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Experimental Strategies to Bridge Large Tissue Gaps in the Injured Spinal Cord after Acute and Chronic Lesion

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Published on: April 5, 2016

Markers for Pressure Injury Risk in Individuals with Chronic Spinal Cord Injury: A Pilot Study.

Yi-Ting Tzen¹, Patricia T Champagne, Jijia Wang

¹At University of Texas Southwestern Medical Center, Dallas, Texas, United States, Yi-Ting Tzen, PhD, is Assistant Professor, Department of Applied Clinical Research, Department of Physical Medicine and Rehabilitation, and Department of Orthopaedic Surgery; Patricia T. Champagne, PhD, is Postdoctoral Fellow, Department of Applied Clinical Research and Department of Physical Medicine and Rehabilitation; Jijia Wang, PhD, is Assistant Professor, Department of Applied Clinical Research; and Merrine Klakeel, DO, is Assistant Professor, Department of Physical Medicine and Rehabilitation. Wei-Han Tan, MD, is Assistant Professor, VA North Texas Health Care System, Dallas, and Department of Physical Medicine and Rehabilitation, University of Texas Southwestern Medical Center. Kath M. Bogie, DPhil, is Professor, Department of Orthopaedics, Case Western Reserve University, Cleveland, Ohio, United States, and VA Northeast Ohio Healthcare System, Cleveland. Timothy J. Koh, PhD, is Professor, Department of Kinesiology and Nutrition, University of Illinois at Chicago, Illinois, United States. Funding for this research was provided by Paralyzed Veterans of America Research Foundation, grant/award number: 3180. The authors have disclosed no other financial relationships related to this article. Submitted August 11, 2023; accepted in revised form January 16, 2024.

Advances in Skin & Wound Care

|January 28, 2025

Summary

Insulin resistance, measured by HOMA-IR, is linked to a history of pressure injuries (PrI) in individuals with spinal cord injury (SCI). This finding may help identify those at higher risk for PrI development.

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Area of Science:

Biomedical research
Clinical investigation
Rehabilitation science

Background:

Individuals with spinal cord injury (SCI) are at increased risk for developing pressure injuries (PrI).
Identifying reliable markers for PrI risk in the SCI population is crucial for preventative strategies.
Previous research has explored various factors, but novel serum markers require investigation.

Purpose of the Study:

To identify potential markers associated with a history of pressure injuries (PrI) in adults with chronic spinal cord injury (SCI).
To investigate the utility of skin blood flow (SBF) response and serum insulin resistance markers in relation to PrI history.

Main Methods:

A cross-sectional, observational study involving adults with chronic traumatic SCI (T12 and above).
Participants were divided into two groups: those with a history of PrI and those without.
Measurements included skin blood flow (SBF) response to localized heating and Homeostatic Model Assessment for Insulin Resistance (HOMA-IR) calculated from fasting blood samples.

Main Results:

The study included 16 adults (7 with PrI history, 9 without).
Participants with a history of PrI exhibited significantly higher HOMA-IR values, indicating greater insulin resistance.
A longer duration of SCI was also observed in the group with a PrI history; no significant differences in SBF were found.

Conclusions:

Homeostatic Model Assessment for Insulin Resistance (HOMA-IR) emerges as a novel serum index associated with pressure injury history in individuals with chronic SCI.
Further longitudinal research is recommended to elucidate the role of insulin resistance in elevating PrI risk within the SCI population.