Objective

To study body composition, measures of insulin resistance and dyslipidemia in Indian men with paraplegia as compared to age and body mass index (BMI) matched able-bodied men.

Design

Cross sectional study

Setting

Departments of Physical Medicine and Rehabilitation and Endocrinology

Participants

Males aged 18–45 years with chronic traumatic paraplegia versus age and BMI-matched able-bodied men

Interventions

None

Main outcome measures

Measures of body composition such as total body fat, lean mass, regional adiposity using dual energy x-ray absorptiometry (DXA), metabolic profile and insulin resistance

Results

Subjects with paraplegia (n = 43), compared to controls (n = 36), had higher %Fat mass (FM) (25.5 (21.2–28.9) vs 20.2 (15.9–22.2); P < 0.01), lower trunk to leg ratio (0.66 (0.51–0.73) vs 0.87 (0.72–0.94); P < 0.01), lower lean mass index (14.38 (2.57) vs 17.80 (2.34); P < 0.01) and lower appendicular lean mass index (5.81 ± 1.26 vs 8.17 ± 1.12; P < 0.01). Fasting blood glucose (mg/dl) was higher (89.0(81.5–96.5) vs 80.0 (74.5–88.2); P < 0.01), Homeostasis model assessment of insulin resistance was higher (1.33 (1.03–2.12) vs 0.94 (0.52–1.78); P = 0.02), Quantitative insulin sensitivity check index (QUICKI) was lower (0.36 ± 0.04 vs 0.38 ± 0.05; P = 0.02) and HDL-C was lower (33.00 (30.00–42.75) vs 38.50 (33.00–43.25); P < 0.02) in cases compared to controls. QUICKI correlated positively with HDL-C and negatively with %FM, estimated VAT volume and TG. Trunk to leg ratio correlated positively with TG even after controlling for %FM.

Conclusion

Men with chronic paraplegia had lower lean mass, higher total and regional fat mass, increased insulin resistance and low HDL-C when compared with BMI-matched able-bodied controls. Both total and regional adiposity correlated with poor metabolic profile.

中文翻译：

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慢性外伤性截瘫男性的身体成分和代谢参数——来自印度的初步研究

客观的

为了研究截瘫印度男性的身体成分、胰岛素抵抗和血脂异常指标，并与年龄和体重指数 (BMI) 匹配的健全男性进行比较。

设计

横断面研究

环境

物理医学和康复与内分泌学系

参加者

18-45 岁患有慢性外伤性截瘫的男性与年龄和 BMI 匹配的健全男性

干预措施

没有任何

主要观察指标

使用双能 X 射线吸收测定法 (DXA)、代谢特征和胰岛素抵抗测量身体成分，例如全身脂肪、瘦体重、局部肥胖

结果

截瘫受试者 ( n  = 43)，与对照组 ( n = 36)，脂肪量 (FM) 百分比较高 (25.5 (21.2–28.9) 对比 20.2 (15.9–22.2)；P < 0.01)，较低的躯干与腿部比例 (0.66 (0.51–0.73) 对比 0.87 (0.72–0.94) ); P < 0.01)，较低的瘦体重指数 (14.38 (2.57) vs 17.80 (2.34)；P < 0.01) 和较低的四肢瘦体重指数 (5.81 ± 1.26 vs 8.17 ± 1.12；P < 0.01)。空腹血糖 (mg/dl) 更高 (89.0(81.5–96.5) vs 80.0 (74.5–88.2)；P < 0.01)，胰岛素抵抗的稳态模型评估更高 (1.33 (1.03–2.12) vs 0.94 (0.52– 1.78)；P = 0.02)，定量胰岛素敏感性检查指数 (QUICKI) 较低 (0.36 ± 0.04 vs 0.38 ± 0.05；P = 0.02)，HDL-C 较低 (33.00 (30.00–42.75) vs 38.50 (33.00–43.25) ); P < 0.02) 在案例中与对照组相比。QUICKI 与 HDL-C 呈正相关，与 %FM、估计的 VAT 体积和 TG 呈负相关。

结论

与 BMI 匹配的健康对照相比，患有慢性截瘫的男性瘦体重较低，总脂肪量和局部脂肪量较高，胰岛素抵抗增加，HDL-C 较低。总肥胖和局部肥胖均与代谢不良相关。