Elevated C-Reactive Protein Associated With Decreased High-Density Lipoprotein Cholesterol in Men With Spinal Cord Injury

Abstract 

Liang H, Mojtahedi MC, Chen D, Braunschweig CL. Elevated C-reactive protein associated with decreased high-density lipoprotein cholesterol in men with spinal cord injury.

Objectives

To determine if people with spinal cord injury (SCI) have elevated C-reactive protein (CRP), to examine the association of CRP with high-density lipoprotein cholesterol (HDL-C), and to assess the influence of completeness and level of injury on these parameters.

Design

Cross-sectional.

Setting

Urban university.

Participants

Men with SCI (n=129) who were free of infection and/or recent anti-inflammatory medication use as well as their 1:1 age- and race-matched able-bodied counterparts from the 1999–2002 National Health and Nutrition Examination Surveys.

Interventions

Not applicable.

Main Outcome Measures

High CRP was defined as 3mg/L or higher and low HDL-C as less than 1.04mmol/L.

Results

Men with SCI were more likely to have high CRP (odds ratio [OR]=2.29; 95% confidence interval [CI], 1.33–3.95) and low HDL-C (OR=1.81; 95% CI, 1.01–3.27). The OR for low HDL-C in SCI was no longer significant when high CRP was controlled. CRP was higher in complete versus incomplete injury (median, 3.7mg/L vs 1.2mg/L; P=.005), and this elevation was independent of age, smoking, physical activity, waist circumference, and weight. No conclusion can be made on the association of injury level and CRP because of a lack of power.

Conclusions

The elevated CRP, possibly the major risk factor, together with decreased HDL-C may contribute to greater incidence for cardiovascular disease in the SCI population.

Key Words: C-reactive protein, Cholesterol, HDL, Cross-sectional studies, Rehabilitation, Risk factors, Spinal cord injuries