Cardiometabolic risk factor clustering in persons with spinal cord injury: A principal component analysis approach

The Journal of Spinal Cord Medicine, 2024 · DOI: 10.1080/10790268.2023.2215998 · Published: January 1, 2024

Spinal Cord Injury Cardiovascular Science Bioinformatics

Simple Explanation

This study explores cardiometabolic (CM) risk factors in individuals with spinal cord injury (SCI) compared to those without SCI. It aims to identify clusters of CM measurements that increase cardiovascular disease (CVD) risk. The researchers used principal component analysis (PCA) to simplify complex data and find underlying patterns in CM biomarkers, adiposity, and inflammation markers. PCA helps in understanding how different risk factors group together. The study found that CM risk factors cluster differently in SCI patients compared to non-SCI individuals, suggesting that these factors have a differential impact on CVD risk in those with SCI. This highlights the need for specialized risk assessment and management strategies for this population.

Study Duration

Not specified

Participants

98 non-ambulatory men with chronic SCI and 51 healthy non-SCI individuals

Evidence Level

Cross-sectional study

Key Findings

1
Principal component analysis (PCA) identified six factor components (FC) explaining 77% and 82% of the total variance in the SCI and non-SCI cohorts, respectively.
2
In both groups, the first factor component (FC-1) was primarily composed of lipoprotein particle concentration variables, indicating its significant role in cardiometabolic risk.
3
In the SCI cohort, increased scores in FC-1 were significantly associated with a higher risk of metabolic syndrome (MetS), increased Framingham Risk Score (FRS), and higher insulin resistance (HOMA2-IR).
4
Total body fat (TBF) and visceral adipose tissue (VAT) were included in FC-2 in the SCI group, but not the non-SCI group, indicating differences in the role of adiposity.

Research Summary

This study used principal component analysis (PCA) to identify how cardiometabolic (CM) risk factors cluster in individuals with spinal cord injury (SCI) compared to non-SCI controls, revealing a six-factor model for both groups. The clustering of CM variables differed significantly between the SCI and non-SCI cohorts, with the SCI group showing a more atherogenic lipoprotein particle profile and a stronger association between adiposity measures and inflammation. The study demonstrated that the primary factor component (FC-1) in the SCI group was significantly associated with increased risks of metabolic syndrome, higher Framingham risk scores, and greater insulin resistance, highlighting the clinical relevance of these risk factor clusters.

Practical Implications

Targeted Interventions

The differential clustering of CM risk factors in SCI patients suggests the need for specialized interventions focusing on lipid management, adiposity reduction, and inflammation control.

Risk Stratification

The study supports the development of SCI-specific risk prediction models incorporating novel biomarkers and factor analysis to improve the identification of high-risk individuals.

Clinical Practice

The findings emphasize the importance of comprehensive cardiometabolic assessments in SCI patients, including lipoprotein profiling and body composition analysis, to guide preventive strategies.

Study Limitations

1
The relatively small sample size limited stratification by lesion level and completeness.
2
Important CMD risk factors such as second-hand smoke exposure, unhealthy diet, and stress were not included.
3
The study was limited to Caucasian men, limiting the translational potential to women and other ethnic groups.

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