Gender Dimorphism in Central Adiposity May Explain Metabolic Dysfunction After Spinal Cord Injury

Abstract

IV.

Skeletal muscle hypertrophy and attenuation of cardio-metabolic risk factors (SHARC) using functional electrical stimulation-lower extremity cycling in persons with spinal cord injury: study protocol for a randomized clinical trial

“…These changes in body fat distribution occur in conjunction with excessive production of hepatic glucose in the absence of autonomic nervous system control after SCI in those with injuries above the fourth thoracic segment [59]. The increase in VAT is negatively related to high density lipoprotein cholesterol (HDL-C) and insulin resistance, with men being 1.8-2.6 times more susceptible to accumulation of VAT than women after SCI [60]. Several anthropometric and imaging measurements have been proposed to accurately quantify changes in muscle size and visceral adiposity [61,62].…”

Anthropometric Prediction of Visceral Adipose Tissue in Persons With Motor Complete Spinal Cord Injury

“…Recent studies clearly demonstrated that increase in VAT CSA [31,32] is tightly associated with cardiometabolic disorders after SCI, especially when VAT CSA exceeded 100 cm 2 . MRI and CT are considered the gold standard techniques in quantifying VAT; however, the existing hurdles (ie, cost, accessibility, and duration of the analysis and ionized radiation in CT) are prohibitive and preclude their use in clinical settings or in large epidemiologic studies [15].…”

“…MRI and CT are considered the gold standard techniques in quantifying VAT; however, the existing hurdles (ie, cost, accessibility, and duration of the analysis and ionized radiation in CT) are prohibitive and preclude their use in clinical settings or in large epidemiologic studies [15]. Advances in imaging technology have helped establishing the independent associations of VAT to cardiometabolic risk factors [30‐34], which is independent of other changes in body composition [5,17]. However, findings were primarily challenged by the small sample size, and therefore establishing a VAT prediction equation may allow enrollment of large sample sizes to decipher the exact mechanism by which VAT may influence an individual's cardiometabolic profile after SCI.…”

“…SAT relevance to cardiometabolic risk factors has been determined in a number of studies [8,21,32]. The findings have shown that SAT is less likely to influence cardiometabolic profile after SCI, and SAT may protect against the development of cardiometabolic disorders.…”

“…This is the first study to develop an anthropometric equation for the prediction of VAT CSA in persons with SCI . Factors such as level of injury, time since injury, ethnic background, and age have previously been shown to influence VAT accumulation [21,31‐34] and may have added heterogeneity to the current study group, thereby increasing the error within the predictive equation. Recruitment within the SCI population is an ongoing challenge and thus it is not uncommon to include participants with both tetraplegia and paraplegia.…”