Effects of spinal cord injury on body composition and metabolic profile – Part I

Abstract

Several body composition and metabolic-associated disorders such as glucose intolerance, insulin resistance, and lipid abnormalities occur prematurely after spinal cord injury (SCI) and at a higher prevalence compared to able-bodied populations. Within a few weeks to months of the injury, there is a significant decrease in total lean mass, particularly lower extremity muscle mass and an accompanying increase in fat mass. The infiltration of fat in intramuscular and visceral sites is associated with abnormal metabolic profiles. The current review will summarize the major changes in body composition and metabolic profiles that can lead to comorbidities such as type 2 diabetes mellitus and cardiovascular diseases after SCI. It is crucial for healthcare specialists to be aware of the magnitude of these changes. Such awareness may lead to earlier recognition and treatment of metabolic abnormalities that may reduce the co-morbidities seen over the lifetime of persons living with SCI.

Effect of adjusting pulse durations of functional electrical stimulation cycling on energy expenditure and fatigue after spinal cord injury

“…Obesity, which is defined as excessive regional and whole body fatness, is a major problem after SCI that leads to several metabolic abnormalities [24,35]. Delta EE between exercise and rest was 42 percent greater in P350 than in P200 (+0.32 Kcal/min).…”

“…This potentially could increase neuromuscular recruitment, evoking more torque and increased energy expenditure (EE) during cycling. Increasing EE may assist in the fight against obesity and other noncommunicable diseases after SCI [1,24].…”

Adiposity and spinal cord injury

“…The evidence suggests that there is up to 22%-40% decline BMR in persons with SCI based on their level of injury and about 50%-75% suffer from impaired glucose tolerance or type Ⅱ diabetes mellitus [43,44] . Dyslipidemia, as manifested by decreased level of circulating high density lipoprotein-cholesterol and increased levels of triglycerides and low density lipoprotein-cholesterol, contributes to an accelerating atheorgenic process to the cardiovascular system after SCI [4,45] . The economic impact and burden of these comorbidities may be of paramount significance to study the regional and ectopic adipose tissue changes after SCI.…”

“…A person with SCI is considered to be on the lowest end of the spectrum of physical activity as determined by the lowest oxygen uptake during peak exercise activity [14] . The low level of physical activity, significant muscle loss with changes in regional and total body composition, dysfunction in the autonomic nervous system and diminished anabolic hormones are a typical phenotype profile for a person with SCI [4,15,16] . The significant loss in lean mass within the first year of injury is accompanied with continuous increase in adipose tissue accumulation representing significant health risks after SCI [17] .…”

“…Additionally, adipose tissues secrete number of active peptides called adipokines [3] . Interest in studying adipose tissue physiology and anatomical distribution has stemmed from its closest association with disturbance in metabolic profile including carbohydrate, lipid, and bone metabolism [3][4][5][6][7] . Most recently the link between adipose tissue and bone health has been recognized after spinal cord injury (SCI) [7] .…”