Factors influencing body composition in persons with spinal cord injury: a cross-sectional study

Spungen, Ann M.; Adkins, Rodney H.; Stewart, Charles A.; Wang, Jack; Pierson, Richard N.; Waters, Robert L.; Bauman, William A.

doi:10.1152/japplphysiol.00729.2002

Cited by 378 publications

(441 citation statements)

References 34 publications

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“…An analysis of the changes in body composition, especially when compared with able-bodied populations, provides additional insights into the long-term effects of SCI. Table 3 summarizes data for regional and total body composition from our study, compared with a second group of tetraplegics and a control population of veterans reported by Spungen et al 5 The data for the two groups of tetraplegics are especially revealing when the percent of BF and LBM are viewed side-by-side with the non-SCI control group. For the total body, the subjects we studied had 142.3% BF and only 82.7% LBM compared to the controls.…”

Section: Discussionmentioning

confidence: 67%

“…Another factor is the reduction in body cell mass of 34% in paraplegics and 49% in tetraplegics. 4 Spungen et al 5 used dual energy X-ray absorptiometry (DXA) to assess body composition and found significant decreases in regional and total body lean tissue percentages in men with paraplegia and tetraplegia compared with controls. Based on this, individuals with tetraplegia can expect to lose approximately 3.0% of their total LBM per decade compared with 1% per decade in the able-bodied population.…”

Section: Introductionmentioning

confidence: 99%

“…Based on this, individuals with tetraplegia can expect to lose approximately 3.0% of their total LBM per decade compared with 1% per decade in the able-bodied population. 5 In addition to a loss of LBM, individuals with SCI incur some degree of pulmonary insufficiency due to muscle weakness directly related to the level of neurologic impairment. 6,7 Linn et al 6 quantified the loss of pulmonary function in subjects with SCI by level of injury compared with able-bodied controls.…”

Section: Introductionmentioning

confidence: 99%

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The effects of an anabolic agent on body composition and pulmonary function in tetraplegia: a pilot study

et al. 2009

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Study design: Prospective repeated-measures longitudinal study. Objectives: To determine if an 8-week course of an oral anabolic steroid can positively effect body composition or pulmonary function in healthy individuals with chronic tetraplegia. Setting: United States. Methods: Oxandrolone (20 mg per day) was administered for 8 weeks to 10 men with motor complete tetraplegia. Dual X-ray absorptiometry scans, pulmonary function tests (PFTs), serum lipids and liver function tests (LFTs) were obtained at baseline, 4,8,12 and 20 weeks. To analyze change over time, a repeated measures General Linear Model and nonparametric tests were utilized. Results: Following treatment, total lean body mass (LBM) increased 1.9% and LBM of the arms increased 5.4%. Total body fat decreased 1.5%, and increased 3.9% in the arms and, on average, combined measures of PFTs improved 2.2%. High-density lipoprotein cholesterol decreased 31.8%, low density lipoprotein cholesterol increased 41.2%, and LFTs increased 9.7-65.6% while on therapy but all trended to baseline at 20 weeks. Conclusion: Baseline body composition was characterized by a high proportion of fat and a body mass index that underestimated chronic disease risk. Treatment with oxandrolone was associated with modest improvements in PFTs and in arm and total body LBM. Unfavorable changes in serum lipids and LFTs indicate that reported benefits of using oxandrolone in this population must be carefully weighed against potential adverse effects.

