Wright; Edward J Roccella Journal: Hypertension Date: 2003-12-01 Impact factor: 10.190
Authors: Jenna C Gibbs; Dany H Gagnon; Austin J Bergquist; Jasmine Arel; Tomas Cervinka; Rasha El-Kotob; Désirée B Maltais; Dalton L Wolfe; B Catharine Craven Journal: J Spinal Cord Med Date: 2017-07-13 Impact factor: 1.985
Authors: Mark S Nash; Suzanne L Groah; David R Gater; Trevor A Dyson-Hudson; Jesse A Lieberman; Jonathan Myers; Sunil Sabharwal; Allen J Taylor Journal: J Spinal Cord Med Date: 2019-06-10 Impact factor: 1.985
Authors: Mark S Nash; Suzanne L Groah; David R Gater; Trevor A Dyson-Hudson; Jesse A Lieberman; Jonathan Myers; Sunil Sabharwal; Allen J Taylor Journal: Top Spinal Cord Inj Rehabil Date: 2018
Authors: Ashraf S Gorgey; Heather Martin; Alyse Metz; Refka E Khalil; David R Dolbow; David R Gater Journal: J Spinal Cord Med Date: 2016-03-17 Impact factor: 1.985