scholarly journals Neurogenic Obesity and Skeletal Pathology in Spinal Cord Injury

2021 ◽  
Vol 27 (1) ◽  
pp. 57-67
Author(s):  
David W. McMillan ◽  
Mark S. Nash ◽  
David R. Gater ◽  
Rodrigo J. Valderrábano
Keyword(s):  
Skeletal Muscle ◽  
Spinal Cord ◽  
Spinal Cord Injury ◽  
Body Composition ◽  
Bone Loss ◽  
Lean Mass ◽  
Endocrine Function ◽  
Official Position ◽  
Cord Injury ◽  
Skeletal Pathology

Spinal cord injury (SCI) results in dramatic changes in body composition, with lean mass decreasing and fat mass increasing in specific regions that have important cardiometabolic implications. Accordingly, the recent Consortium for Spinal Cord Medicine (CSCM) released clinical practice guidelines for cardiometabolic disease (CMD) in SCI recommending the use of compartmental modeling of body composition to determine obesity in adults with SCI. This recommendation is guided by the fact that fat depots impact metabolic health differently, and in SCI adiposity increases around the viscera, skeletal muscle, and bone marrow. The contribution of skeletal muscle atrophy to decreased lean mass is self-evident, but the profound loss of bone is often less appreciated due to methodological considerations. General-population protocols for dual-energy x-ray absorptiometry (DXA) disregard assessment of the sites of greatest bone loss in SCI, but the International Society for Clinical Densitometry (ISCD) recently released an official position on the use of DXA to diagnose skeletal pathology in SCI. In this review, we discuss the recent guidelines regarding the evaluation and monitoring of obesity and bone loss in SCI. Then we consider the possible interactions of obesity and bone, including emerging evidence suggesting the possible influence of metabolic, autonomic, and endocrine function on bone health in SCI.

Factors influencing body composition in persons with spinal cord injury: a cross-sectional study

2003 ◽  
Vol 95 (6) ◽  
pp. 2398-2407 ◽  
Author(s):  
Ann M. Spungen ◽  
Rodney H. Adkins ◽  
Charles A. Stewart ◽  
Jack Wang ◽  
Richard N. Pierson ◽  
...  
Keyword(s):  
Body Mass Index ◽  
Spinal Cord ◽  
Spinal Cord Injury ◽  
Body Composition ◽  
Body Mass ◽  
Lean Mass ◽  
The Body ◽  
Control Group ◽  
Cord Injury ◽  
Total Body

To determine the body composition differences across age, 133 men with chronic spinal cord injury (SCI) (66 with tetraplegia, 67 with paraplegia) were compared with an age-, height-, and ethnicity-matched able-bodied male reference population ( n = 100) using two different dual-energy X-ray absorptiometry densitometers. The effects of duration of injury, level, and completeness of lesion were analyzed in the SCI population. Independent of age, total body and regional lean mass were lower and fat mass was higher in persons with SCI compared with controls. The SCI group was 13 ± 1% (means ± SE) fatter per unit of body mass index (kg/m2) compared with the control group ( P < 0.0001). Advancing age was strongly associated with less lean mass and greater adiposity in those with SCI, whereas it was mildly related in the controls. Total body and regional arm and trunk, but not leg, lean tissues were lower in subjects with SCI, across all ages, than in the controls. In summary, persons with SCI were fatter for any body mass index and demonstrated significantly less lean and more adipose tissues for any given age compared with controls.

Progressive Sublesional Bone Loss Extends into the Second Decade After Spinal Cord Injury

2019 ◽  
Vol 22 (2) ◽  
pp. 185-194 ◽  
Author(s):  
Christopher M. Cirnigliaro ◽  
Mary Jane Myslinski ◽  
Pierre Asselin ◽  
Joshua C. Hobson ◽  
Adam Specht ◽  
...  
Keyword(s):  
Spinal Cord ◽  
Spinal Cord Injury ◽  
Bone Loss ◽  
Cord Injury

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

2021 ◽  
Vol 10 (17) ◽  
pp. 3911
Author(s):  
Peter Francis Raguindin ◽  
Alessandro Bertolo ◽  
Ramona Maria Zeh ◽  
Gion Fränkl ◽  
Oche Adam Itodo ◽  
...  
Keyword(s):  
Body Mass Index ◽  
Spinal Cord ◽  
Spinal Cord Injury ◽  
Body Composition ◽  
Body Mass ◽  
Weighted Mean Difference ◽  
Central Adiposity ◽  
Fat Percentage ◽  
Anthropometric Measures ◽  
Cord Injury

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.

scholarly journals Longitudinal changes in body composition and metabolic profile between exercise clinical trials in men with chronic spinal cord injury

2016 ◽  
Vol 39 (6) ◽  
pp. 699-712 ◽  
Author(s):  
Ashraf S. Gorgey ◽  
Heather Martin ◽  
Alyse Metz ◽  
Refka E. Khalil ◽  
David R. Dolbow ◽  
...  
Keyword(s):  
Spinal Cord ◽  
Spinal Cord Injury ◽  
Clinical Trials ◽  
Body Composition ◽  
Metabolic Profile ◽  
Chronic Spinal Cord Injury ◽  
Longitudinal Changes ◽  
Cord Injury

scholarly journals Effect of self-guided training for the HandbikeBattle on body composition in people with spinal cord injury

2018 ◽  
Vol 4 (1) ◽  
Author(s):  
Sonja de Groot ◽  
◽  
Ingrid Kouwijzer ◽  
Marjolein Baauw ◽  
Rogier Broeksteeg ◽  
...  
Keyword(s):  
Spinal Cord ◽  
Spinal Cord Injury ◽  
Body Composition ◽  
Cord Injury
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