Lipid Profiles of Persons With Paraplegia and Tetraplegia: Sex Differences

Abstract

Background/Objective: To examine the lipoprotein profiles of men and women with paraplegia and tetraplegia. Impairment of the sympathetic nervous system (dependent on the level of injury) and the extent of physical capacity and activity were correlated with the lipid profile in men with spinal cord injury (SCI). Sex-related differences of the lipoprotein profiles could be found in nondisabled and premenopausal women with SCI mainly because of the different effects of sexual hormones. Methods: Lipoprotein profiles of 112 participants with SCI (32 premenopausal women, 80 men) were analyzed and correlated to sex, lesion level, and physical performance capacity. Results: Women with tetraplegia or paraplegia showed significantly higher levels of high-density lipoprotein and lower ratios of total cholesterol to high-density lipoprotein-cholesterol compared with men with corresponding lesion levels, without a difference in peak oxygen consumption. Concentrations of very-low-density lipoproteins were lower in women with paraplegia than in men with paraplegia; no differences were found in total cholesterol, low-density lipoprotein-cholesterol, and triglycerides. Sexindependent elevations in total cholesterol and low-density lipoprotein-cholesterol were associated with paraplegia, and sex-independent elevations in triglyceride levels were associated with tetraplegia. Conclusions: Persons with SCI showed sex-related differences in their lipoprotein profiles. Independent of physical fitness, the lipoprotein profile of premenopausal women with SCI did not exhibit the adverse lipoprotein characteristics observed in men with SCI, probably because of the influence of sexual hormones independent of lesion level.

The influence of level of spinal cord injury on adipose tissue and its relationship to inflammatory adipokines and cardiometabolic profiles

“…Previous reports in TSCI have implicated a greater number of lipid abnormalities than those with PSCI, 10 while others have reported elevated TC, LDLC, and HDLC profiles and a lower TC:HDLC ratio in individuals with PSCI than those with TSCI. 4,8,[43][44][45] We have demonstrated similar results showing elevated TC, LDLC, and HDLC, but a lower TC/HDLC ratio. The relatively elevated HDLC profiles observed in the PSCI group may stem from a larger LBM percentage and better aerobic fitness, which has been implicated in favorable HDLC profiles in PSCI versus TSCI.…”

“…44,46,47 With reference to TG, greater levels of inactivity, such as that reported with higher levels of SCI, have been reported to reduce lipoprotein lipase resulting in elevated levels of circulating TG. 43 This observation could account for the elevated levels of TG in the TSCI who have less LBM available for leisure and physical activity versus PSCI. Higher levels of TG have also been previously reported by Schmid et al 43 and Gibson et al 23 Moreover, elevated catecholamine levels have been reported in PSCI due to greater activity of the SNS, 43 which may increase lipolysis and the eventual production of LDLC, thus accounting for the overall increase in TC.…”

“…However, such sample sizes are not uncommon in SCI studies, especially when using advanced imaging technologies. 5,25,33,43 Third, inflammatory and cardiometabolic markers were assessed at a single time point for each participant, thus we were unable to exclude variability of these markers with time. Nonetheless, it has been reported that in approximately 90% of cases, two measurements of CRP taken about 3 months apart were within one quartile of each other.…”

The Prevalence of Dyslipidemia in Patients with Spinal Cord Lesion in Thailand

“…There was a difference in the prevalence of low HDL-C and high LDL-C between genders which may have been a result of different sex hormones that influence blood lipid profiles [ 27 , 28 ].…”

The analysis of serum lipid levels in patients with spinal cord injury

“…12 There are also studies reporting that the higher serum catecholamine levels in patients with paraplegia than patients with tetraplegia due to the increased sympathetic activity in patients with paraplegia lead to high serum LDL-c levels. 25 Despite some studies reporting a relationship between the lesion level and serum lipid levels, no such relationship was found in many studies 16,26,27 and also in a collective work in 2008. 15 HDL-c levels in patients with motor complete SCI were significantly lower than patients with motor incomplete SCI in our study and we found no relationship between other serum lipid levels and lesion grade.…”