Lipid profile in spinal cord-injured women with different injury levels

Abstract

Background. In dependence on their injury level, male subjects with spinal cord injury (SCI) exhibit a less favorable lipoprotein profile than control persons. The impairment of the sympathetic nervous system and the fact that persons with spinal cord injury are subject to extreme physical inactivity may have an influence on their lipid profile and lipoprotein(a) concentration. It has been shown that sex-specific differences in hormonal regulation are responsible for differences in lipoprotein levels between nondisabled men and women. However, the role of hormones on lipoprotein levels has not been investigated in female subjects with spinal cord injury. Methods. Therefore, we performed a detailed investigation regarding the lipid profile in 32 premenopausal women with spinal cord injury ranging from tetraplegia to low paraplegia and in 36 control subjects. VO(2max) was determined by a wheelchair ergometry with stepwise increase in work load. Result. VO(2max) was significantly higher in paraplegics than in tetraplegics but significantly lower than in control subjects. Paraplegics had significantly higher low-density lipoprotein levels than both tetraplegics and control persons. The lipid profile of female tetraplegics was characterized by elevated triglycerides. An association between high-density lipoprotein levels and spinal cord injury or the level of the injury was not observed. No significant difference in lipoprotein(a) was found within SCI individuals as well as between SCI individuals and control persons indicating the predominant genetic determination of lipoprotein(a) and the thus related cardiovascular risk. Conclusion. Despite the extreme reduction of VO(2max), the assumed physical inactivity and low serum catecholamine levels due to the impairment of the sympathetic nervous system, female tetraplegic persons did not show an adverse lipoprotein profile with respect to high-density lipoprotein cholesterol levels. If the higher low-density lipoprotein cholesterol concentrations in female with spinal cord injury with low lesion levels or the elevated TG levels in female tetraplegics bare relevance with respect to an increased cardiovascular risk in this population needs to be clarified in further longitudinal investigations.