ODP140 Association of Body Composition with Cardiometabolic Risk Factors, Insulin Resistance, and Inflammation in Spinal Cord Injury
Authors: Barve Shirish , Zin Myet Mon , Nicholas Dietz , Enrico Rejc , Denghzi Wang , Gobijeshvili Leila , Boakye Maxwell , Mokshagundam Sri Prakash 
Published: November 2022

Abstract

Background
In the United States there are an estimated 296,000 individuals with spinal cord injury (SCI). With increasing survival after acute injury, cardiovascular disease (CVD) has emerged as a major cause of mortality and morbidity in these individuals. Changes in body composition, dyslipidemia, glucose intolerance, systemic inflammation, and autonomic dysregulation have all been reported as potential causes of higher CVD risk in SCI. However, the factors that lead to these changes and mechanisms by which they increase CVD risk remains unclear. Understanding these would be critical to developing effective strategies to reduce CVD in SCI. In this study, we evaluated the association of body composition with cardiometabolic risk factors including dyslipidemia, glucose intolerance, insulin resistance, and systemic inflammation.

Subjects and Methods
Sixty two individuals (69% male, 21% female) with chronic spinal cord injury (mean duration 7.4 +/- 5.8 years) were recruited for the study. Individuals had review of history and complete physical exam. Body composition was measured by DEXA scan. Blood was drawn for measurement of metabolic profile, lipids, hsCRP, and an array of inflammatory cytokines. A subset of 38 individuals had oral glucose tolerance test among whom 27 had insulin resistance assessed by HOMA-IR and the Matsuda Index. Pearson correlation was used to assess the correlation between different parameters.

Results
The mean age of the population was 34.4+/- 12.1 years. The mean BMI was 23.8 +/- 5 with 64% having BMI &lt; 25 and 11% &gt; 30. Low HDL was noted in 47% and high TG in 22% of individuals. High fasting glucose was noted in 15% and high 2 Hour glucose in 32% of individuals. HOMA IR was &gt; 2 in 37% and Matsuda Index &lt; 4.3 in 59% of individuals. Several measures of body fat were significantly correlated (p &lt; 0. 05) with cardiometabolic risk factors. Total and percent truncal fat correlated positively (p &lt; 0. 05) with serum triglycerides, non-HDL cholesterol, hsCRP, glucose at 30, 60, and 120 minutes during OGTT, and HOMA IR. Total and percent truncal fat correlated negatively (p &lt; 0. 05) with HDL cholesterol and Matsuda Index. On the other hand, IL 8, macrophage inflammatory protein 1b, and monocyte chemoattractant protein-1 correlated positively with total and truncal lean mass.

Conclusions
Cardiometabolic risk factors were highly prevalent in this group of young individuals with chronic SCI. Despite a relatively normal BMI, total and truncal fat appear to be a major factors associated with these abnormalities. The pathways leading to this association are still unclear. The association of lean mass with certain cytokines need further exploration. The impact of interventions such as diet, exercises aimed at changing body composition, epidural stimulation, and use of probiotics are among interventions that are being studied.
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