Farkas Gary J, Gorgey Ashraf S, Dolbow David R, Berg Arthur S, Gater David R
a Department of Physical Medicine and Rehabilitation , Penn State College of Medicine , Hershey , Pennsylvania, USA.
b Spinal Cord Injury and Disorders Center, Hunter Holmes McGuire VA Medical Center , Richmond , Virginia, USA.
J Spinal Cord Med. 2018 Jul;41(4):407-415. doi: 10.1080/10790268.2017.1357918. Epub 2017 Jul 30.
Level of injury (LOI) and the role of adipose tissue and its proinflammatory adipokines in cardiometabolic dysfunction following spinal cord injury (SCI) remains poorly understood. We aim to examine the influence of LOI on adipose tissue and its relationship to proinflammatory adipokines and cardiometabolic profiles following SCI.
Cross sectional and correlational study.
Clinical hospital and academic setting.
Forty-seven individuals with chronic motor complete SCI (age 43.8±11.5 y, BMI: 27.3±5.3) were classified as having tetraplegia (TSCI; n=12) or paraplegia (PSCI; n=35).
Non applicable.
Visceral (VAT) and subcutaneous (SAT) adipose tissue volumes were measured using magnetic resonance imaging. Proinflammatory adipokines (tumor neurosis factor-α, interleukin-6 (IL-6), plasminogen activatable inhibitor-1, thrombin-activatable fibrinolysis inhibitor, and high-sensitivity c-reactive protein) and cardiovascular, carbohydrate, and lipid profiles were assessed according to standard techniques.
VAT volume was greater in TSCI versus PSCI (p=0.042); however, after covarying for age this significance was lost (p>0.05). IL-6 was significantly elevated in TSCI (p<0.05), while other markers of inflammation generally were elevated, but did not reach statistical significance (p>0.05). Systolic blood pressure and total cholesterol were significantly lower in TSCI (p<0.05), while fasting glucose was significantly lower in PSCI (p<0.05). A number of proinflammatory adipokines and cardiometabolic markers significantly correlated with adipose tissue depots by LOI (p<0.05).
The results show that LOI does not influence the distribution of adipose tissue, but does influence proinflammatory adipokines and cardiometabolic profiles following SCI. Further research is needed to evaluate impact of lean body mass on these findings.
损伤平面（LOI）以及脂肪组织及其促炎脂肪因子在脊髓损伤（SCI）后心脏代谢功能障碍中的作用仍未得到充分了解。我们旨在研究LOI对脂肪组织的影响及其与SCI后促炎脂肪因子和心脏代谢指标的关系。
横断面相关性研究。
临床医院和学术环境。
47例慢性运动完全性SCI患者（年龄43.8±11.5岁，体重指数：27.3±5.3）被分为四肢瘫（TSCI；n = 12）或截瘫（PSCI；n = 35）。
无。
使用磁共振成像测量内脏（VAT）和皮下（SAT）脂肪组织体积。根据标准技术评估促炎脂肪因子（肿瘤神经因子-α、白细胞介素-6（IL-6）、纤溶酶原激活抑制剂-1、凝血酶激活的纤维蛋白溶解抑制剂和高敏C反应蛋白）以及心血管、碳水化合物和脂质指标。
与PSCI相比，TSCI的VAT体积更大（p = 0.042）；然而，在对年龄进行协变量调整后，这种显著性消失（p>0.05）。TSCI中IL-6显著升高（p<0.05），而其他炎症标志物一般也升高，但未达到统计学显著性（p>0.05）。TSCI的收缩压和总胆固醇显著较低（p<0.05），而PSCI的空腹血糖显著较低（p<0.05）。一些促炎脂肪因子和心脏代谢标志物与按LOI划分的脂肪组织库显著相关（p<0.05）。
结果表明，LOI不影响脂肪组织的分布，但会影响SCI后的促炎脂肪因子和心脏代谢指标。需要进一步研究来评估瘦体重对这些结果的影响。
