Department of Biomedical Physiology and Kinesiology, Simon Fraser University, Burnaby, BC, Canada.
International Collaboration on Repair and Discoveries (ICORD), University of British Columbia, Vancouver, BC, Canada.
Spinal Cord. 2021 Jul;59(7):716-729. doi: 10.1038/s41393-020-00566-5. Epub 2020 Oct 17.
Multicentre, cross-sectional study.
To identify which markers of obesity, injury characteristics and autonomic function variables are related to cardiovascular disease (CVD) risk after spinal cord injury (SCI), and establish cut-points for detection and risk management.
Eight SCI rehabilitation centres in the Netherlands.
Individuals (n = 257) with a traumatic, chronic (≥10 years) SCI, with age at injury between 18 and 35 years, completed a self-report questionnaire and a one-day visit to a rehabilitation centre for testing. Three anthropometric measures were tested: body mass index (BMI); waist circumference (WC); and waist-to-height ratio (WHtR). Injury characteristics included: American Spinal Injury Association impairment scale (AIS); duration of injury (DOI); and neurological level of injury (LOI). Cardiovascular autonomic function was assessed from peak heart rate during maximal exercise (HR). Systolic arterial pressure (SAP) and aerobic capacity (VO) were also determined. CVD risk was calculated using the Framingham risk score (FRS).
All anthropometric variables were associated with FRS, with WC showing the strongest correlation (r = 0.41, p < 0.001) and greatest area under the curve (0.73) for 10-year CVD risk (%). WC, DOI, SAP, HR, LOI, and VO (variable importance: 0.81, 1.0, 0.98, 0.98, 0.66, 0.68, respectively) were important predictive variables for 10-year CVD risk in individuals with SCI.
We confirm that WC is a simple, practical measure of CVD risk, and along with DOI and markers of cardiovascular autonomic function, plays a role in the increased CVD risk following SCI.
多中心、横断面研究。
确定肥胖标志物、损伤特征和自主功能变量中哪些与脊髓损伤（SCI）后心血管疾病（CVD）风险相关，并确定检测和风险管理的临界点。
荷兰 8 个 SCI 康复中心。
年龄在 18 至 35 岁之间、创伤性、慢性（≥10 年）SCI 的个体（n=257）完成了一份自我报告问卷，并在康复中心进行了为期一天的测试。测试了三种人体测量指标：体重指数（BMI）；腰围（WC）；和腰高比（WHtR）。损伤特征包括：美国脊髓损伤协会损伤量表（AIS）；损伤持续时间（DOI）；和损伤的神经学水平（LOI）。心血管自主功能是通过最大运动时的峰值心率（HR）来评估的。还测定了收缩压（SAP）和有氧能力（VO）。使用弗雷明汉风险评分（FRS）计算 CVD 风险。
所有人体测量变量均与 FRS 相关，WC 相关性最强（r=0.41，p<0.001），10 年 CVD 风险（%）的曲线下面积最大（0.73）。WC、DOI、SAP、HR、LOI 和 VO（变量重要性：0.81、1.0、0.98、0.98、0.66、0.68，分别）是 SCI 个体 10 年 CVD 风险的重要预测变量。
我们证实 WC 是 CVD 风险的一种简单实用的测量方法，与 DOI 和心血管自主功能标志物一起，在 SCI 后 CVD 风险增加中发挥作用。
