Original research| Volume 99, ISSUE 8, P1561-1567.e1, August 2018

Download started.


Impact of Regular Physical Activity on Adipocytokines and Cardiovascular Characteristics in Spinal Cord–Injured Subjects

Published:March 13, 2018DOI:



      To investigate the relationship of carotid artery intima-media thickness (IMT) and cardiac structure and function with adipocytokines in sedentary (S-SCI) and physically active (PA-SCI) subjects with spinal cord injury (SCI).


      Cross-sectional observational study.


      Academic medical center.


      Men with chronic (>1y) SCI (N=41; 16 S-SCI, 25 PA-SCI) were evaluated. S-SCI subjects did not perform labor that required physical effort, recreational physical activity, or sports, while PA-SCI subjects included competing athletes who were regularly performing adapted sports.


      Not applicable.

      Main Outcome Measures

      Clinical, laboratory, carotid ultrasonography, and echocardiography analysis. Plasma leptin, adiponectin, and plasminogen activating inhibitor-1 (PAI-1) levels were determined.


      PA-SCI subjects had similar levels of adipocytokines, but lower carotid IMT and carotid IMT/diameter, and better left ventricular diastolic function than S-SCI participants. Bivariate analysis showed that adiponectin was inversely correlated with triglycerides (r=–.85, P<.001), low-density lipoprotein cholesterol (r=–.57, P<.05), and carotid IMT/diameter (r=–.56, P<.05) in S-SCI but not in PA-SCI participants. Additionally, the leptin-adiponectin ratio showed a direct correlation with triglycerides (r=.84, P<.001) and low-density lipoprotein cholesterol (r=.53, P<.05) in S-SCI but not in PA-SCI individuals. By contrast, the studied adipocytokines did not correlate with cardiac structure and function in PA-SCI and S-SCI participants.


      Lower adiponectin levels and higher leptin-adiponectin ratio are related to adverse vascular and/or metabolic characteristics in individuals with SCI. This relationship, however, appears to be mitigated by regular physical activity.


      List of abbreviations:

      BMI (body mass index), E/Em (peak early velocity/peak longitudinal initial diastolic velocity ratio), Em (peak longitudinal initial diastolic velocity), IMT (intima-media thickness), LV (left ventricular), PAI-1 (plasminogen activating inhibitor-1), PA-SCI (physically active subjects with spinal cord injury), SCI (spinal cord injury), S-SCI (sedentary subjects with spinal cord injury)
      To read this article in full you will need to make a payment

      Purchase one-time access:

      Academic & Personal: 24 hour online accessCorporate R&D Professionals: 24 hour online access
      One-time access price info
      • For academic or personal research use, select 'Academic and Personal'
      • For corporate R&D use, select 'Corporate R&D Professionals'


      Subscribe to Archives of Physical Medicine and Rehabilitation
      Already a print subscriber? Claim online access
      Already an online subscriber? Sign in
      Institutional Access: Sign in to ScienceDirect


