Cardiometabolic Changes and Disparities Among Persons With Spinal Cord Injury: A 17-Year Cohort Study

Top Spinal Cord Inj Rehabil, 2014 · DOI: 13.1310/sci2002-96 · Published: April 1, 2014

Spinal Cord Injury Cardiovascular Science Rehabilitation

Simple Explanation

This study looks at how cardiometabolic syndrome (a group of risk factors for heart disease and diabetes) changes over time in people with spinal cord injury (SCI). It aims to see if these changes are different based on race/ethnicity and sex. Researchers followed 150 people with SCI for about 17 years, measuring things like blood pressure, cholesterol, blood sugar, and waist size to see how many developed cardiometabolic syndrome or diabetes. The study found that cardiometabolic syndrome and diabetes became much more common over time in this group, especially among Hispanic people and women. This suggests that healthcare guidelines for people with SCI should be tailored to these groups.

Study Duration

17 Years

Participants

150 participants with chronic SCI

Evidence Level

Cohort study

Key Findings

1
The frequency of cardiometabolic syndrome increased significantly from 6.7% to 20.8% or 38.2% depending on the diagnostic definitions used.
2
Diabetes increased significantly by a factor of 6.7 over the 17-year follow-up period.
3
Hispanics had a markedly higher frequency of cardiometabolic syndrome in both the full cohort baseline sample and the follow-up sample (58.7% and 57.9%; P < .001, in both cases).

Research Summary

This 17-year cohort study examined the progression of cardiometabolic syndrome and diabetes in individuals aging with SCI, focusing on disparities related to race/ethnicity and sex. The study found a clinically important increase in the frequency of cardiometabolic syndrome and diabetes over time, with Hispanics and women showing a greater increase. The findings suggest that clinical practice guidelines for individuals with SCI need to be customized, taking into account demographic disparities and the natural progression of cardiometabolic syndrome.

Practical Implications

Customized Clinical Guidelines

Clinical practice guidelines need to be tailored for people with SCI, particularly women and Hispanics, to address the increased risk of cardiometabolic syndrome and diabetes.

Demographic Disparities

Rehabilitation professionals need to understand the reported demographic disparities in cardiometabolic syndrome among people with SCI to provide better care.

Pharmacological Interventions

Updated recommendations for pharmacotherapies and customized strategies of exercise and diet should be implemented for cardiometabolic syndrome in persons with SCI.

Study Limitations

1
The attrition rate was high after 17 years.
2
The number of indicators of cardiometabolic syndrome differed between the 2 assessment points.
3
The sample size of women was relatively small, which may have limited the statistical significance of findings related to sex disparities.

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