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Section: Discussionmentioning

confidence: 67%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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The effects of an anabolic agent on body composition and pulmonary function in tetraplegia: a pilot study

et al. 2009

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“…12 This is particularly evident for the musculoskeletal, endocrine and cardiovascular systems. [13][14][15] (2) The frequency of certain health conditions increases with duration of SCI. These include chronic pain, 16 osteoporosis, 15,17 pressure sores 18 and kidney stones, 18 among many others.…”

Section: Background and History Of The Secondary Conditions Conceptmentioning

confidence: 99%

Secondary health conditions in individuals aging with SCI: Terminology, concepts and analytic approaches

et al. 2011

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Study design: Literature review. Objectives: Utilizing individuals with spinal cord injury (SCI) as a representative population for physical disability, this paper: (1) reviews the history of the concept of secondary conditions as it applies to the health of individuals aging with long-term disabilities; (2) proposes a definition of secondary health conditions (SHCs) and a conceptual model for understanding the factors that are related to SHCs as individuals age with a disability; and (3) discusses the implications of the model for the assessment of SHCs and for developing interventions that minimize their frequency, severity and negative effects on the quality of life of individuals aging with SCI and other disabilities. Methods: Key findings from research articles, reviews and book chapters addressing the concept of SHCs in individuals with SCI and other disabilities were summarized to inform the development of a conceptual approach for measuring SCI-related SHCs. Conclusions: Terms used to describe health conditions secondary to SCI and other physical disabilities are used inconsistently throughout the literature. This inconsistency represents a barrier to improvement, measurement and for the development of effective interventions to reduce or prevent these health conditions and mitigate their effects on participation and quality of life. A working definition of the term SHCs is proposed for use in research with individuals aging with SCI, with the goal of facilitating stronger evidence and increased knowledge upon which policy and practice can improve the health and well-being of individuals aging with a disability.

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“…Our tetraplegic men had higher body fat mass, as measured by dual energy X-ray absorptiometry (DEXA) scan and higher plasma levels of leptin compared to able-bodied men, 16 despite apparently similar BMI values, which is in agreement with previous studies. 17,18 Moreover, DEXA might be more suitable for detecting fat mass in able-bodied group than in tetraplegic group, as in contrast to able-bodied group, fat accumulates within muscle fibres in tetraplegia. 19 Higher body fat mass, intramuscularly fat accumulation and autonomic deficits in tetraplegia could all result in disturbed secretion of gonadotrophins, as well as higher leptin levels.…”

Section: Hypogonadism In Cervical Spinal Cord Injury E Kostovski Et Almentioning

confidence: 99%

Decreased levels of testosterone and gonadotrophins in men with long-standing tetraplegia

et al. 2008

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Study Design: Blood samples were frequently collected during a 24-h period from six tetraplegic men. The results were compared with those of eight able-bodied controls. Objective: Previous studies have reported conflicting results regarding the plasma concentrations of testosterone, luteinizing hormone (LH) and follicle-stimulating hormone (FSH) in tetraplegia. The objective of this study was to examine the pituitary-gonadal axis by determining the plasma concentrations and circadian variations of these hormones in men with long-standing tetraplegia. Setting: Sunnaas Hospital, Norway. Methods: The plasma concentrations of hormones were measured with standardized assays. Results: All three hormones and free testosterone index were decreased in the tetraplegic subjects compared with the able-bodied controls (Po0.05). We also determined the morning levels of hormones with regulatory effects on testosterone, LH and FSH. Whereas plasma leptin was significantly higher in the tetraplegic group, no significant differences in the morning plasma values for insulin, SHBG, GH or IGF-1, or in the 24-h urine concentrations of cortisol were detected between the two groups. The plasma concentration of LH displayed a circadian variation (Po0.05) in the tetraplegic group, but not among the able-bodied. No circadian variation was noted for the plasma concentrations of testosterone and FSH in either group. Conclusion: Our data indicate that, over time, tetraplegic male subjects might be at risk of developing hypogonadism.

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Factors influencing body composition in persons with spinal cord injury: a cross-sectional study

Cited by 378 publications

References 34 publications

The effects of an anabolic agent on body composition and pulmonary function in tetraplegia: a pilot study

The effects of an anabolic agent on body composition and pulmonary function in tetraplegia: a pilot study

Secondary health conditions in individuals aging with SCI: Terminology, concepts and analytic approaches

Decreased levels of testosterone and gonadotrophins in men with long-standing tetraplegia

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