TY  - BOOK
AU  - Groah, Suzanne L
AU  - Ljungberg, Inger H
AU  - Tinsley, Emily A
TI  - Cardiometabolic Syndrome in People With Spinal Cord Injury/Disease: Guideline-Derived and Nonguideline Risk Components in a Pooled Sample
SN  - 0003-9993
PY  - 2016///
KW  - *Metabolic Syndrome X/ep [Epidemiology]
KW  - *Spinal Cord Diseases/ep [Epidemiology]
KW  - *Spinal Cord Injuries/ep [Epidemiology]
KW  - Adolescent
KW  - Adult
KW  - Aged
KW  - Blood Pressure
KW  - Body Weight
KW  - Cross-Sectional Studies
KW  - Female
KW  - Hemoglobin A, Glycosylated
KW  - Humans
KW  - Inflammation Mediators/bl [Blood]
KW  - Insulin Resistance
KW  - Lipids/bl [Blood]
KW  - Male
KW  - Middle Aged
KW  - Practice Guidelines as Topic
KW  - Risk Factors
KW  - Spinal Cord Injuries/cl [Classification]
KW  - Trauma Severity Indices
KW  - Young Adult
KW  - MedStar National Rehabilitation Network
KW  - MedStar Washington Hospital Center
KW  - Physical Medicine and Rehabilitation
KW  - Journal Article
N1  - Available online from MWHC library: 2000 - present, Available in print through MWHC library:1999-2007
N2  - CONCLUSIONS: As expected, guideline-derived CMS risk factors were prevalent in individuals with SCI/D. Overweight/obesity, hypertension, and elevated CRP were common in SCI/D and, because they may compound risks associated with CMS, should be considered population-specific risk determinants. Heightened surveillance for risk, and adoption of healthy living recommendations specifically directed toward weight reduction, hypertension management, and inflammation control, should be incorporated as a priority for disease prevention and management; Copyright � 2016 American Congress of Rehabilitation Medicine. Published by Elsevier Inc. All rights reserved; DESIGN: Cross-sectional analysis of a pooled sample; INTERVENTIONS: Not applicable; MAIN OUTCOME MEASURES: We computed the prevalence of CMS using the American Heart Association/National Heart, Lung, and Blood Institute guideline (CMS diagnosis as sum of risks >3 method) for the following risk components: overweight/obesity, insulin resistance, hypertension, and dyslipidemia. We compared this prevalence with the risk calculated from 2 routinely used nonguideline CMS risk assessments: (1) key cut scores identifying insulin resistance derived from the homeostatic model 2 (HOMA2) method or quantitative insulin sensitivity check index (QUICKI), and (2) a cardioendocrine risk ratio based on an inflammation (C-reactive protein [CRP])-adjusted total cholesterol/high-density lipoprotein cholesterol ratio; OBJECTIVE: To assess cardiometabolic syndrome (CMS) risk definitions in spinal cord injury/disease (SCI/D); PARTICIPANTS: Baseline data from subjects in 7 clinical studies were pooled; not all variables were collected in all studies; therefore, participant numbers varied from 119 to 389. The pooled sample included men (79%) and women (21%) with SCI/D >1 year at spinal cord levels spanning C3-T2 (American Spinal Injury Association Impairment Scale [AIS] grades A-D); RESULTS: After adjustment for multiple comparisons, injury level and AIS grade were unrelated to CMS or risk factors. Of the participants, 13% and 32.1% had CMS when using the sum of risks or HOMA2/QUICKI model, respectively. Overweight/obesity and (pre)hypertension were highly prevalent (83% and 62.1%, respectively), with risk for overweight/obesity being significantly associated with CMS diagnosis (sum of risks, chi(2)=10.105; adjusted P=.008). Insulin resistance was significantly associated with CMS when using the HOMA2/QUICKI model (chi(2)2=21.23, adjusted P<.001). Of the subjects, 76.4% were at moderate to high risk from elevated CRP, which was significantly associated with CMS determination (both methods; sum of risks, chi(2)2=10.198; adjusted P=.048 and HOMA2/QUICKI, chi(2)2=10.532; adjusted P=.04); SETTING: Two SCI/D academic medical and rehabilitation centers
UR  - https://dx.doi.org/10.1016/j.apmr.2016.07.002
ER  -