Cardiometabolic Risk Clustering in Spinal Cord Injury: Results of Exploratory Factor Analysis

Top Spinal Cord Inj Rehabil, 2013 · DOI: 10.1310/sci1903-183 · Published: July 1, 2013

Spinal Cord Injury Cardiovascular Science Rehabilitation

Simple Explanation

This study explores the clustering of cardiometabolic risk factors in individuals with spinal cord injury (SCI), differentiating between those with paraplegia and tetraplegia. The research involved assessing medical histories, body measurements, blood pressure, and fasting serum lipids, glucose, insulin, and HbA1c levels in 121 participants with chronic SCI. The findings indicate that the composition of risk clusters may vary depending on the level of injury, with tetraplegics showing a greater propensity for impaired carbohydrate metabolism.

Study Duration

5 years

Participants

121 subjects with chronic C5 to T12 motor complete SCI

Evidence Level

Not specified

Key Findings

1
Overweight/obesity, high LDL-C, and low HDL-C were the most common cardiometabolic risk factors.
2
Risk clustering was present in 76.9% of the study population.
3
Factor analysis revealed a 3-factor model for paraplegia and a 4-factor model for tetraplegia, with differences in the composition of extracted factors.

Research Summary

The study investigated cardiometabolic risk factor clustering in individuals with SCI, focusing on differences between paraplegia and tetraplegia. Results indicated that the most prevalent risk factors were overweight/obesity, high LDL-C, and low HDL-C, with significant risk clustering observed in the majority of participants. Factor analysis highlighted variations in risk factor clustering based on the level of injury, suggesting that the composition of risk clusters is dependent on whether the individual has paraplegia or tetraplegia.

Practical Implications

Clinical Monitoring

Early and regular monitoring for cardiometabolic risk factors is recommended for individuals with SCI.

Individualized Care

Clinicians should critically apply existing guidelines (NCEP ATP III, etc.) to the care of people with SCI.

Targeted Interventions

Therapeutic lifestyle changes (diet and physical activity) and pharmacotherapy can be implemented to modify risk factors.

Study Limitations

1
The cross-sectional design did not allow exploration of the interplay between factors over time.
2
Relatively small sample sizes in each subgroup limited the use of various factor models.
3
Age and gender were not used as covariates in the outcome model.

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