Anthropometric Prediction of Visceral Adiposity in Persons With Spinal Cord Injury

Top Spinal Cord Inj Rehabil, 2021 · DOI: 10.46292/sci20-00055 · Published: January 1, 2021

Spinal Cord Injury Cardiovascular Science Physiology

Simple Explanation

Persons with spinal cord injury (SCI) often experience obesity-related health issues. This obesity can hinder their social activities, quality of life, and create socioeconomic burdens. Measuring abdominal fat is crucial because it's linked to heart and metabolic problems after SCI. Currently, there isn't a specific waist circumference (WC) measurement for SCI patients to predict visceral adipose tissue (VAT). This review aims to summarize factors contributing to VAT in SCI patients and suggest a WC cutoff as an indicator for central obesity and related disorders. Central obesity, marked by increased waist and abdominal size, as well as VAT, poses health risks for SCI individuals. While imaging techniques help measure adiposity, they are expensive. This review seeks to develop a prediction equation for VAT using anthropometric data in SCI patients.

Study Duration

Not specified

Participants

Persons with spinal cord injury

Evidence Level

Review

Key Findings

1
Level of injury, age, and time since injury influence visceral adipose tissue (VAT) distribution, but the effect of the level of injury may be influenced by aging and time since injury.
2
Men with SCI tend to have greater VAT volume and VAT:SAT ratio compared to women, even with similar trunk fat mass.
3
A waist circumference cutoff of 86.5 cm may distinguish persons with reduced aerobic fitness, insulin resistance, and dyslipidemia after SCI.

Research Summary

Cardiometabolic disorders are a leading cause of mortality in persons with SCI, and visceral adipose tissue (VAT) plays a significant role. Factors like age, level of injury, and sex influence VAT distribution after SCI. Strong associations exist between anthropometrics and central obesity, leading to equations to predict VAT after SCI, which is vital for diagnosing those at risk for cardiometabolic disorders.

Practical Implications

Annual Waist Circumference Measurement

Clinicians should measure supine WC annually and train patients to monitor it monthly as a proxy index for cardiometabolic syndrome (CMS).

Individualized Rehabilitation Plans

Use WC measurements to guide patients in rehabilitation plans, including exercise, diet, and surgical intervention, to protect against cardiometabolic disorders.

Early Intervention for High-Risk Patients

Employ SCI-specific anthropometric cutoffs to identify persons at risk of developing central obesity-associated cardiometabolic consequences and intervene in a timely manner.

Study Limitations

1
The anthropometric and DXA prediction equations for VAT are yet to be validated.
2
Existing general population criteria underestimate persons with SCI who are at risk of developing obesity, CMS, and CVD.
3
MRI scans are laborious, time-consuming, not effective in population studies with a large sample size, costly, and access is limited.

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