Demographics, Body Composition and Lipid Profiles in Three Ethnic Groups with Spinal Cord Injury
Secondary Conditions in Spinal Cord Injury
Relationships among demographics, body composition (BC) and lipid profiles (LP) were explored in Caucasians, African Americans and Latinos with spinal cord injury (SCI). Despite similarities in demographic measures Latinos with SCI appeared to have BCs and LPs generally associated with poorer health outcomes.
OBJECTIVE: This study examined the relationships among demographics, body composition (BC) and lipid profiles (LP) in Caucasians (C), African Americans (AA) and Latinos (L) with spinal cord injury (SCI).
DESIGN: Multi-center cross-sectional study.
SETTINGS: Two large, metropolitan academic and rehabilitation medical centers.
PARTICIPANTS: Three female and 28 male adults with chronic, complete SCI (AIS A or B) at the C4-T12 spinal cord levels without history of traumatic brain injury, cardiovascular disease, or diabetes.
METHODS: Body composition was analyzed by dual x-ray absorptiometry (DXA) incorporating methods for compartmental analysis. Testing for LP was conducted in the post-absorptive state following an overnight (10h) fast.
RESULTS: Ethnicities of 31 participants were 33% W, 24% AA and 36% L. Mean age (41.7 ± 12.8y), BMI (26.4 ± 4.4kg/m2), injury level, and injury duration (15 ± 12y) did not differ between ethnic groups (p = .166, .414, .951, and .281, respectively). Total body fat was highest for L (37 ± 4.5%) compared to C (30.6 ± 8.7%) and AA (34.9 ± 13.3%), but this difference did not reach significance (p = .202). Significant differences were identified for total body fat distribution, with L having significantly higher android percent fat (45.1 ± 4.4%) compared to C (35.2 ± 8.3%, p = .020) but not AA (35.5 ± 15.4%, p = .065). Similarly, TG and the global risk index TC/HDL were significantly higher for L (167 ± 80 mg/dL and 5.0 ± 1.0) compared to C (94.0 ± 45 mg/dL, p = .022 and 3.9 ± 0.7, p = .020) and AA (87 ± 81 mg/dL, p = .023 and 3.6 ± 1.5, p = .014). Gynoid lean mass appeared to be to the most consistent predictor of blood lipids, displaying significant correlations with TC (r = -.597, p < .001), LDL (r = -.439, p = .015), VLDL (r = -.439, p = .015) and TG (r = -.390, p = .033). In addition, gynoid tissue was significantly correlated with TC/HDL (r = -.402, p = .028). Neither total body fat nor BMI was significantly correlated with any of the LP markers. BMI however, was significantly correlated with most body composition measures, most notably trunk tissue mass (r = .851, p < .001) and trunk fat mass (r = .800, p < .001) as well as total body fat (r = .583, p = .001). Regression analysis revealed no significant difference in the effects of BMI on BC measures for the different ethnic groups.
CONCLUSION: Despite similarities in demographic measures, Latinos with SCI appeared to have body compositions and lipid profiles generally associated with poorer health outcomes. Overall, body fat and BMI assessments warn of health risks and future complications for all study groups, as does the global CVD risk index TC/HDL and various lipid markers. Ongoing studies will determine whether these markers can be coalesced into a risk equation that predicts future disease risk for persons with SCI.