ArticleHealthy body mass index values often underestimate body fat in men with spinal cord injury1☆,
Section snippets
Methods
Twenty men with SCI (age range, 16–52y) and 20 age-, height- and weight-matched able-bodied male controls participated in this study, which was approved by the Health Funding Authority, Otago and Canterbury Ethics Committees. Participants with SCI were recruited through the Burwood Spinal Unit, whereas the controls were recruited via advertisement. None of our subjects were amputees, and none of participants with SCI had heterotopic ossification or orthopedic pins in scan regions of interest.
Results
The results from 19 SCI participants and 19 controls were used in the statistical analyses. One of the 20 participants with SCI originally enrolled in our sample (a tetraplegic patient with an incomplete [ASIA class D] spinal cord lesion) was excluded because he was under 18 years of age and thus was outside of the age range for the WHO criteria for the BMI values used in this study. His matched control was also excluded from the final analysis. It is known that BMI values of healthy subjects
Discussion
Obesity is a major contributing factor in the development of both coronary heart disease and type II diabetes mellitus. BMI generally correlates well with adiposity,41 and body mass indices between 19 and 26kg/m2 show a linear correlation with body fat in healthy able-bodied men.42 The association between excessive adiposity with heart disease and type II diabetes has led to the widespread use of BMI as a simple, cost-effective measure of adiposity. Epidemiologic studies18, 19 favor use of BMI
Conclusion
We found substantially greater adiposity for similar healthy BMI values in a group of men with SCI who do not appear obese, compared with able-bodied men of similar age, height, and weight. A major purpose of this study was to raise awareness among health professionals that a healthy BMI may mask excessive adiposity in people with SCI. The sample in this study was limited in size, thus we suggest that further large-scale studies attempt to identify BMI cutoff values that may characterize
Acknowledgements
We acknowledge Brian Niven, Department of Mathematics and Statistics, University of Otago, for his assistance with our statistical analyses.
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2020, Experimental NeurologyCitation Excerpt :Other studies have described post-SCI disruption of glucose metabolism in rats and adipokine production in people, both of which can contribute to elevated cardiovascular disease in the SCI population (Farkas and Gater, 2018; Gaudet et al., 2019). Clinical studies suggest that two-thirds of individuals with chronic SCI have a greater degree of adiposity for any given BMI value, thus characterizing them as overweight or obese more frequently than the general population (Gorgey and Gater, 2011; Gupta et al., 2006; Jones et al., 2003; Spungen et al., 2003; Weaver et al., 2007). Additionally, 76% of people with SCI have dyslipidemia, while 50% of paraplegics and 62% of tetraplegics exhibit impaired glucose tolerance (Bauman and Spungen, 1994; Cragg et al., 2012; Manns et al., 2005; Nelson et al., 2007; Vichiansiri et al., 2012).
Correlates of metabolic syndrome in people with chronic spinal cord injury
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Supported by the Lamar Trust and Group Bone Health, Dunedin, NZ.
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