Prospective Analysis of Lipid Profiles in Persons With a Spinal Cord Injury During and 1 Year After Inpatient Rehabilitation

Groot, Sonja de; Dallmeijer, Annet J.; Post, Marcel W M; Angenot, Edmond L.; Berg-Emons, Rita J G van den; Woude, Lucas H V van der

doi:10.1016/j.apmr.2007.11.023

Cited by 20 publications

(31 citation statements)

References 25 publications

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“…This result was in contrast to the percentage at risk of cardiovascular disease based on TC and LDL; these percentages increased during those 5 years. The percentages are much higher than when using the older cutoff values, used in our previous study, 4 for determining the risk of cardiovascular disease (for example, 17-22% of our present group would be at risk of HDL when using the old cutoff values). When analyzing these kind of data, it is important to look at the cutoff values that were applied.…”

Section: Discussioncontrasting

confidence: 65%

“…Although there was a positive change in lipid profiles during rehabilitation, the lipid profiles as well as the BMI showed unfavorable changes in the year after discharge from inpatient rehabilitation. 4,5 These results showed the importance of a followup measurement on a longer term after discharge from rehabilitation.…”

Section: Introductionmentioning

confidence: 79%

“…As far as known, only two studies have looked at the course of lipid profiles after SCI but on a shorter term, that is during about 2 years post injury. 4,17 During these 2 years, post-injury changes in lipid profiles were seen. Although a significant increase was found in LDL and TC in the first year after discharge, 4 these values showed a (non-signifcant) decrease between the 1st and 5th year after discharge.…”

Section: Discussionmentioning

confidence: 99%

“…4,17 During these 2 years, post-injury changes in lipid profiles were seen. Although a significant increase was found in LDL and TC in the first year after discharge, 4 these values showed a (non-signifcant) decrease between the 1st and 5th year after discharge. Although the BMI increased significantly after discharge and was significantly related to all lipid profiles, the increase in BMI was not accompanied by a Figure 1 Answers on the self-care questions at 1 year after discharge.…”

Section: Discussionmentioning

confidence: 99%

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Longitudinal association between lifestyle and coronary heart disease risk factors among individuals with spinal cord injury

et al. 2012

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Objective: To investigate: (1) the course of coronary heart disease risk factors (lipid profiles and body mass index (BMI)) in the first five years after discharge from inpatient spinal cord injury (SCI) rehabilitation and (2) the association between lifestyle (physical activity, self-care related to fitness, smoking, alcohol, body mass and low-fat diet) and coronary heart disease risk factors during that period. Design: Prospective cohort study. Participants/methods: Individuals with SCI (N ¼ 130). Total cholesterol (TC), high-density lipoprotein (HDL), low-density lipoprotein (LDL), triglycerides (TG) and BMI were determined at discharge from inpatient rehabilitation and 1 and 5 years after discharge. Using multilevel regression models, the effects of lifestyle (drinking alcohol, smoking, active lifestyle and self-care) on the lipid profiles and BMI were determined. Results: After correction for lesion and personal characteristics, no changes in lipid profiles in the five years after discharge were seen, whereas the BMI increased significantly with 1.8 kg m À2 . A high percentage was at risk of cardiovascular disease due to high BMI (63-75%) or HDL (66-95%). The individuals who indicated to maintain their fitness level as good as possible and the individuals with a low BMI showed better lipid profiles. Individuals with a more active lifestyle showed higher HDL levels. Individuals who avoid smoking showed a 1.5 kg m À2 higher BMI. Conclusion: Lipid profiles seem to stabilize in the years after discharge from inpatient SCI rehabilitation, whereas the BMI increased. Lifestyle factors associated with a favorable lipid profile and BMI could be identified.

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Section: Discussioncontrasting

confidence: 65%

Section: Introductionmentioning

confidence: 79%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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Longitudinal association between lifestyle and coronary heart disease risk factors among individuals with spinal cord injury

et al. 2012

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“…14 Some studies point out that patients undergoing physiotherapy have, during hospitalization, a better course with regard to levels of HDL cholesterol, which increased in these patients. 15 On the other hand long-term immobilization (longer than 15 years) lowers the levels of HDL cholesterol. 16 In our study, pain intensity did not differ between patients with different lesion levels or in patients who suffered a craniocerebral injury as a consequence of their accident.…”

