Elevated C-reactive protein associated with decreased high-density lipoprotein cholesterol in men with spinal cord injury

Abstract

Objectives: To determine if people with spinal cord injury (SCI) have elevated C-reactive protein (CRP), to examine the association of CRP with high-density lipoprotein cholesterol (HDL-C), and to assess the influence of completeness and level of injury on these parameters.

Design: Cross-sectional.

Setting: Urban university.

Participants: Men with SCI (n=129) who were free of infection and/or recent anti-inflammatory medication use as well as their 1:1 age- and race-matched able-bodied counterparts from the 1999-2002 National Health and Nutrition Examination Surveys.

Interventions: Not applicable.

Main outcome measures: High CRP was defined as 3 mg/L or higher and low HDL-C as less than 1.04 mmol/L.

Results: Men with SCI were more likely to have high CRP (odds ratio [OR]=2.29; 95% confidence interval [CI], 1.33-3.95) and low HDL-C (OR=1.81; 95% CI, 1.01-3.27). The OR for low HDL-C in SCI was no longer significant when high CRP was controlled. CRP was higher in complete versus incomplete injury (median, 3.7 mg/L vs 1.2mg/L; P=.005), and this elevation was independent of age, smoking, physical activity, waist circumference, and weight. No conclusion can be made on the association of injury level and CRP because of a lack of power.

Conclusions: The elevated CRP, possibly the major risk factor, together with decreased HDL-C may contribute to greater incidence for cardiovascular disease in the SCI population.