Regional Adiposity and Syndrome X in Spinal Cord Injury

描述（由申请人提供）：全身肥胖和腹部肥胖是SCI患者的常见症状。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）和大腿骨骼肌脂肪（TSKMAT）过多，与低度全身性炎症和代谢综合征（MS）（也称为X综合征）有关，代谢综合征被定义为存在以下三个或更多特征：腰围（WC）大于40英寸，空腹甘油三酯至少150毫克/分升，葡萄糖等于或大于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。多发性硬化症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。脊髓损伤患者的这些疾病患病率高于健全个体，然而，在这一人群中，VAAT或TSKMAT体积及其与炎症、多发性硬化症特征或胰岛素抵抗的关系尚未报道。这是不幸的，因为身体脂肪分布和炎症状态都是可改变的危险因素。这项试点研究的目的是探讨截瘫男性与类似健全男性相比，肥胖（总、腹部、VAAT和TSKMAT）、炎症敏感标志物（CRP）、多发性硬化症特征和胰岛素抵抗之间的关系。

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.