Role of exercise on visceral adiposity after spinal cord injury: a cardiometabolic risk factor

Goldsmith, Jacob A.; Ennasr, Areej N.; Farkas, Gary J.; Gater, David R.; Gorgey, Ashraf S.

doi:10.1007/s00421-021-04688-3

Cited by 5 publications

(8 citation statements)

References 201 publications

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“…Recently, a lower muscle stiffness of the vastus lateralis muscle has been reported in persons with SCI compared to health controls, due to the infiltration of IMF [7]. The extensive loss in the contractile myofilaments forces the paralyzed muscle to downsize its metabolic demands by an extensive reduction in mitochondrial density and, subsequently, leading to a decreased basal metabolic rate [8], which has been shown to be a critical consequence to increasing the prevalence of obesity after SCI [9,10].…”

Section: Obesity Decreases Functional Mobilitymentioning

confidence: 99%

“…Van den Berg-Emons et al used an accelerometer to demonstrate that the physical activity level of community-dwelling individuals with SCI is only 40% of that of able-bodied individuals [18]. The increases in visceral and intramuscular adiposity have been linked to altered cardio-metabolic profiles in persons with SCI [10,19,20].…”

Section: Obesity Decreases Functional Mobilitymentioning

confidence: 99%

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Invasive and Non-Invasive Approaches of Electrical Stimulation to Improve Physical Functioning after Spinal Cord Injury

Dolbow

Gorgey

Sutor

et al. 2021

JCM

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This review of literature provides the latest evidence involving invasive and non-invasive uses of electrical stimulation therapies that assist in restoring functional abilities and the enhancement of quality of life in those with spinal cord injuries. The review includes neuromuscular electrical stimulation and functional electrical stimulation activities that promote improved body composition changes and increased muscular strength, which have been shown to improve abilities in activities of daily living. Recommendations for optimizing electrical stimulation parameters are also reported. Electrical stimulation is also used to enhance the skills of reaching, grasping, standing, and walking, among other activities of daily living. Additionally, we report on the use of invasive and non-invasive neuromodulation techniques targeting improved mobility, including standing, postural control, and assisted walking. We attempt to summarize the effects of epidural stimulation on cardiovascular performance and provide a mechanistic explanation to the current research findings. Future trends such as the combination of epidural stimulation and exoskeletal-assisted walking are also discussed.

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Section: Obesity Decreases Functional Mobilitymentioning

confidence: 99%

Section: Obesity Decreases Functional Mobilitymentioning

confidence: 99%

Invasive and Non-Invasive Approaches of Electrical Stimulation to Improve Physical Functioning after Spinal Cord Injury

Dolbow

Gorgey

Sutor

et al. 2021

JCM

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“…People with SCI classically show decreased lean body mass through muscle atrophy [ 9 , 14 ], impaired autonomic nervous system function [ 15 , 16 ], decreased physical activity capacity [ 17 ], and transformation of skeletal muscle from an oxidative to a glycolytic phenotype [ 18 ]. These adaptations have been linked to glucose intolerance and metabolic syndrome [ 19 , 20 ]. Outwardly, individuals with SCI may not appear to fit the body mass index (BMI) criteria used to classify people for obesity.…”

Section: Introductionmentioning

confidence: 99%

“…Therefore, we assessed VAT, rather than relying on BMI, to allow us to measure a characteristic of obesity that is independent of lean mass among people with and without SCI. Our primary hypothesis in this study is that people with SCI, who have lower VAT, may have better glucose tolerance than people without a central nervous system disorder who have higher VAT [ 14 , 20 , 23 , 24 , 25 ].…”

Section: Introductionmentioning

confidence: 99%

Impaired Glucose Tolerance and Visceral Adipose Tissue Thickness among Lean and Non-Lean People with and without Spinal Cord Injury

Kimball,

Petrie,

McCue

et al. 2023

JFMK

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After spinal cord injury (SCI), multiple adaptations occur that influence metabolic health and life quality. Prolonged sitting and inactivity predispose people with SCI to body composition changes, such as increased visceral adipose tissue (VAT) thickness, which is often associated with impaired glucose tolerance. Our goal is to understand whether VAT is an index of leanness, and, secondarily, whether mobility methods influence glucose tolerance for people living with SCI. A total of 15 people with SCI and 20 people without SCI had fasting oral glucose tolerance tests (OGTT) and VAT thickness (leanness) measured during a single session. Glucose was 51% and 67% greater for individuals with SCI relative to those without SCI after 60 and 120 min of an OGTT (p < 0.001). Glucose area under the curve (AUC) was 28%, 34%, and 60% higher for non-lean people with SCI than lean people with SCI and non-lean and lean people without SCI, respectively (p = 0.05, p = 0.009, p < 0.001). VAT was associated with glucose AUC (R2 = 0.23, p = 0.004). Taken together, these findings suggest that leanness, as estimated from VAT, may be an important consideration when developing rehabilitation programs to influence metabolism among people with SCI.

