A Preliminary Report on the Effects of the Level of Spinal Cord Injury on the Association Between Central Adiposity and Metabolic Profile

Objectives: To determine the effects of the level of injury on visceral adipose tissue (VAT), subcutaneous adipose tissue (SAT), and the VAT:SAT ratio in individuals with tetraplegia (T-spinal cord injury [SCI]) and paraplegia (P-SCI) and the relationships among central adiposity and glucose and lipid profile. Design: Cross-sectional and correlation. Settings: Clinical hospital and academic settings. Methods: Thirteen individuals with motor complete SCI were divided into T-SCI (n = 6, C5-C7, American Spinal Injury Association Impairment Scale [AIS] A and B) and P-SCI (n = 7, T4-T11, AIS A and B) groups. Both groups underwent overnight fasting to measure serum lipid profile, plasma glucose, and insulin responses to an oral glucose tolerance test, which was followed by magnetic resonance imaging to quantify VAT and SAT cross-sectional areas (CSA) and volume across multi-axial slices. Results: The CSA and volumes of VAT and SAT were not different between T-SCI and P-SCI. VAT CSA was related to the fasting glucose in both groups, with nonsignificant association with glucose area under the curve. The CSA and volume of SAT were strongly associated with lipid profile outcomes in the T-SCI (r = 0.86-0.99, P < .02) but not in the P-SCI. Conclusion: The preliminary work suggests that the level of injury does not appear to influence the distribution of VAT and SAT. VAT and SAT distribution could not explain the difference noted in glucose and insulin profiles between the T-SCI and P-SCI groups. Finally, SAT is a strong predictor of lipid profile in individuals with T-SCI. PM R 2011;3:440-446