Adiposity and spinal cord injury

World J Orthop, 2015 · DOI: 10.5312/wjo.v6.i8.567 · Published: September 18, 2015

Simple Explanation

Following a spinal cord injury (SCI), drastic changes in body composition can significantly impact cardiovascular and metabolic health. Magnetic resonance imaging helps us understand how different regional adipose tissue compartments interact and their role in developing chronic diseases. This editorial aims to provide a scientific basis for developing interventions like diet, rehabilitation, or medication to manage the negative effects of increased adiposity after SCI.

Study Duration

Not specified

Participants

Not specified

Evidence Level

Level 5, Editorial

Key Findings

1
Individuals with tetraplegia tend to accumulate greater leg fat mass compared to those with paraplegia, but have a lower ratio of trunk fat mass to whole-body fat mass.
2
Increased visceral adipose tissue (VAT) accumulation is an independent risk factor for developing cardiovascular disease and insulin resistance.
3
Spasticity and exercise activity, such as resistance training, can decrease intramuscular fat (IMF), unlike subcutaneous adipose tissue (SAT).

Research Summary

The editorial introduces different adipose tissue types and establishes a scientific basis to develop interventions to manage adiposity after spinal cord injury (SCI). It summarizes available evidence on ectopic adipose tissue (visceral fat, intramuscular fat, and bone marrow fat) and highlights the use of magnetic resonance imaging (MRI) for measuring ectopic adipose tissue in persons with SCI. The editorial acknowledges the clinical implications and future directions of measuring different types of adipose tissue and cardio-metabolic health, emphasizing the significance of exercise and dietary interventions.

Practical Implications

Personalized Treatment Plans

Individuals with SCI require personalized treatment plans involving a multidisciplinary approach to prevent excessive adipose tissue gain and lean muscle mass loss.

Targeted Rehabilitation Interventions

Rehabilitation interventions like exercise, electrical stimulation, and dietary changes should be studied for their effects on subcutaneous and ectopic adipose tissues.

Pharmaceutical Interventions

Pharmaceutical interventions like testosterone replacement should be explored for their long-term effects on ectopic adipose tissue sites and interaction with exercise.

Study Limitations

1
Limited sample sizes in some studies may affect the generalizability of findings related to the level of injury and central adiposity.
2
Factors such as spinal fusion, gunshot wounds, and the ability to hold breath during MRI scans can influence the quality and accuracy of central adiposity measurements.
3
The disruption of the autonomic nervous system and limited access to rehabilitation interventions may attenuate the effects of exercise and other therapies on adipose tissue.

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