Abstract
Objective
To investigate the differences in glucose metabolism among women with paraplegic,
and tetraplegic spinal cord injury (SCI) in comparison to their able-bodied (AB) counterparts
after adjusting for differences in body composition.
Design
Cross-sectional study. After an overnight fast, each participant consumed a 75-g glucose
solution for oral glucose tolerance test (OGTT). Blood glucose, insulin, and C-peptide
concentrations were analyzed before and 30, 60, 90, and 120 minutes after ingesting
glucose solution. Insulin sensitivity index (ISI) was estimated using the Matsuda
index. Percentage fat mass (%FM) and total body lean mass (TBLM) were estimated using
data from dual-energy x-ray absorptiometry. Visceral fat (VF) was quantified using
computed tomography. Outcome measures were compared among groups using analysis of
covariance with %FM (or VF) and TBLM as covariates.
Setting
Research university.
Participants
Women (N=42) with SCI (tetraplegia: n=8; paraplegia: n=14) and their race-, body mass
index-, and age-matched AB counterparts (n=20).
Interventions
Not applicable.
Results
At fasting, there was no difference in glucose homeostasis (glucose, insulin, C-peptide
concentrations) among 3 groups of women. In contrast, glucose, insulin, and C-peptide
concentrations at minute 120 during OGTT were higher in women with tetraplegia versus
women with paraplegia and AB women (P<.05, adjusted for TBLM and %FM). In addition, women with tetraplegia had lower ISI
(P<.05, adjusted for TBLM and %FM) versus AB women. These differences remained after
adjusting for VF and TBLM.
Conclusion
Our study confirms that impaired glucose metabolism among women with tetraplegia may
not be fully explained by changes in their body composition. Future studies exploring
additional factors involved in glucose metabolism are warranted.
Keywords
List of abbreviations:
AB (able-bodied), ANCOVA (analysis of covariance), BMI (body mass index), CT (computed tomography), DXA (dual-energy x-ray absorptiometry), FM (fat mass), IMF (intramuscular fat), ISI (insulin sensitivity index), OGTT (oral glucose tolerance test), SCI (spinal cord injury), TBLM (total body lean mass), TBLMI (total body lean mass index), UAB (University of Alabama at Birmingham), VF (visceral fat), Wt (weight)To read this article in full you will need to make a payment
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Article info
Publication history
Published online: October 11, 2018
Footnotes
Supported by the National Institutes of Health (NIH) under grant nos. K12 HD001402/HD/NICHD NIH (Chen) and M01 RR000032/RR/NCRR NIH (Chen), NIDLRR – DHHS—Administration for Community Living Sponsor award no. 02-90SI501901, and the University of Alabama at Birmingham Spinal Cord Injury Model System (McLain).
Disclosures: Yuying Chen reports grants from NIH during the conduct of the study; Amie McLain reports personal fees from New Jersey Commission on Spinal Cord Research and from CSRA 2016 spinal cord injury research program peer review meeting, outside the submitted work.
Identification
Copyright
© 2018 Published by Elsevier Inc. on behalf of the American Congress of Rehabilitation Medicine
