Original articleFitness, Inflammation, and the Metabolic Syndrome in Men With Paraplegia
Section snippets
Participants
Twenty-two male volunteers with functionally complete paraplegia (ie, they use a wheelchair as their only mode of locomotion) of at least 3 years in duration participated. Participants with diabetes and coronary heart disease were excluded. All participants stated that they had no acute infections. The level of SCI ranged from T2 to L2, and 5 participants had injuries at or above T6. Participants were asked to maintain a consistent medication schedule during the course of the study.
Testing
A 75-g oral
Results
Twenty-two men with paraplegia participated in the study. Subject characteristics are presented in table 1. All participants were completely independent with horizontal transfers and mobility, and all participants used a manual wheelchair. On average, participants were overweight, had low HDL-C levels, and had subclinical inflammation, as indicated by elevated levels of IL-6 and CRP. Older age was associated with lower peak aerobic capacity (P=.031) and higher 2-hour postload insulin levels (P
Discussion
We found that lower physical activity levels were associated with higher fasting glucose levels, lower HDL-C levels, and larger ASDs in men with a paraplegic SCI (see table 2). We also found that larger ASDs were associated with higher fasting glucose, higher fasting and postload insulin, higher HOMA-derived estimates of insulin resistance, lower HDL-C, higher TG, and higher CRP levels in men with a paraplegic SCI (see table 3). Other studies have reported associations between aerobic capacity
Conclusions
We found that lower physical activity levels were associated with higher fasting glucose, lower HDL-C, and larger ASDs. Larger ASDs, in turn, were associated with higher fasting glucose, higher fasting and postload insulin, lower HDL-C, higher TG, and higher CRP levels. These findings suggest that the metabolic syndrome is prevalent in people with SCI and that diet and exercise trials are needed to determine the efficacy and effectiveness of lifestyle interventions aimed at slowing the
References (57)
- et al.
HDL cholesterol across a spectrum of physical activity from quadriplegia to marathon running
Lancet
(1983) - et al.
Disorders of carbohydrate and lipid metabolism in veterans with paraplegia or quadriplegiaa model of premature aging
Metabolism
(1994) - et al.
Circulating levels of IL-2r, ICAM-1, and IL-6 in spinal cord injuries
Arch Phys Med Rehabil
(1997) - et al.
The self-reported functional measurepredictive validity for health care utilization in multiple sclerosis and spinal cord injury
Arch Phys Med Rehabil
(2001) - et al.
The reliability of a self-reported measure of disease, impairment, and function in persons with spinal cord dysfunction
Arch Phys Med Rehabil
(1998) - et al.
Simple anthropometric indices associated with ischemic heart disease
J Clin Epidemiol
(1996) - et al.
Coronary heart disease risk indicators, aerobic power, and physical activity in men with spinal cord injuries
Arch Phys Med Rehabil
(1997) - et al.
Lipid, lipoprotein, and apolipoprotein profiles in active and sedentary men with tetraplegia
Arch Phys Med Rehabil
(1997) - et al.
Natural variability of circulating levels of cytokines and cytokine receptors in patients with heart failureimplications for clinical trials
J Am Coll Cardiol
(1999) - et al.
Long-term medical complications after traumatic spinal cord injurya regional model systems analysis
Arch Phys Med Rehabil
(1999)
Influence of urinary management on urologic complications in a cohort of spinal cord injury patients
Arch Phys Med Rehabil
Epidemiology and risk factors for urinary tract infection in patients with spinal cord injury
J Urol
Continuous-scale physical functional performance in healthy older adultsa validation study
Arch Phys Med Rehabil
The wheelchair circuitreliability of a test to assess mobility in persons with spinal cord injuries
Arch Phys Med Rehabil
Atherosclerosis—an inflammatory disease
N Engl J Med
NIDDM as a disease of the innate immune systemassociation of acute-phase reactants and interleukin-6 with metabolic syndrome X
Diabetologia
C-reactive protein, a sensitive marker of inflammation, predicts future risk of coronary heart disease in initially healthy middle-aged menresults from the MONICA (Monitoring Trends and Determinants in Cardiovascular Disease) Augsburg Cohort Study, 1984 to 1992
Circulation
Inflammation, aspirin, and the risk of cardiovascular disease in apparently healthy men
N Engl J Med
C-reactive protein, interleukin 6, and risk of developing type 2 diabetes mellitus
JAMA
C-reactive protein in healthy subjects: associations with obesity, insulin resistance, and endothelial dysfunction: a potential role for cytokines originating from adipose tissue?
Arterioscler Thromb Vasc Biol
Chronic subclinical inflammation as part of the insulin resistance syndromethe insulin resistance atherosclerosis study (IRAS)
Circulation
Executive summary of the Third Report of the National Cholesterol Education Program (NCEP) Expert Panel on Detection, Evaluation, and Treatment of High Blood Cholesterol in Adults (Adult Treatment Panel III)
JAMA
High density lipoprotein cholesterol in individuals with spinal cord injurythe potential role of physical activity
Spinal Cord
Metabolic syndromepathophysiology and implications for management of cardiovascular disease
Circulation
Soft tissue body composition differences in monozygotic twins discordant for spinal cord injury
J Appl Physiol
Proteins of the complement system and acute phase reactants in sera of patients with spinal cord injury
Ann Allergy
The prevalence of hypertension, ischaemic heart disease and diabetes in traumatic spinal cord injured patients and amputees
Paraplegia
Reduction of the plasma concentration of C-reactive protein following nine months of endurance training
Int J Sports Med
Cited by (150)
Post-processing Peak Oxygen Uptake Data Obtained During Cardiopulmonary Exercise Testing in Individuals With Spinal Cord Injury: A Scoping Review and Analysis of Different Post-processing Strategies
2023, Archives of Physical Medicine and RehabilitationSystemic inflammation after spinal cord injury: A review of biological evidence, related health risks, and potential therapies
2022, Current Opinion in PharmacologyHepatic dysfunction after spinal cord injury: A vicious cycle of central and peripheral pathology?
2020, Experimental NeurologyThe interaction of macronutrients and body composition among individuals with chronic spinal cord injury
2023, British Journal of NutritionEnergy expenditure and nutrient intake after spinal cord injury: A comprehensive review and practical recommendations
2022, British Journal of Nutrition
Supported by the Christopher Reeve Paralysis Foundation.
No commercial party having a direct financial interest in the results of the research supporting this article has or will confer a benefit on the author(s) or on any organization with which the author(s) is/are associated.