Impaired Glucose Tolerance and Visceral Adipose Tissue Thickness among Lean and Non-Lean People with and without Spinal Cord Injury

J. Funct. Morphol. Kinesiol., 2023 · DOI: 10.3390/jfmk8030123 · Published: August 21, 2023

Spinal Cord Injury Endocrinology Physiology

Simple Explanation

This study investigates the relationship between visceral adipose tissue (VAT), a measure of leanness, and glucose tolerance in individuals with and without spinal cord injury (SCI). It aims to determine if VAT is a reliable indicator of metabolic health in people with SCI. The researchers also explored whether different methods of mobility, such as manual versus powered wheelchairs, influence glucose tolerance in individuals with SCI. This is because daily movement can affect how the body processes glucose. The findings suggest that VAT may be an important factor to consider when designing rehabilitation programs to improve metabolism in individuals with SCI. People with SCI who use powered wheelchairs are more likely to have impaired glucose tolerance.

Study Duration

Not specified

Participants

15 people with SCI and 20 people without SCI

Evidence Level

Not specified

Key Findings

1
Glucose levels were significantly higher in individuals with SCI compared to those without SCI at 60 and 120 minutes after an oral glucose tolerance test (OGTT).
2
Non-lean individuals with SCI had significantly higher glucose area under the curve (AUC) compared to lean individuals with SCI and lean and non-lean individuals without SCI.
3
Visceral adipose tissue (VAT) was associated with glucose AUC, indicating that leanness, as estimated from VAT, may be an important consideration for rehabilitation programs targeting metabolism in individuals with SCI.

Research Summary

The study compared glucose tolerance biomarkers among people with and without SCI, finding that individuals with SCI are more glucose intolerant compared to people without SCI. It also compared glucose tolerance biomarkers in lean and non-lean people, revealing that non-lean individuals with SCI are less glucose tolerant than lean individuals with or without SCI. The study provided support that people with SCI who use powered mobility, compared to wheeled mobility, are less glucose tolerant and have higher VAT levels.

Practical Implications

Rehabilitation Programs

Leanness, as measured by VAT, should be considered when developing rehabilitation programs to influence metabolism among people with SCI.

Mobility Considerations

Mobility status may serve as a tool to help clinicians identify and monitor patients for the risk of developing abnormal glucose tolerance, even if they appear healthy based on BMI.

Clinical Assessments

Clinicians should consider VAT thickness as a unique measure to better understand the relationship between phenotypic leanness and glucose tolerance in people with SCI.

Study Limitations

1
The study lacked adequate power to stratify groups by age, sex, lesion level, length of injury, socio-economic status, education, and abusive/addictive behaviors.
2
The non-SCI group was not age-matched to the SCI group, which could influence results.
3
The patient case mix was inconsistent across mobility methods.

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