Matthew C Dorton1,2, V-E M Lucci1,2, Sonja de Groot3,4,5, Thomas M Loughin6, Jacquelyn J Cragg2,7, John K Kramer2, Marcel W M Post8,9, Victoria E Claydon10,11. 1. Department of Biomedical Physiology and Kinesiology, Simon Fraser University, Burnaby, BC, Canada. 2. International Collaboration on Repair and Discoveries (ICORD), University of British Columbia, Vancouver, BC, Canada. 3. Amsterdam Rehabilitation Research Center, Reade, Amsterdam, The Netherlands. 4. Center for Human Movement Sciences, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands. 5. Department of Human Movement Sciences, Faculty of Behavioural and Movement Sciences, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands. 6. Department of Statistics and Actuarial Science, Simon Fraser University, Burnaby, BC, Canada. 7. Collaboration for Outcomes Research & Evaluation (CORE), Faculty of Pharmaceutical Sciences, University of British Columbia, Vancouver, BC, Canada. 8. Center of Excellence in Rehabilitation Medicine, UMC Utrecht Brain Center, University Medical Center Utrecht, and de Hoogstraat Rehabilitation, Utrecht, The Netherlands. 9. Department of Rehabilitation Medicine, Center for Rehabilitation, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands. 10. Department of Biomedical Physiology and Kinesiology, Simon Fraser University, Burnaby, BC, Canada. victoria_claydon@sfu.ca. 11. International Collaboration on Repair and Discoveries (ICORD), University of British Columbia, Vancouver, BC, Canada. victoria_claydon@sfu.ca.
Abstract
STUDY DESIGN: Multicentre, cross-sectional study. OBJECTIVES: To identify which markers of obesity, injury characteristics and autonomic function variables are related to cardiovascular disease (CVD) risk after spinal cord injury (SCI), and establish cut-points for detection and risk management. SETTING: Eight SCI rehabilitation centres in the Netherlands. METHODS: Individuals (n = 257) with a traumatic, chronic (≥10 years) SCI, with age at injury between 18 and 35 years, completed a self-report questionnaire and a one-day visit to a rehabilitation centre for testing. Three anthropometric measures were tested: body mass index (BMI); waist circumference (WC); and waist-to-height ratio (WHtR). Injury characteristics included: American Spinal Injury Association impairment scale (AIS); duration of injury (DOI); and neurological level of injury (LOI). Cardiovascular autonomic function was assessed from peak heart rate during maximal exercise (HRpeak). Systolic arterial pressure (SAP) and aerobic capacity (VO2peak) were also determined. CVD risk was calculated using the Framingham risk score (FRS). RESULTS: All anthropometric variables were associated with FRS, with WC showing the strongest correlation (r = 0.41, p < 0.001) and greatest area under the curve (0.73) for 10-year CVD risk (%). WC, DOI, SAP, HRpeak, LOI, and VO2peak (variable importance: 0.81, 1.0, 0.98, 0.98, 0.66, 0.68, respectively) were important predictive variables for 10-year CVD risk in individuals with SCI. CONCLUSIONS: We confirm that WC is a simple, practical measure of CVD risk, and along with DOI and markers of cardiovascular autonomic function, plays a role in the increased CVD risk following SCI.
STUDY DESIGN: Multicentre, cross-sectional study. OBJECTIVES: To identify which markers of obesity, injury characteristics and autonomic function variables are related to cardiovascular disease (CVD) risk after spinal cord injury (SCI), and establish cut-points for detection and risk management. SETTING: Eight SCI rehabilitation centres in the Netherlands. METHODS: Individuals (n = 257) with a traumatic, chronic (≥10 years) SCI, with age at injury between 18 and 35 years, completed a self-report questionnaire and a one-day visit to a rehabilitation centre for testing. Three anthropometric measures were tested: body mass index (BMI); waist circumference (WC); and waist-to-height ratio (WHtR). Injury characteristics included: American Spinal Injury Association impairment scale (AIS); duration of injury (DOI); and neurological level of injury (LOI). Cardiovascular autonomic function was assessed from peak heart rate during maximal exercise (HRpeak). Systolic arterial pressure (SAP) and aerobic capacity (VO2peak) were also determined. CVD risk was calculated using the Framingham risk score (FRS). RESULTS: All anthropometric variables were associated with FRS, with WC showing the strongest correlation (r = 0.41, p < 0.001) and greatest area under the curve (0.73) for 10-year CVD risk (%). WC, DOI, SAP, HRpeak, LOI, and VO2peak (variable importance: 0.81, 1.0, 0.98, 0.98, 0.66, 0.68, respectively) were important predictive variables for 10-year CVD risk in individuals with SCI. CONCLUSIONS: We confirm that WC is a simple, practical measure of CVD risk, and along with DOI and markers of cardiovascular autonomic function, plays a role in the increased CVD risk following SCI.
Authors: Stephen Burns; Fin Biering-Sørensen; William Donovan; Daniel E Graves; Amitabh Jha; Mark Johansen; Linda Jones; Andrei Krassioukov; Steven Kirshblum; M J Mulcahey; Mary Schmidt Read; William Waring Journal: Top Spinal Cord Inj Rehabil Date: 2012
Authors: Henrike J C Rianne Ravensbergen; Sonja de Groot; Marcel W M Post; Hans J Slootman; Lucas H V van der Woude; Victoria E Claydon Journal: Neurorehabil Neural Repair Date: 2013-11-15 Impact factor: 3.919