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Fitness, inflammation, and the metabolic syndrome in men with paraplegia.

Manns PJ, McCubbin JA, Williams DP

College of Health and Human Sciences, Department of Exercise and Sport Science, Oregon State University, Corvallis, OR, USA. trish.manns@ualberta.ca

OBJECTIVE: To determine the relations among peak aerobic capacity, physical activity, functional ability, components of the metabolic syndrome (high-density lipoprotein cholesterol [HDL-C], triglycerides [TG], glucose, insulin, abdominal obesity, high blood pressure), and inflammatory factors (interleukin-6 [IL-6], C-reactive protein [CRP]) in men with paraplegia. DESIGN: Cross-sectional exploratory design. SETTING: University research laboratory. PARTICIPANTS: Twenty-two men (age, 39+/-9y; duration of injury, 17+/-9y; level of injury, T2-L2) with functionally complete paraplegia volunteered to participate. INTERVENTIONS: Not applicable. MAIN OUTCOME MEASURES: Peak aerobic capacity was measured using a graded peak exercise test with an arm ergometer, and physical activity was assessed by the Physical Activity and Disability Scale. Functional ability was assessed by the Self-Report Functional Measure. Circulating glucose, insulin, HDL-C, TG, total cholesterol, IL-6, and CRP levels were determined by specific enzyme or immunologic assays. Body fat was determined by dual-energy x-ray absorptiometry, and central obesity was estimated from abdominal sagittal diameters. RESULTS: Lower peak aerobic capacities were associated with lower HDL-C and lower physical activity levels ( P <.014). Lower physical activity levels were associated with higher fasting glucose, lower HDL-C level, and larger abdominal sagittal diameters ( P <.036). Larger abdominal sagittal diameters were associated with higher fasting glucose, higher fasting and postload insulin, lower HDL-C, higher TG, and higher CRP levels ( P <.05). CONCLUSIONS: Diet and exercise trials are needed to determine the efficacy and effectiveness of lifestyle interventions aimed at slowing the progression of the metabolic syndrome in people with spinal cord injury.

Published 14 June 2005 in Arch Phys Med Rehabil, 86(6): 1176-81.
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