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Depressed serum high density lipoprotein cholesterol levels in veterans with spinal cord injury
W A Bauman1, A M Spungen, Y G Zhong
1Spinal Cord Damage Research Center, Bronx, New York.
Insights
Individuals with spinal cord injury (SCI) experience premature cardiovascular disease due to altered lipoprotein profiles, specifically lower high-density lipoprotein (HDL) cholesterol. This increases their risk for heart disease, necessitating careful monitoring.
Area of Science:
- Cardiology
- Neurology
- Metabolic Disorders
Background:
- Cardiovascular diseases (CVD) are the leading cause of death in individuals with spinal cord injury (SCI).
- CVD occurs prematurely in SCI populations compared to the able-bodied.
- Lipoprotein profiles may explain accelerated coronary heart disease (CHD) in SCI.
Purpose of the Study:
- To investigate the lipoprotein profiles in veterans with SCI.
- To compare lipoprotein levels between SCI subgroups (paraplegia, quadriplegia) and controls.
- To identify dyslipidemia patterns associated with SCI.
Main Methods:
- Fasting lipoprotein determinations were performed.
- 100 veterans with SCI (50 paraplegia, 50 quadriplegia) and 50 veteran controls were analyzed.
- Serum levels of HDL cholesterol, LDL cholesterol, and total cholesterol were measured.
Main Results:
- Mean serum HDL cholesterol was significantly depressed in SCI subjects (37-40 mg/dL) compared to controls (48 mg/dL).
- Total cholesterol was lower in SCI subjects, but LDL cholesterol showed no significant difference.
- 37% of SCI subjects had HDL cholesterol < 35 mg/dL; 18% had LDL > 160 mg/dL.
Conclusions:
- SCI is associated with significantly lower HDL cholesterol levels.
- A substantial proportion of SCI individuals exhibit dyslipidemia, including low HDL and elevated LDL.
- Current screening recommendations may miss low HDL in SCI patients with borderline total cholesterol.
Abstract:
Cardiovascular diseases are the most frequent cause of death among persons with spinal cord injury (SCI), and these diseases are reported to occur prematurely in the disabled compared to the able bodied population. The mechanism of accelerated coronary heart disease (CHD) in persons with SCI may be partially explicable on the basis of the lipoprotein profile. We performed fasting lipoprotein determinations on 100 veterans with SCI, 50 with paraplegia and 50 with quadriplegia, and 50 veteran controls. The mean age of the subjects with SCI was 47.8 +/- 1.4 years with a duration of injury of 16.3 +/- 1.2 years. The mean serum high-density lipoprotein (HDL) cholesterol was depressed in subjects with paraplegia or quadriplegia compared to controls (37 +/- 1 or 40 +/- 1 versus 48 +/- 2 mg/dL, p < 0.0001). Although serum total cholesterol was lower (p < 0.01) in subjects with SCI than in controls, there was no significant difference in mean serum low-density lipoprotein (LDL) cholesterol. Thirty-seven percent of subjects with SCI have serum HDL cholesterol levels less than 35 mg/dL with no significant difference in lipoprotein distribution between high and low cord lesions. Eighteen percent of individuals with SCI have an absolute elevation of LDL cholesterol (greater than 160 mg/dL). About 40% of those with SCI and LDL cholesterol levels between 130 and 160 mg/dL also have serum HDL cholesterol values below 35 mg/dL, all of whom would have their serum HDL cholesterol level undetected if lipoprotein profiles were performed according to present recommendations--that is, only if the serum total cholesterol is elevated.(ABSTRACT TRUNCATED AT 250 WORDS)