Different risk factor patterns for metabolic syndrome in men with spinal cord injury compared with able-bodied men despite similar prevalence rates

Abstract

Objective: To determine if the prevalence of metabolic syndrome and risk factors differs between age- and race-matched men with spinal cord injury (SCI) and able-bodied men.

Design: Cross-sectional.

Setting: Urban university.

Participants: Men with SCI (n=185), ages 20 to 59 years, were matched 1 to 1 with able-bodied men from the 1999-2002 National Health and Nutrition Examination Surveys.

Interventions: Not applicable.

Main outcome measures: Waist circumference, blood pressure, glucose, triglyceride (TG), total (TC), and low- (LDL) and high-density lipoprotein (HDL) cholesterol.

Results: Despite similar prevalence for metabolic syndrome, different risk factor patterns were found between groups. Men with SCI had a significantly lower mean HDL, TG, and glucose in addition to lower TC and LDL. After adjusting for smoking, education, and household income by using conditional logistic regression, men with SCI had a higher risk for abdominal obesity (odd ratio [OR]=1.78; 95% confidence interval [CI], 1.07-2.96) and reduced HDL (OR=1.76; 95% CI, 1.06-2.94) but lower risks for elevated glucose (OR=0.55; 95% CI, 0.33-0.94) than their able-bodied counterparts. By using linear regression and controlling for waist circumference, men with SCI had lower TC, LDL, TG, and glucose concentrations but lower HDL. Racial differences in risks were found in both SCI and able-bodied men; however, among the SCI men, prevalence for low HDL and elevated glucose was similar between whites and African Americans.

Conclusions: Men with SCI do not appear to have an increased prevalence of metabolic syndrome compared with able-bodied counterparts, suggesting that other nontraditional risks may contribute to their increased mortality from cardiovascular disease and diabetes.