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. 2019 Jun;100(6):1061-1067.e1.
doi: 10.1016/j.apmr.2018.08.191. Epub 2018 Oct 12.

Differences in Glucose Metabolism Among Women With Spinal Cord Injury May Not Be Fully Explained by Variations in Body Composition

Jia Li  1 , Gary R Hunter  2 , Yuying Chen  3 , Amie McLain  3 , Daniel L Smith  2 , Ceren Yarar-Fisher  4
Affiliations

Differences in Glucose Metabolism Among Women With Spinal Cord Injury May Not Be Fully Explained by Variations in Body Composition

Jia Li et al. Arch Phys Med Rehabil. 2019 Jun.

Abstract

Objective: To investigate the differences in glucose metabolism among women with paraplegic, and tetraplegic spinal cord injury (SCI) in comparison to their able-bodied (AB) counterparts after adjusting for differences in body composition.

Design: Cross-sectional study. After an overnight fast, each participant consumed a 75-g glucose solution for oral glucose tolerance test (OGTT). Blood glucose, insulin, and C-peptide concentrations were analyzed before and 30, 60, 90, and 120 minutes after ingesting glucose solution. Insulin sensitivity index (ISI) was estimated using the Matsuda index. Percentage fat mass (%FM) and total body lean mass (TBLM) were estimated using data from dual-energy x-ray absorptiometry. Visceral fat (VF) was quantified using computed tomography. Outcome measures were compared among groups using analysis of covariance with %FM (or VF) and TBLM as covariates.

Setting: Research university.

Participants: Women (N=42) with SCI (tetraplegia: n=8; paraplegia: n=14) and their race-, body mass index-, and age-matched AB counterparts (n=20).

Interventions: Not applicable.

Results: At fasting, there was no difference in glucose homeostasis (glucose, insulin, C-peptide concentrations) among 3 groups of women. In contrast, glucose, insulin, and C-peptide concentrations at minute 120 during OGTT were higher in women with tetraplegia versus women with paraplegia and AB women (P<.05, adjusted for TBLM and %FM). In addition, women with tetraplegia had lower ISI (P<.05, adjusted for TBLM and %FM) versus AB women. These differences remained after adjusting for VF and TBLM.

Conclusion: Our study confirms that impaired glucose metabolism among women with tetraplegia may not be fully explained by changes in their body composition. Future studies exploring additional factors involved in glucose metabolism are warranted.

Keywords: Body composition; Insulin resistance; Rehabilitation; Spinal cord injury; Tetraplegia.

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Figures

Fig 1
Fig 1
Glucose, insulin, and C-peptide concentrations during OGTT. #P<.05, women with tetraplegia were different from women with paraplegia and AB women.
See this image and copyright information in PMC

References

    1. Bauman WA, Spungen AM. Coronary heart disease in individuals with spinal cord injury: assessment of risk factors. Spinal Cord 2008;46: 466–76. - PubMed
    1. Kressler J, Cowan RE, Bigford GE, Nash MS. Reducing cardiometabolic disease in spinal cord injury. Phys Med Rehabil Clin N Am 2014;25:573–604, viii. - PubMed
    1. Bauman WA, Spungen AM. Disorders of carbohydrate and lipid metabolism in veterans with paraplegia or quadriplegia: a model of premature aging. Metabolism 1994;43:749–56. - PubMed
    1. Bauman WA, Spungen AM. Carbohydrate and lipid metabolism in chronic spinal cord injury. J Spinal Cord Med 2001;24:266–77. - PubMed
    1. National Spinal Cord Injury Statistical Center. 2016 SCIMS annualreport – complete public version. Available at: https://www.nscisc.uab.edu. Accessed December 1, 2017.

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