Regional Adiposity and Syndrome X in Spinal Cord Injury

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DESCRIPTION (provided by applicant): Total and abdominal obesity frequently occur following SCI. Excessive total body adiposity, particularly excessive visceral abdominal adipose tissue (VAAT), and thigh skeletal muscle adiposity (TSKMAT), measured by magnetic resonance imaging (MRI), have been associated with a low-grade systemic inflammation and the metabolic syndrome (MS) (also called syndrome X) which has been defined as the presence of three or more of the following features: waist circumference (WC) greater than 40 inches, fasting triglycerides of at least 150 mg/dl, glucose equal or greater than 110 mg/dl, HDL cholesterol equal or less than 40 mg/dl and/or blood pressure of at least 130/85 mmHg. People with the MS are predisposed to developing insulin resistance and increased risks for diabetes mellitus, hypertension, and cardiovascular disease. Individuals with SCI have higher prevalence rates for these diseases than able-bodied individuals, however, measures of VAAT or TSKMAT volumes and their relation to a measure for inflammation, features of the MS or insulin resistance have not been reported for this population. This is unfortunate given that body fat distribution and inflammatory status are both modifiable risk factors. The purpose of this pilot investigation is to explore the association between measures of adiposity (total, abdominal, VAAT and TSKMAT), a sensitive marker of inflammation (CRP), features of the MS, and insulin resistance in paraplegic men compared to similar able-bodied men. The investigators propose a cross sectional investigation of community dwelling males (N = 60) recruited from urban SCI rehabilitation and trauma centers to determine whether the volume of VAAT, its anthropometric surrogates (WC and/or sagittal diameter), and/or the volume of TSKMAT predict concentrations of CRP, levels and numbers of features of the MS, and insulin resistance in paraplegic men and whether these variables are similar in direction, magnitude and association to those observed in able-bodied men. Four groups of men more than one year post SCI or trauma, frequency matched for age and ethnicity (15/group; 30 paraplegic SCI and 30 able-bodied men with a history of trauma resulting in a hospital stay over 5 days), will be recruited as follows: group 1 lean SCI (WC < 37 inches), group 2 large SCI (WC > 40 inches), group 3 lean able-bodied (WC <37 inches), and group 4 large able-bodied (WC> 40 inches). Correlation analysis, multiple regression, and analysis of variance will be used to determine the association between CRP, the MS, insulin sensitivity, and various measures of regional adiposity between these groups.