Acute Spinal Cord Injury Is Associated With Prevalent Cardiometabolic Risk Factors

Area of Science:

• Cardiology
• Neurology
• Public Health

Background:

• Cardiometabolic disease (CMD) poses a significant health challenge, particularly for individuals with spinal cord injury (SCI).
• Understanding the prevalence and risk factors of CMD post-SCI is crucial for effective rehabilitation and long-term health management.

Purpose of the Study:

• To determine the prevalence of CMD at the time of discharge from SCI rehabilitation.
• To compare CMD prevalence in SCI individuals with a control group without SCI.
• To identify factors associated with an increased risk of CMD in the SCI population.

Main Methods:

• A multicenter, prospective observational study involving 95 participants with SCI and 1609 age/sex/BMI-matched controls from the National Health and Nutrition Examination Education Survey (2016-2019).
• CMD determinants including obesity, insulin resistance (IR), lipid profiles (triglycerides, HDL-C, LDL-C, total cholesterol), and blood pressure were assessed within two months of rehabilitation discharge.

Main Results:

• Participants with SCI exhibited significantly higher diastolic blood pressure and triglycerides, and lower fasting glucose and HDL-C compared to controls.
• Obesity prevalence was 74.0% in the SCI group versus 38.5% in controls. Low HDL-C was observed in 54.2% of SCI participants, compared to 15.4% of controls.
• Over 31.6% of SCI participants had three or more CMD determinants, a 40.7% higher rate than controls. Age was the only significant variable associated with CMD.

Conclusions:

• Individuals with SCI have a substantially increased risk of cardiometabolic disease compared to the general population.
• Obesity, insulin resistance, and low HDL-C are the most prevalent CMD risk determinants in the early post-rehabilitation phase for SCI patients.
• Age is a significant factor associated with the early development of cardiometabolic disease in individuals with spinal cord injury.