Serum lipids during the first year following acute spinal cord injury

Patients with chronic spinal cord injury (SCI) have low levels of high-density lipoprotein (HDL) cholesterol. The cause of this abnormality and its relation to SCI are unknown. We studied 100 consecutively admitted males with acute SCI prospectively for 1 year to determine changes in serum lipids following acute SCI and the relation of these changes to the level of injury and physical activity. Low-density lipoprotein (LDL), HDL, and total cholesterol and triglycerides were all decreased following acute SCI and gradually increased toward normal by 1 year. Serum HDL, LDL, and total cholesterol levels correlated with the level of SCI: levels were lower in quadriplegic compared with paraplegic patients. Serum HDL showed the greatest change following SCI, increasing by 26% in quadriplegic and 18% in paraplegic patients. These changes in serum lipid levels could not be explained by changes in alcohol consumption or body weight. We estimated that only 44% of the increase in HDL following SCI was associated with an increase in physical activity. We postulate that interruption of the autonomic nervous system influences lipid metabolism and serum lipid levels.