Bigford Gregory, Nash Mark S
Department of Neurological Surgery, University of Miami School of Medicine, Miami, Florida.
The Miami Project to Cure Paralysis, University of Miami Miller School of Medicine, Miami, Florida.
Top Spinal Cord Inj Rehabil. 2017 Summer;23(3):188-206. doi: 10.1310/sci2303-188.
Chronic spinal cord injury (SCI) often results in morbidity and mortality due to all-cause cardiovascular disease (CVD) and comorbid endocrine disorders. Several component risk factors for CVD, described as the (CMS), are prevalent in SCI, with the individual risks of obesity and insulin resistance known to advance the disease prognosis to a greater extent than other established risks. Notably, adiposity and insulin resistance are attributed in large part to a commonly observed maladaptive dietary/nutritional profile. Although there are no evidence-based nutritional guidelines to address the CMS risk in SCI, contemporary treatment strategies advocate more comprehensive lifestyle management that includes sustained nutritional guidance as a necessary component for overall health management. This monograph describes factors in SCI that contribute to CMS risks, the current nutritional profile and its contribution to CMS risks, and effective treatment strategies including the adaptability of the Diabetes Prevention Program (DPP) to SCI. Establishing appropriate nutritional guidelines and recommendations will play an important role in addressing the CMS risks in SCI and preserving optimal long-term health.
慢性脊髓损伤（SCI）常因全因性心血管疾病（CVD）和合并的内分泌紊乱导致发病和死亡。几种被称为心血管代谢综合征（CMS）的CVD组成风险因素在SCI中很常见，已知肥胖和胰岛素抵抗的个体风险比其他既定风险更能推动疾病预后。值得注意的是，肥胖和胰岛素抵抗在很大程度上归因于常见的适应性不良饮食/营养状况。尽管没有基于证据的营养指南来解决SCI中的CMS风险，但当代治疗策略提倡更全面的生活方式管理，包括持续的营养指导作为整体健康管理的必要组成部分。本专著描述了SCI中导致CMS风险的因素、当前的营养状况及其对CMS风险的影响，以及有效的治疗策略，包括糖尿病预防计划（DPP）对SCI的适应性。制定适当的营养指南和建议将在解决SCI中的CMS风险和保持最佳长期健康方面发挥重要作用。
