Predicting Cardiometabolic Risk From Visceral Abdominal Adiposity in Persons With Chronic Spinal Cord Injury

Christopher M Cirnigliaro; Michael F La Fountaine; Joshua C Hobson; Steven C Kirshblum; Donald R Dengel; Ann M Spungen; William A Bauman

doi:10.1016/j.jocd.2021.03.010

Predicting Cardiometabolic Risk From Visceral Abdominal Adiposity in Persons With Chronic Spinal Cord Injury

J Clin Densitom. 2021 Jul-Sep;24(3):442-452. doi: 10.1016/j.jocd.2021.03.010. Epub 2021 Apr 8.

Authors

Christopher M Cirnigliaro¹, Michael F La Fountaine², Joshua C Hobson³, Steven C Kirshblum⁴, Donald R Dengel⁵, Ann M Spungen⁶, William A Bauman⁶

Affiliations

¹ Department of Veterans Affairs Rehabilitation Research & Development Service, National Center for the Medical Consequences of Spinal Cord Injury, James J. Peters Veterans Affairs Medical Center, Bronx, NY, USA. Electronic address: christopher.cirnigliaro@va.gov.
² Department of Veterans Affairs Rehabilitation Research & Development Service, National Center for the Medical Consequences of Spinal Cord Injury, James J. Peters Veterans Affairs Medical Center, Bronx, NY, USA; Department of Physical Therapy, School of Health and Medical Sciences, Seton Hall University, South Orange, NJ; Departments of Medical Sciences and Neurology, Hackensack Meridian School of Medicine at Seton Hall University, Nutley, NJ, USA.
³ Department of Kinesiology and Applied Physiology, University of Delaware, Newark, DE, USA.
⁴ Kessler Institute for Rehabilitation, West Orange, NJ; Department of Physical Medicine and Rehabilitation, Rutgers New Jersey Medical School, Newark, NJ.
⁵ School of Kinesiology, University of Minnesota, Minneapolis, MN.
⁶ Medical Service, James J. Peters Veterans Affairs Medical Center, Bronx, NY, USA; Department of Veterans Affairs Rehabilitation Research & Development Service, National Center for the Medical Consequences of Spinal Cord Injury, James J. Peters Veterans Affairs Medical Center, Bronx, NY, USA; Departments of Medicine and Rehabilitation and Human Performance, Icahn School of Medicine at Mount, Sinai, New York, NY, USA.

PMID: 34001430
DOI: 10.1016/j.jocd.2021.03.010

Abstract

Persons with spinal cord injury (SCI) have increased adiposity that may predispose to cardiovascular disease compared to those who are able-bodied (AB). The purpose of this study was to determine the relationships between dual energy X-ray absorptiometry (DXA)-derived visceral adipose tissue (VAT) and biomarkers of lipid metabolism and insulin resistance in persons with chronic SCI. A prospective observational study in participants with chronic SCI and age- and gender-matched AB controls. The study was conducted at a Department of Veterans Affairs Medical Center and Private Rehabilitation Hospital. The quantification of DXA-derived VAT volume (VAT_vol) and blood-derived markers of lipid and carbohydrate metabolism were determined in 100 SCI and 51 AB men. The VAT_vol was acquired from a total body DXA scan and analyzed using iDXA enCore CoreScan software (GE Lunar). Blood samples were collected for the serum lipid profile and plasma and glucose concentrations, with the latter two values used to calculate a measure of insulin resistance. In the SCI and AB groups, VAT% was significantly correlated with most cardiometabolic biomarkers. The results of the binary logistic regression analysis revealed that participants who had a VAT_vol above the cutoff value of 1630 cm³ were 3.1-, 4.8-, 5.6-, 19.2-, and 16.7-times more likely to have high serum triglycerides (R²_N= 0.09, p = 0.014), low serum high density lipoprotein cholesterol (R²_N = 0.16, p < 0.001), HOMA2-IR (R²_N = 0.18, p < 0.001), metabolic syndrome (R²_N = 0.25, p < 0.001), and a 10-yr Framingham Risk Score ≥ 10% (R²_N = 0.16, p = 0.001), respectively, when compared to participants below this VAT_vol cutoff value. Our findings reveal that persons with chronic SCI have a higher VAT_vol than that of AB controls, and VAT_vol correlates directly with biomarkers of lipid and carbohydrate metabolism that are strong predictors of cardiometabolic disorders.

Keywords: Biomarkers; Dual energy X-ray absorptiometry; Spinal cord injury; Subcutaneous adipose tissue; Visceral adipose tissue.

Published by Elsevier Inc.

Publication types

Observational Study
Research Support, U.S. Gov't, Non-P.H.S.

MeSH terms

Absorptiometry, Photon
Adiposity
Cardiovascular Diseases* / diagnostic imaging
Cardiovascular Diseases* / epidemiology
Cardiovascular Diseases* / etiology
Humans
Intra-Abdominal Fat / diagnostic imaging
Male
Obesity, Abdominal* / metabolism
Spinal Cord Injuries* / complications
Spinal Cord Injuries* / diagnostic imaging