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Review
. 2021 Aug 30;10(17):3911.
doi: 10.3390/jcm10173911.

Body Composition According to Spinal Cord Injury Level: A Systematic Review and Meta-Analysis

Peter Francis Raguindin  1   2   3 , Alessandro Bertolo  2 , Ramona Maria Zeh  2 , Gion Fränkl  2   4 , Oche Adam Itodo  1   2   3 , Simona Capossela  2 , Lia Bally  5 , Beatrice Minder  6 , Mirjam Brach  2 , Inge Eriks-Hoogland  2   7 , Jivko Stoyanov  2 , Taulant Muka  1 , Marija Glisic  1   2
Affiliations
Review

Body Composition According to Spinal Cord Injury Level: A Systematic Review and Meta-Analysis

Peter Francis Raguindin et al. J Clin Med. .

Abstract

The level of injury is linked with biochemical alterations and limitations in physical activity among individuals with spinal cord injury (SCI), which are crucial determinants of body composition. We searched five electronic databases from inception until 22 July 2021. The pooled effect estimates were computed using random-effects models, and heterogeneity was calculated using I2 statistics and the chi-squared test. Study quality was assessed using the Newcastle-Ottawa Scale. We pooled 40 studies comprising 4872 individuals with SCI (3991 males, 825 females, and 56 sex-unknown) in addition to chronic SCI (median injury duration 12.3 y, IQR 8.03-14.8). Individuals with tetraplegia had a higher fat percentage (weighted mean difference (WMD) 1.9%, 95% CI 0.6, 3.1) and lower lean mass (WMD -3.0 kg, 95% CI -5.9, -0.2) compared to those with paraplegia. Those with tetraplegia also had higher indicators of central adiposity (WMD, visceral adipose tissue area 0.24 dm2 95% CI 0.05, 0.43 and volume 1.05 L 95% CI 0.14, 1.95), whereas body mass index was lower in individuals with tetraplegia than paraplegia (WMD -0.9 kg/mg2, 95% CI -1.4, -0.5). Sex, age, and injury characteristics were observed to be sources of heterogeneity. Thus, individuals with tetraplegia have higher fat composition compared to paraplegia. Anthropometric measures, such as body mass index, may be inaccurate in describing adiposity in SCI individuals.

Keywords: body composition; fat composition; obesity; paraplegia; spinal cord injury.

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Conflict of interest statement

The authors declare no conflict of interest. The funders had no role in the design of the study; in the collection, analyses, or interpretation of data; in the writing of the manuscript, or in the decision to publish the results.

Figures

Figure 1
Figure 1
Flowchart of study inclusion (SCI: spinal cord injury; * Some studies reported information on multiple outcomes. Thus, the number of studies per outcome exceeds the total number of available studies).
Figure 2
Figure 2
Summary of important findings.
See this image and copyright information in PMC

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