Point: Counterpoint synopsis of cardiometabolic risk after spinal cord injury

Spinal Cord Series and Cases, 2019 · DOI: https://doi.org/10.1038/s41394-019-0242-4 · Published: October 31, 2019

Spinal Cord Injury Cardiovascular Science Endocrinology

Simple Explanation

Current definitions of obesity used for people without SCI are not suitable for those with SCI due to differences in body fat, sarcopenia, and osteopenia. Adjustments for body composition reveal accelerated body fat accumulation in people with SCI compared to able-bodied individuals. Elevated levels of biomarkers should alert the clinician to begin intervention, including diet, exercise, and potentially pharmacology.

Study Duration

Not specified

Participants

Not specified

Evidence Level

Not specified

Key Findings

1
Inappropriate application of obesity definitions for the general population to individuals with SCI.
2
Accelerated body fat accumulation in persons with SCI.
3
Adiposity increases blood pressure through multiple physiological mechanisms.

Research Summary

The article discusses the recently published guidelines for identification and management of cardiometabolic risks after spinal cord injury (SCI). It highlights the inappropriateness of applying general population obesity definitions to SCI patients due to differences in body composition. The author advocates for further research and appropriate management of obesity and related comorbidities in the SCI population.

Practical Implications

Refine Obesity Definitions

Adjust current obesity definitions to account for unique body composition in SCI patients.

Aggressive Management

Aggressively manage dyslipidemia in SCI patients through diet, exercise, and pharmacology.

Further Research

Conduct randomized, placebo-controlled trials to determine best practices for screening and management of cardiometabolic risk in SCI.

Study Limitations

1
General biomarkers for diabetes and dyslipidemia are somewhat nonspecific.
2
True insulin resistance can only be determined through complex testing.
3
More research is needed in the areas of obesity, diabetes, dyslipidemia, and hypertension in the SCI population.

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