(1) Describe the prevalence cardiometabolic disease (CMD) at spinal cord injury (SCI) rehabilitation discharge; (2) compare this with non-SCI controls; (3) identify factors associated with increased CMD.
Multicenter, prospective observational study.
Five NIDILRR Model SCI Rehabilitation Centers.
SCI; n=95 aged 18-70 years with SCI (neurological levels of injury (NLI) C2-L2, American Spinal Injury Association Impairment Scale grades A-D) enrolled within two months of initial rehabilitation discharge. Controls; n=1609 age/sex/body mass index-matched entries in the National Health and Nutrition Examination Education Survey (NHANES, 2016-19).
none MAIN OUTCOME MEASURE(S): Percentage of SCI subjects with CMD diagnosis, prevalence of CMD determinants within two months of rehabilitation discharge, and other significant early risk associations were analyzed using: age, sex, body mass index, insulin resistance (IR) by fasting glucose and Homeostasis Model Assessment (HOMA-2), fasting triglycerides and high-/low-density lipoprotein cholesterol (HDL-C, LDL-C), total cholesterol (TC) and resting blood pressure (BP systolic and diastolic).
Subjects with SCI had significantly higher diastolic BP and triglycerides than controls, with lower fasting glucose and HDL-C. 74.0% of SCI subjects versus 38.5% of controls were obese when applying population-specific criteria (p<0.05). Low HDL-C was measured in 54.2% of SCI subjects versus 15.4% of controls (p<0.05). IR was not significantly different between groups. 31.6% of SCI subjects had ≥3 CMD determinants, which was 40.7% higher than controls (p<0.05). Interplay of lipids and lipoproteins (i.e., total cholesterol: HDL-C ratio and triglyceride: HDL-C ratio) were associated with elevated risk in SCI subjects for myocardial infarction and stroke. The only significant variable associated with CMD was age (p<0.05).
Individuals with SCI have an increased CMD risk when compared to the general population; obesity, IR, and low HDL-C are the most common CMD risk determinants; age is significantly associated with early CMD.

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