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“…In a follow-up trial, the same research group showed that a waist circumference of 86.5 cm distinguishes those at risk of developing cardiometabolic disorders in persons with SCI ( Gill et al, 2020 ). A recent review summarized potential mechanisms for increasing VAT to contribute to the prevalence of cardiometabolic diseases after SCI ( Goldsmith et al, 2021 ).…”

Section: Introductionmentioning

confidence: 99%

Visceral Adiposity, Inflammation, and Testosterone Predict Skeletal Muscle Mitochondrial Mass and Activity in Chronic Spinal Cord Injury

et al. 2022

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BackgroundMitochondrial health is an important predictor of several health-related comorbidities including obesity, type 2 diabetes mellitus, and cardiovascular disease. In persons with spinal cord injury (SCI), mitochondrial health has been linked to several important body composition and metabolic parameters. However, the complex interplay of how mitochondrial health is affected has yet to be determined in this population.ObjectiveIn this study, we examined the contribution of visceral adiposity, inflammatory biomarkers, testosterone and circulating serum growth factors as predictors of mitochondrial health in persons with chronic SCI.ParticipantsThirty-three individuals with chronic SCI (n = 27 Males, n = 6 Females, age: 40 ± 13.26 years, level of injury: C4-L1, BMI: 23 ± 5.57) participated in this cross-sectional study.MethodsVisceral adipose tissue (VAT) was measured via magnetic resonance imaging (MRI). After an overnight fast, serum testosterone, inflammatory biomarkers [interleukin 6 (IL-6), tumor necrosis factor alpha (TNF-α), c-reactive protein (CRP)], and anabolic growth factors [insulin-like growth factor 1 (IGF-1), insulin-like growth factor binding protein 3 (IGFBP-3)] were measured. Skeletal muscle biopsies were obtained from the vastus lateralis muscle to measure citrate synthase (CS) and Complex III activity. Regression analyses were used to examine predictors of mitochondrial mass and activity.ResultsCS activity was negatively associated with VAT (r2 = 0.360, p < 0.001), CRP (r2 = 0.168, p = 0.047), and positively associated with testosterone (r2 = 0.145, p = 0.042). Complex III activity was negatively associated with VAT relative to total lean mass (VAT:TLM) (r2 = 0.169, p = 0.033), trended for CRP (r2 = 0.142, p = 0.069), and positively associated with testosterone (r2 = 0.224, p = 0.010). Multiple regression showed CS activity was significantly associated with VAT + CRP (r2 = 0.412, p = 0.008) and VAT + Testosterone (r2 = 0.433, p = 0.001). Complex III activity was significantly associated with VAT relative to total trunk cross-sectional area (CSA) + CRP (VAT:total trunk CSA + CRP; r2 = 0.286, p = 0.048) and VAT + Testosterone (r2 = 0.277, p = 0.024).ConclusionIncreased visceral adiposity and associated inflammatory signaling (CRP) along with reduced testosterone levels predict mitochondrial dysfunction following SCI. Specifically, lower VATCSA and higher testosterone levels or lower VATCSA and lower CRP levels positively predict mitochondrial mass and enzyme activity in persons with chronic SCI. Future research should investigate the efficacy of diet, exercise, and potentially testosterone replacement therapy on enhancing mitochondrial health in chronic SCI.Clinical Trial Registration[www.ClinicalTrials.gov], identifier: [NCT02660073].

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Role of exercise on visceral adiposity after spinal cord injury: a cardiometabolic risk factor

Cited by 5 publications

References 201 publications

Invasive and Non-Invasive Approaches of Electrical Stimulation to Improve Physical Functioning after Spinal Cord Injury

Invasive and Non-Invasive Approaches of Electrical Stimulation to Improve Physical Functioning after Spinal Cord Injury

Impaired Glucose Tolerance and Visceral Adipose Tissue Thickness among Lean and Non-Lean People with and without Spinal Cord Injury

Visceral Adiposity, Inflammation, and Testosterone Predict Skeletal Muscle Mitochondrial Mass and Activity in Chronic Spinal Cord Injury

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