Section: Discussionmentioning

confidence: 99%

Intensity of pain and biochemical changes in blood plasma in spinal cord trauma

2009

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Study design: Cross-sectional, observational and longitudinal. Objectives: The aim of the study was to analyze the relationship between pain intensity, plasma lipids and severity of spinal cord injuries in patients with paraplegia (n ¼ 11), tetraplegia (n ¼ 16) and polytrauma (n ¼ 15). We concentrated on the hospitalization period immediately following injury. Methods: Pain intensity was assessed on a visual analog scale immediately after patients were transported to hospital, again 14 days after injury and before discharge from hospital. Blood samples were also obtained at these same times. We measured following biochemical parameters: total protein, albumin, total cholesterol, HDL cholesterol, LDL cholesterol, triglycerides, glycemia, and C-reactive protein. Data were analyzed with respect to type of injury, state of unconsciousness immediately after injury, hemorrhage, measure of liability (self-inflicted injuries vs casualties), cause of the accident and pre-injury cholesterol levels. Results: On the day of injury, pain intensity correlated positively with HDL cholesterol (r ¼ 0.48, P ¼ 0.04); on the day of discharge from hospital, pain intensity correlated positively with blood glucose levels (r ¼ 0.67, P ¼ 0.0002). Diagnostic subgroups did not differ either in pain intensity or in pain dynamics during hospitalization. Total cholesterol level was lowest in patients with polytrauma. In all patients, the lowest total cholesterol level was observed immediately after injury. HDL cholesterol was highest after injury. Conclusion: After spinal cord injury, lower total cholesterol levels reflected more serious trauma intensity and HDL cholesterol predicted more intensive pain. Subjects responsible for their own injuries suffered less intensive pain than those who were not responsible for their injuries.

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Cardiometabolic risk profiling during spinal cord injury rehabilitation: A longitudinal analysis from the Swiss Spinal Cord Injury (SwiSCI) cohort

Raguindin

Stoyanov

Eriks‐Hoogland

et al. 2022

PM&R

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BACKGROUND Early screening is important in individuals with spinal cord injury (SCI) as they were deemed high-risk for cardiometabolic diseases. Few studies explored changes in cardiometabolic risk profile in the early phase of the injury. Thus, it remains unclear how early the cardiometabolic status deteriorates after injury. OBJECTIVE We determined the longitudinal changes in the cardiometabolic risk profile and examined the association between injury characteristics and cardiometabolic status in subacute SCI. SETTING Multicenter Swiss Spinal Cord Injury Cohort. PARTICIPANTS Adults with traumatic SCI without history of cardiovascular disease or type 2 diabetes. MAIN OUTCOME MEA-SURES Blood pressure (BP), lipid profile, fasting glucose, waist circumference (WC), weight, body mass index (BMI) and Framingham risk score (FRS) were compared across time and according to the injury characteristics. RESULTS We analyzed the data of 258 individuals with traumatic SCI (110 tetraplegia and 148 paraplegia, 122 motor complete and 136 incomplete). The median age was 50 years (IQR 32-60), with 76.36% (n=197) of the population being male. The median rehabilitation duration was 5.5 months (IQR 3.2-7.1). At admission to rehabilitation, fully-adjusted linear regression models showed higher baseline weight ( 0.06, 95% CI 0.005, 0.11), systolic BP ( 0.05, 95% CI 0.008, 0.09), diastolic BP ( 0.05 95% CI 0.004, 0.10), and triglycerides ( 0.27 95% CI 0.13, 0.42) in paraplegia than tetraplegia. Systolic BP, diastolic BP, HDL-C were higher in incomplete than complete injury. In our main analysis, we observed an increase in cholesterol and HDL-C and lipid ratio when comparing the beginning and end of rehabilitation. Individuals with paraplegia had a higher increase in BMI than tetraplegia, while no differences in other cardiometabolic risk factors were detected when comparing motor incomplete and complete injury. Trajectories of each participant showed that the majority of individuals with SCI decreased FRS score at follow-up compared to baseline and no significant changes in prevalence of cardiometabolic syndrome were observed. At discharge, one-third of study participants were classified as moderate to high risk of CVD, 64% were overweight, and 39.45% had cardiometabolic syndrome. CONCLUSION We observed a modest improvement in lipid profile and FRS during the first inpatient rehabilitation hospitalization. Injury characteristics, such as level and completeness, were not associated with changes in cardiometabolic risk factors in the subacute phase of the injury. Despite this, a significant proportion of study participants remained at risk of cardiometabolic disease at discharge, suggesting that early cardiometabolic preventive strategies may be initiated as early as during the first inpatient rehabilitation hospitalization.

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Prospective Analysis of Lipid Profiles in Persons With a Spinal Cord Injury During and 1 Year After Inpatient Rehabilitation

Cited by 20 publications

References 25 publications

Longitudinal association between lifestyle and coronary heart disease risk factors among individuals with spinal cord injury

Longitudinal association between lifestyle and coronary heart disease risk factors among individuals with spinal cord injury

Intensity of pain and biochemical changes in blood plasma in spinal cord trauma

Cardiometabolic risk profiling during spinal cord injury rehabilitation: A longitudinal analysis from the Swiss Spinal Cord Injury (SwiSCI) cohort

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