Regional Adiposity and Syndrome X in Spinal Cord Injury

描述（由申请人提供）：SCI后经常发生全身和腹部肥胖。 通过磁共振成像（MRI）测量的全身过度肥胖，特别是内脏腹部脂肪组织（VAAT）和大腿骨骼肌肥胖（TSKMAT）过多，与低度全身炎症和代谢综合征（MS）相关。（也称为综合征X），其定义为存在以下三个或更多个特征：腰围（WC）大于40英寸，空腹甘油三酯至少为150 mg/dl，葡萄糖等于或大于110 mg/dl，HDL胆固醇等于或小于40 mg/dl和/或血压至少为130/85 mmHg。 MS患者易发生胰岛素抵抗，并增加患糖尿病、高血压和心血管疾病的风险。 SCI患者的这些疾病的患病率高于身体健全的个体，然而，VAAT或TSKMAT体积的测量及其与炎症测量、MS特征或胰岛素抵抗的关系尚未报告。 这是不幸的，因为身体脂肪分布和炎症状态都是可改变的风险因素。 这项初步研究的目的是探讨截瘫男性与类似的健全男性相比，肥胖（总，腹部，VAAT和TSKMAT），炎症（CRP）的敏感标志物，MS的特征和胰岛素抵抗之间的关系。 研究人员建议对从城市SCI康复和创伤中心招募的社区居住男性（N = 60）进行横断面调查，以确定VAAT的体积，其人体测量替代物，（WC和/或矢状径）和/或TSKMAT的体积预测CRP的浓度、MS的特征的水平和数量，和胰岛素抵抗，以及这些变量是否在方向、幅度和关联上与在健全男性中观察到的相似。 四组SCI或创伤后超过一年的男性，频率与年龄和种族相匹配（每组15名; 30名截瘫SCI患者和30名有创伤史且住院超过5天的健全男性），招募如下：第1组瘦型SCI（WC <37英寸），第2组大型SCI（WC> 40英寸），第3组瘦型健全人（WC <37英寸），和第4组大型健全人（WC> 40英寸）。 相关分析、多元回归和方差分析将用于确定CRP、MS、胰岛素敏感性和这些组之间的各种局部肥胖测量之间的关联。

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.