        • Matos-Souza J.R.
        • Pithon K.R.
        • Ozahata T.M.
        • Gemignani T.
        • Cliquet Jr., A.
        • Nadruz Jr., W.
        Carotid intima-media thickness is increased in patients with spinal cord injury independent of traditional cardiovascular risk factors.
        Atherosclerosis. 2009; 202: 29-31
        • Matos-Souza J.R.
        • Pithon K.R.
        • Oliveira R.T.
        • et al.
        Altered left ventricular diastolic function in spinal cord injury subjects.
        Spinal Cord. 2011; 49: 65-69
        • Cragg J.J.
        • Noonan V.K.
        • Krassioukov A.
        • Borisoff J.
        Cardiovascular disease and spinal cord injury: results from a national population health survey.
        Neurology. 2013; 81: 723-728
        • Driussi C.
        • Ius A.
        • Bizzarini E.
        • et al.
        Structural and functional left ventricular impairment in subjects with chronic spinal cord injury and no overt cardiovascular disease.
        J Spinal Cord Med. 2014; 37: 85-92
        • Su T.W.
        • Chou T.Y.
        • Jou H.J.
        • et al.
        Peripheral arterial disease and spinal cord injury: a retrospective nationwide cohort study.
        Medicine. 2015; 94e1655
        • Matos-Souza J.R.
        • Silva A.A.
        • Campos L.F.
        • et al.
        Physical activity is associated with improved subclinical atherosclerosis in spinal cord injury subjects independent of variation in traditional risk factors.
        Int J Cardiol. 2013; 167: 592-593
        • De Rossi G.
        • Matos-Souza J.R.
        • Costa e Silva A.D.
        • et al.
        Physical activity and improved diastolic function in spinal cord-injured subjects.
        Med Sci Sports Exerc. 2014; 46: 887-892
        • Matos-Souza J.R.
        • de Rossi G.
        • Costa e Silva A.A.
        • et al.
        Impact of adapted sports activities on the progression of carotid atherosclerosis in subjects with spinal cord injury.
        Arch Phys Med Rehabil. 2016; 97: 1034-1037
        • Currie K.D.
        • West C.R.
        • Stöhr E.J.
        • Krassioukov A.V.
        Left ventricular mechanics in untrained and trained males with tetraplegia.
        J Neurotrauma. 2017; 34: 591-598
        • Gorgey A.S.
        • Dolbow D.R.
        • Dolbow J.D.
        • Khalil R.K.
        • Castillo C.
        • Gater D.R.
        Effects of spinal cord injury on body composition and metabolic profile—part I.
        J Spinal Cord Med. 2014; 37: 693-702
        • Liberale L.
        • Bonaventura A.
        • Vecchiè A.
        • et al.
        The role of adipocytokines in coronary atherosclerosis.
        Curr Atheroscler Rep. 2017; 19: 10
        • Fontes-Carvalho R.
        • Pimenta J.
        • Bettencourt P.
        • Leite-Moreira A.
        • Azevedo A.
        Association between plasma leptin and adiponectin levels and diastolic function in the general population.
        Expert Opin Ther Targets. 2015; 19: 1283-1291
        • Francisco C.
        • Neves J.S.
        • Falcão-Pires I.
        • Leite-Moreira A.
        Can adiponectin help us to target diastolic dysfunction?.
        Cardiovasc Drugs Ther. 2016; 30: 635-644
        • Martin Ginis K.A.
        • Jörgensen S.
        • Stapleton J.
        Exercise and sport for persons with spinal cord injury.
        PM R. 2012; 4: 894-900
        • Gorla J.I.
        • Costa e Silva A.A.
        • Borges M.
        • et al.
        Impact of wheelchair rugby on body composition of subjects with tetraplegia: a pilot study.
        Arch Phys Med Rehabil. 2016; 97: 92-96
        • Koury J.C.
        • Passos M.C.
        • Figueiredo F.A.
        • Chain A.
        • Franco J.G.
        Time of physical exercise practice after injury in cervical spinal cord-injured men is related to the increase in insulin sensitivity.
        Spinal Cord. 2013; 51: 116-119
        • Rosety-Rodriguez M.
        • Camacho A.
        • Rosety I.
        • et al.
        Low-grade systemic inflammation and leptin levels were improved by arm cranking exercise in adults with chronic spinal cord injury.
        Arch Phys Med Rehabil. 2014; 95: 297-302
        • Cipolli J.A.
        • Ferreira-Sae M.C.
        • Martins R.P.
        • et al.
