State of the Science on Cardiometabolic Risk After Spinal Cord Injury: Recap of the 2013 ASIA Pre-Conference on Cardiometabolic Disease

Top Spinal Cord Inj Rehabil, 2014 · DOI: 13.1310/sci2002-105 · Published: January 1, 2014

Spinal Cord Injury Cardiovascular Science Rehabilitation

Simple Explanation

Cardiovascular disease is a major cause of death in people with spinal cord injuries. Because current risk assessments are designed for the general population, there's a need to better understand cardiovascular risks specifically for those with SCI. One significant risk is cardiometabolic syndrome, a combination of factors including obesity, insulin resistance, diabetes, dyslipidemia, and atherosclerosis. Research is focusing on dyslipidemia and obesity within this syndrome in SCI patients. Body Mass Index (BMI), a common measure of body fat, isn't accurate for SCI patients due to changes in body composition. Researchers are working on a more accurate body fat calculator tailored for this population.

Study Duration

Not specified

Participants

101 individuals with chronic SCI (BMI calculator); 4,512 persons with SCI and 1,252 persons without SCI (lipid data)

Evidence Level

Not specified

Key Findings

1
Traditional BMI underestimates obesity in individuals after SCI.
2
Individuals with SCI have significantly lower average levels of HDL-C than controls.
3
A specific combination of variables has the potential to provide a more accurate, indirect measure of adiposity in persons with SCI than does BMI alone.

Research Summary

Research indicates the necessity for regular monitoring of cardiometabolic risk factors in individuals with SCI, particularly dyslipidemia and overweight/obesity. Current methods like BMI may not accurately assess body fat in SCI patients, emphasizing the need for adjusted calculations and better surveillance tools. Advancements in imaging technologies offer a way to refine risk assessment algorithms using indirect measures like lipid and BMI profiles, leading to more personalized prevention and treatment strategies for SCI patients.

Practical Implications

Improved Screening Protocols

Implement more stringent lipid panel screening at earlier ages and increased frequency for the SCI population.

Accurate Surveillance Tools

Develop clinically friendly and accurate surveillance tools to allow clinicians to intervene earlier to reduce obesity-related CVD in SCI patients.

Personalized Risk Assessment

Tailor risk assessment individually to inform prevention and treatment for populations who diverge from the physiologic norm, such as persons with SCI.

Study Limitations

1
CVD risk is not the only factor impacting morbidity and mortality after SCI.
2
Improvements in lipid screening and BMI calculations might not positively affect other risks like pressure ulcer development.
3
CVD risk management requires a holistic prevention program due to complex interactions.

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