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  4. Effect of functional sympathetic nervous system impairment of the liver and abdominal visceral adipose tissue on circulating triglyceride-rich lipoproteins

Effect of functional sympathetic nervous system impairment of the liver and abdominal visceral adipose tissue on circulating triglyceride-rich lipoproteins

PLoS ONE, 2017 · DOI: https://doi.org/10.1371/journal.pone.0173934 · Published: March 27, 2017

Spinal Cord InjuryNeurologyGenetics

Simple Explanation

This study investigates how damage to the nerves controlling the liver and abdominal fat affects fat levels in the blood, specifically triglyceride-rich lipoproteins, in men with spinal cord injury. The researchers compared men with spinal cord injuries at different levels of the spine to see if the level of injury, and therefore the extent of nerve damage, influenced their triglyceride and VLDL levels. They found that men with higher spinal cord injuries, which likely meant more nerve damage affecting the liver and abdominal fat, had lower levels of these fats in their blood compared to those with lower injuries.

Study Duration
Not specified
Participants
103 non-ambulatory men with SCI and 53 able-bodied (AB) subjects
Evidence Level
Not specified

Key Findings

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    Men with SCI at or above the 4th thoracic vertebrae (T4), indicating more extensive sympathetic nervous system impairment, had significantly lower serum triglyceride (TG) concentrations compared to those with SCI at or below the 5th thoracic vertebrae (T5) and able-bodied (AB) subjects.
  • 2
    VLDL-P concentration was significantly elevated in the #T5 group compared to AB and "T4 groups.
  • 3
    The #T5 group showed a significant linear relationship between triglyceride-rich lipoproteins (TG or Large VLDL-P) and VAT volume or HOMA-IR, which was not observed in the "T4 and AB groups.

Research Summary

The study found that loss of functional sympathetic innervation to the liver and VAT appears to favorably impact circulating TG concentrations and concentrations of total and specific subclasses of VLDL-P. The SCI group with preserved hepatic SNS modulation (e.g., #T5 group) had a TRL profile that was more adverse than the AB group presumably, at least in part, as a consequence of a larger adipose burden and relatively increased insulin resistance. Functional sympathetic innervation to the abdomen should be recognized as an important contributing factor in the prediction of the concentration of circulating TRL products, which may play a role in the genesis and perpetuation of cardiometabolic dysfunction and atherosclerotic disease.

Practical Implications

Clinical Monitoring

Persons with SCI at or distal to T5 who are overweight/obese may warrant more aggressive clinical monitoring.

Therapeutic Interventions

Rehabilitation intervention(s) to increase the level of activity and, if possible, reduce adiposity in an effort to maintain peripheral insulin sensitivity and thus improve the lipid profile and associated risk of cardiovascular disease.

Understanding Cardiometabolic Risk

Functional sympathetic innervation to the abdomen should be recognized as an important contributing factor in the prediction of the concentration of circulating TRL products

Study Limitations

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