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脊髓损伤患者下肢严重痉挛与肥胖程度降低及空腹血糖水平较低有关。

Severe spasticity in lower extremities is associated with reduced adiposity and lower fasting plasma glucose level in persons with spinal cord injury.

作者信息

Jung I-Y, Kim H-R, Chun S M, Leigh J-H, Shin H-I

机构信息

Department of Rehabilitation Medicine, Seoul National University College of Medicine, Seoul, South Korea.

Department of Rehabilitation Medicine, National Rehabilitation Center, Seoul, South Korea.

出版信息

Spinal Cord. 2017 Apr;55(4):378-382. doi: 10.1038/sc.2016.132. Epub 2016 Sep 13.

Abstract

STUDY DESIGN

Cross-sectional study.

OBJECTIVES

To investigate the effects of severe lower extremity spasticity on anthropometric dimensions, body composition and metabolic profiles in persons with chronic motor complete spinal cord injury (SCI).

SETTING

Outpatient clinic.

METHODS

Fifty-five of the 61 participants were divided into two groups (no or mild spasticity group, 28; severe spasticity group, 27) based on the assessment of the extensor muscle spasticity according to the modified Ashworth scale. Anthropometric dimensions (waist circumference (WC), waist-to-height ratio (WtHR)), body composition (fat mass (FM), body fat percentage (BFP), fat-free mass (FFM), fat-free mass percentage (FFMP), bone mineral density (BMD)) and metabolic profiles (leptin, total cholesterol, low-density lipoprotein (LDL), high-density lipoprotein (HDL), triglyceride (TG), fasting plasma glucose (FPG) and glycosylated hemoglobin (HbA1c)) were compared between the two groups with different degree of spasticity.

RESULTS

Spasticity of the extensor muscle group negatively correlated with BFP (r=-0.458, P<0.001). Patients with severe spasticity showed a lower WC and WtHR than those in the no or mild spasticity group (P=0.038, P=0.006, respectively). The FM, BFP, leptin and FPG of the severe spasticity group were significantly lower than those of the patients in the no or mild spasticity group (P=0.003, P<0.001, P<0.001 and P=0.037, respectively). However, no differences in BMD, total cholesterol, LDL, HDL, TG and HbA1c were observed between the groups.

CONCLUSIONS

The results of this study suggest that severe spasticity in lower extremities is associated with reduced adiposity and lower FPG levels in persons with chronic motor complete SCI.

摘要

研究设计

横断面研究。

目的

探讨严重下肢痉挛对慢性运动完全性脊髓损伤(SCI)患者人体测量学指标、身体成分和代谢谱的影响。

研究地点

门诊诊所。

方法

根据改良Ashworth量表对伸肌痉挛进行评估,将61名参与者中的55名分为两组(无或轻度痉挛组,28名;严重痉挛组,27名)。比较两组不同程度痉挛患者的人体测量学指标(腰围(WC)、腰高比(WtHR))、身体成分(脂肪量(FM)、体脂百分比(BFP)、去脂体重(FFM)、去脂体重百分比(FFMP)、骨密度(BMD))和代谢谱(瘦素、总胆固醇、低密度脂蛋白(LDL)、高密度脂蛋白(HDL)、甘油三酯(TG)、空腹血糖(FPG)和糖化血红蛋白(HbA1c))。

结果

伸肌组痉挛与BFP呈负相关(r = -0.458,P < 0.001)。严重痉挛患者的WC和WtHR低于无或轻度痉挛组(分别为P = 0.038,P = 0.006)。严重痉挛组的FM、BFP、瘦素和FPG显著低于无或轻度痉挛组患者(分别为P = 0.003,P < 0.001,P < 0.001和P = 0.037)。然而,两组之间在BMD、总胆固醇、LDL、HDL、TG和HbA1c方面未观察到差异。

结论

本研究结果表明,慢性运动完全性SCI患者下肢严重痉挛与肥胖减轻和FPG水平降低有关。

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