The Diagnosis and Management of Cardiometabolic Risk and Cardiometabolic Syndrome after Spinal Cord Injury

J. Pers. Med., 2022 · DOI: 10.3390/jpm12071088 · Published: June 30, 2022

Spinal Cord Injury Cardiovascular Science Endocrinology

Simple Explanation

Individuals with spinal cord injuries (SCI) commonly have risk factors for cardiometabolic risk and cardiometabolic syndrome (CMS), including obesity, dyslipidemia, dysglycemia/insulin resistance, and hypertension. Cardiometabolic risk and CMS are often called “silent killers” because they increase the risk of cardiovascular disease, a major cause of death after SCI. This review examines current data on cardiometabolic risk, CMS, and cardiovascular disease related to SCI, focusing on research from the last five years. It also offers diagnostic criteria, a new obesity classification based on body fat, and lifestyle management strategies.

Study Duration

Not specified

Participants

Not specified

Evidence Level

Review

Key Findings

1
Obesity after SCI is characterized not just by increased body fat but by the dysregulation of adipose tissue, leading to inflammation, insulin resistance, and other metabolic issues.
2
Hypertension may be underdiagnosed in people with high SCI levels because typical diagnostic thresholds may not be reached due to SCI-induced autonomic nervous system dysregulation.
3
Cardiovascular disease is a major concern for people with SCI, being the second leading cause of death, and is intensified by highly prevalent modifiable risk factors following SCI.

Research Summary

Cardiometabolic risk and CMS are a significant global public health crisis for the population with SCI. Many people with SCI present with cardiometabolic risk factors, the most serious of which is obesity. Management measures should focus on annual risk factor surveillance and lifestyle modifications that incorporate physical exercise and a heart-healthy dietary pattern.

Practical Implications

Annual Screening

Annual screening for cardiometabolic risk factors is crucial for early detection and management in individuals with SCI.

Lifestyle Modifications

Promoting physical activity and heart-healthy diets can significantly reduce cardiometabolic risk and improve cardiovascular health in SCI patients.

Personalized Interventions

Tailoring interventions based on individual risk profiles, injury level, and sex differences is necessary for effective management of cardiometabolic syndrome after SCI.

Study Limitations

1
Lack of long-term follow-up studies quantifying cardiovascular disease development from cardiometabolic risk after SCI.
2
Limited quality prospective trials evaluating the prevalence and impact of cardiometabolic disorders and corresponding cardiovascular disease complications and endpoints after SCI compared to matched controls.
3
Need for further studies to validate current SCI-specific BMI and WC metrics, especially regarding waist circumference.

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