        Relationship between serum uric acid and internal carotid resistive index in hypertensive women: a cross-sectional study.
        BMC Cardiovasc Disord. 2012; 12: 52
        • Sales M.L.
        • Ferreira M.C.
        • Leme Jr., C.A.
        • et al.
        Non-effect of p22-phox -930A/G polymorphism on end-organ damage in Brazilian hypertensive patients.
        J Hum Hypertens. 2007; 21: 504-506
        • Sales M.L.
        • Schreiber R.
        • Ferreira-Sae M.C.
        • et al.
        Toll-like receptor 6 Ser249Pro polymorphism is associated with lower left ventricular wall thickness and inflammatory response in hypertensive women.
        Am J Hypertens. 2010; 23: 649-654
        • Paim L.R.
        • Schreiber R.
        • Matos-Souza J.R.
        • et al.
        Oxidized low-density lipoprotein, matrix-metalloproteinase-8 and carotid atherosclerosis in spinal cord injured subjects.
        Atherosclerosis. 2013; 231: 341-345
        • Bellinazzi V.R.
        • Cipolli J.A.
        • Pimenta M.V.
        • et al.
        Carotid flow velocity/diameter ratio is a predictor of cardiovascular events in hypertensive patients.
        J Hypertens. 2015; 33: 2054-2060
        • Lang R.M.
        • Bierig M.
        • Devereux R.B.
        • et al.
        Recommendations for chamber quantification.
        Eur J Echocardiogr. 2006; 7: 79-108
        • Gasbarrino K.
        • Gorgui J.
        • Nauche B.
        • Côté R.
        • Daskalopoulou S.S.
        Circulating adiponectin and carotid intima-media thickness: a systematic review and meta-analysis.
        Metabolism. 2016; 65: 968-986
        • Maruyama Y.
        • Mizuguchi M.
        • Yaginuma T.
        • et al.
        Serum leptin, abdominal obesity and the metabolic syndrome in individuals with chronic spinal cord injury.
        Spinal Cord. 2008; 46: 494-499
        • Lee D.C.
        • Park I.
        • Jun T.W.
        • et al.
        Physical activity and body mass index and their associations with the development of type 2 diabetes in Korean men.
        Am J Epidemiol. 2012; 176: 43-51
        • Power C.
        • Pinto Pereira S.M.
        • Law C.
        • Ki M.
        Obesity and risk factors for cardiovascular disease and type 2 diabetes: investigating the role of physical activity and sedentary behaviour in mid-life in the 1958 British cohort.
        Atherosclerosis. 2014; 233: 363-369
        • Norata G.D.
        • Raselli S.
        • Grigore L.
        • et al.
        Leptin:adiponectin ratio is an independent predictor of intima media thickness of the common carotid artery.
        Stroke. 2007; 38: 2844-2846
        • Kappelle P.J.
        • Dullaart R.P.
        • van Beek A.P.
        • Hillege H.L.
        • Wolffenbuttel B.H.
        The plasma leptin/adiponectin ratio predicts first cardiovascular event in men: a prospective nested case-control study.
        Eur J Intern Med. 2012; 23: 755-759
        • Sabour H.
        • Norouzi Javidan A.
        • Latifi S.
        • et al.
        Relationship between leptin and adiponectin concentrations in plasma and femoral and spinal bone mineral density in spinal cord-injured individuals.
        Spine J. 2015; 15: 1-9
        • Latifi S.
        • Koushki D.
        • Norouzi Javidan A.
        • Matin M.
        • Sabour H.
        Changes of leptin concentration in plasma in patients with spinal cord injury: a meta-analysis.
        Spinal Cord. 2013; 51: 728-731
        • Astorino T.A.
        • Harness E.T.
        • Witzke K.A.
        Chronic activity-based therapy does not improve body composition, insulin-like growth factor-I, adiponectin, or myostatin in persons with spinal cord injury.
        J Spinal Cord Med. 2015; 38: 615-625
        • Totosy de Zepetnek J.O.
        • Pelletier C.A.
        • Hicks A.L.
        • MacDonald M.J.
        Following the physical activity guidelines for adults with spinal cord injury for 16 weeks does not improve vascular health: a randomized controlled trial.
        Arch Phys Med Rehabil. 2015; 96: 1566-1575
        • de Groot S.
        • Post M.W.
        • Postma K.
        • Sluis T.A.
        • van der Woude L.H.
        Prospective analysis of body mass index during and up to 5 years after discharge from inpatient spinal cord injury rehabilitation.
        J Rehabil Med. 2010; 42: 922-928