Regional Adiposity and Syndrome X in Spinal Cord Injury

局部肥胖和脊髓损伤中的 X 综合征

• 批准号: 6694094
• 负责人: CAROL L BRAUNSCHWEIG
• 金额: $ 7.79万
• 依托单位: UNIVERSITY OF ILLINOIS AT CHICAGO
• 依托单位国家: 美国
• 财政年份: 2003
• 资助国家: 美国
• 起止时间: 2003-01-01 至 2005-12-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/6694094
• 关键词: abdomen; acute phase protein; adipose tissue; blood chemistry; blood pressure; body composition; clinical research; disease /disorder proneness /risk; human subject; inflammation; insulin sensitivity /resistance; leg; magnetic resonance imaging; male; metabolism disorder; obesity; questionnaires; spinal cord injury; statistics /biometry

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.

描述(申请人提供)：脊髓损伤后经常发生全身性和腹型肥胖。全身过度肥胖，特别是腹部内脏脂肪组织过度肥胖(VAAT)和大腿骨骼肌肥胖(TSKMAT)，经磁共振成像(MRI)测量，已与轻度全身炎症和代谢综合征(MS)(也称为X综合征)相关，代谢综合征(MS)被定义为存在以下三种或三种以上特征：腰围(WC)大于40英寸，空腹甘油三酯至少150毫克/分升，血糖等于或大于110毫克/分升，高密度脂蛋白胆固醇等于或小于40毫克/分升和/或血压至少130/85毫米汞柱。患有多发性硬化症的人容易出现胰岛素抵抗，并增加患糖尿病、高血压和心血管疾病的风险。脊髓损伤患者的这些疾病的患病率比健全的人更高，然而，VAAT或TSKMAT的测量及其与炎症、MS特征或胰岛素抵抗的关系在这一人群中尚未报道。这是不幸的，因为体脂分布和炎症状态都是可改变的危险因素。这项初步调查的目的是探索截瘫男性与类似健全男性相比，肥胖指标(总体、腹部、VAAT和TSKMAT)、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的体积是否可以预测截瘫男性的CRP浓度、MS的水平和数量以及胰岛素抵抗，以及这些变量在方向、大小和相关性上是否与正常男性相似。将招募四组在脊髓损伤或创伤后一年以上的男性，按年龄和种族匹配的频率(15/组；30名截瘫脊髓损伤和30名有创伤史导致住院5天以上的健全男性)如下：第1组瘦脊髓损伤(WC&lt；37英寸)，2组大脊髓损伤(WC&gt；40英寸)，3组瘦身体(WC&lt；37英寸)，和4组大身体(WC&gt；40英寸)。相关分析、多元回归和方差分析将被用来确定这些组之间的CRP、MS、胰岛素敏感性和各种区域肥胖指标之间的关联。