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

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 sacrittal 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.