Lowering body mass index cutoffs better identifies obese persons with spinal cord injury

Laughton, G E; Buchholz, Annick; Ginis, Kathleen A. Martin; Goy, Richard

doi:10.1038/sc.2009.33

Cited by 191 publications

(168 citation statements)

References 17 publications

(17 reference statements)

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“…Visceral fat area and spinal cord injury T Inayama et al able-bodied individuals often underestimate obesity in individuals with SCI. 16,17,28 Laughton et al 28 reported that BMI values 422 kg m − 2 should be considered a high risk for obesity and obesity-related chronic diseases for individuals with chronic SCI. Buchholz and Bugaresti 13 noted that BMI has low sensitivity as an indicator of obesity in individuals with SCI and recommended that SCI-specific BMI classifications be determined.…”

Section: Discussionmentioning

confidence: 99%

Associations between abdominal visceral fat and surrogate measures of obesity in Japanese men with spinal cord injury

et al. 2014

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Study design: Cross-sectional study. Objectives: There are ethnic differences in the distribution of abdominal obesity associated with metabolic disorders. In Japan, the appropriate reference values for abdominal obesity have not been established in individuals with spinal cord injury (SCI), although there are a number of studies in Western countries. This study evaluates the associations between visceral fat area (VFA), waist circumference (WC) and body mass index (BMI), to examine cutoffs and estimate the error for WC and BMI equivalent to 100 cm 2 VFA in Japanese men with SCI. Setting: National Rehabilitation Center for Persons with Disabilities, Japan. Methods: Seventy-four men (aged 45.6 (s.d. 14.3) years) participated in the study. VFA was quantified using computed tomography at the level of the umbilicus, and associations were determined using nonlinear regression analysis. The error of the estimates from the regression equation was assessed using a Bland-Altman plot. Results: The mean VFA was 101.2 (s.d. 53.0) cm 2 and 32 subjects had a VFA ⩾ 100 cm 2 . The cutoffs for a VFA of 100 cm 2 were WC, 81.3 cm and BMI, 22.5 kg m − 2 . The relationship between the estimated and actual values showed that the error increased as VFA increased, which resulted in a negative proportional bias. Conclusion: The suggested cutoff for Japanese men with SCI is a VFA of 100 cm 2 , which is lower than that in the healthy able-bodied population for both WC and BMI. Further investigation is needed to determine the reference value for estimating SCI-specific VF accumulation. Spinal Cord (2014) 52, 836-841; doi:10.1038/sc.2014.162; published online 30 September 2014 INTRODUCTIONWheelchair users because of spinal cord injury (SCI) have a higher risk of metabolic disorders than do those who do not require a wheelchair because of a lower level of physical activity and adverse body compositional changes. 1 Many people with SCI participate socially (for example, study and work) while leading an unassisted home life. Early risk assessment for metabolic disorders can help to maintain and enhance health in community-dwelling individuals with SCI. Caring for SCI individuals' health in their homes requires the development of indicators to easily assess the risk of metabolic disorders.People with metabolic disorders have an elevated risk of developing arteriosclerotic disease. 2 The risk factors include elevated blood pressure, dyslipidaemia (elevated triglycerides and low high-density lipoprotein cholesterol), high fasting glucose and abdominal obesity. Abdominal obesity is a major risk factor for metabolic syndrome and is characterized by an accumulation of visceral fat (VF) in the abdominal cavity. 3,4 Waist circumference (WC) is used as a surrogate measure of abdominal obesity. There are several recommended cutoffs for WC to estimate abdominal obesity in people of European origin (Europids): ⩾ 94 cm in men and ⩾ 80 cm in women (International Diabetes Federation, World Health Organization); ⩾ 102 cm in men and

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Section: Discussionmentioning

confidence: 99%

Associations between abdominal visceral fat and surrogate measures of obesity in Japanese men with spinal cord injury

et al. 2014

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“…19 In fact, recent recommendations are to consider people with chronic SCI and BMI values >22 kg/m 2 as being at high risk for obesity and obesity-related chronic diseases. 22 Growing evidence supports the contention that excess adiposity, especially abdominal adiposity, is the driver of the metabolic syndrome due to its secretion of proinflammatory cytokines, hypertensive agents and nonesterified free fatty acids that contribute to hypertension, dyslipidemia, insulin resistance and atherosclerosis. 5,6 Appropriate characterization of obesity and body composition changes in SCI is essential for ongoing evaluation of the metabolic syndrome.…”

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confidence: 99%

Weight after SCI: the good, the bad and the ugly

Gater

2017

The Journal of Spinal Cord Medicine

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“…Table 2 presents anthropometric and biochemical data of the patients [2124]. According to Laughton et al [21], since a BMI score of >22 is overweight and >25 is obese, 62.96 (n = 102) and 32.71 (n = 53) percent of the patients in this study were classified as overweight and obese, respectively. Table 3 compares mean ± standard deviation for cardiometabolic risk factors in tetraplegic and paraplegic and complete and incomplete groups.…”

Section: Resultsmentioning

confidence: 99%

Cardiometabolic risk factors in Iranians with spinal cord injury: Analysis by injury-related variables

Sabour

Javidan²,

Ranjbarnovin³

et al. 2013

JRRD

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Abstract-Persons with spinal cord injury (SCI) have a high prevalence of abnormalities in carbohydrate and lipid metabolism. These abnormalities cause adverse coronary heart disease (CHD) in patients with SCI. In this study, we performed a detailed analysis of the level-specific cardiometabolic risk factors in individuals with SCI and analyzed the association of injury level on these risk factors. This was a cross-sectional study of 162 patients with SCI, assessing the prevalence of diabetes mellitus, dyslipidemia, hypertension, obesity, and smoking. Fasting blood sugar (>100) was diagnosed in 27 patients (16.7%). Of the total patients, 36 (22.2%) had a total cholesterol (TC) level of >200. A triglyceride level of >150 was present in 56 patients (34.6%). Hypertension was present in 2.5% of the entire patient group. Body mass index (BMI), TC, and low-density lipoprotein cholesterol (LDL-C) were significantly higher in the paraplegia group than the tetraplegia group (24.44 +/-4.23 vs 22.65 +/-4.27, p = 0. 01; 185.71 +/-40.69 vs 163.28 +/-37.92, p < 0.001; and 102.51 +/-28.20 vs 89.15 +/-22.35, p = 0.01, respectively). Patients with paraplegia may have increased hypertension, higher BMI, and increasing levels of serum LDL-C and TC than those with tetraplegia. Conventional risk factors for CHD should be identified and treated in individuals with SCI.

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Lowering body mass index cutoffs better identifies obese persons with spinal cord injury

Cited by 191 publications

References 17 publications

Associations between abdominal visceral fat and surrogate measures of obesity in Japanese men with spinal cord injury

Associations between abdominal visceral fat and surrogate measures of obesity in Japanese men with spinal cord injury

Weight after SCI: the good, the bad and the ugly

Cardiometabolic risk factors in Iranians with spinal cord injury: Analysis by injury-related variables

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