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  4. Lipoprotein heterogeneity in persons with Spinal Cord Injury: a model of prolonged sitting and restricted physical activity

Lipoprotein heterogeneity in persons with Spinal Cord Injury: a model of prolonged sitting and restricted physical activity

Lipids in Health and Disease, 2015 · DOI: 10.1186/s12944-015-0084-4 · Published: July 22, 2015

Spinal Cord InjuryCardiovascular ScienceEndocrinology

Simple Explanation

This study explores the link between reduced physical activity due to spinal cord injury (SCI) and changes in lipoprotein profiles, which are related to cardiovascular disease (CVD) risk. Using nuclear magnetic resonance (NMR) spectroscopy, the researchers looked at the size and number of different lipoprotein particles in people with SCI compared to able-bodied individuals. The study found that people with SCI often have lower levels of HDL-C (good cholesterol), but normal LDL-C (bad cholesterol). However, NMR analysis revealed unfavorable changes in the size and number of lipoprotein particles, especially in those with lower HDL-C, suggesting a higher risk of CVD. These changes were linked to increased waist circumference (abdominal adiposity) and insulin resistance, both common in people with SCI due to prolonged sitting and reduced physical activity. The findings suggest that detailed lipoprotein analysis using NMR could help better assess CVD risk in this population.

Study Duration
Not specified
Participants
83 persons with chronic SCI and 62 able-bodied (AB) subjects
Evidence Level
Not specified

Key Findings

  • 1
    Individuals with SCI and normal HDL-C had negligible differences in lipoprotein particle profile compared to able-bodied individuals, except for fewer number and smaller size of HDL-P.
  • 2
    The SCI-Low group had a similar lipoprotein profile to that of the AB-Low group, but with a lipid particle composition associated with a heightened atherogenic risk.
  • 3
    Decreased number and reduced size of lipoprotein particles were more prevalent in the SCI-Low group and may be associated with increased waist circumference and elevated TG values.

Research Summary

This study investigated the lipoprotein profiles of individuals with spinal cord injury (SCI) using nuclear magnetic resonance (NMR) spectroscopy to assess cardiovascular disease (CVD) risk. It compared lipoprotein particle numbers and sizes in SCI patients with able-bodied (AB) controls, stratified by HDL-C levels. The findings revealed that SCI patients with low HDL-C had a more adverse lipoprotein profile, characterized by a heightened atherogenic risk and a greater tendency toward insulin resistance. These individuals also exhibited a decreased number and reduced size of lipoprotein particles, which were associated with increased waist circumference and elevated triglyceride levels. The study concludes that prolonged sitting and restricted physical activity in individuals with SCI primarily affects HDL-C and its lipoprotein subclasses, but also unfavorably impacts LDL-C subclasses. It suggests that quantifying lipoprotein particle characteristics via NMR spectroscopy is a potent tool for determining CVD risk in this population.

Practical Implications

Improved Risk Assessment

NMR spectroscopy can provide a more accurate assessment of CVD risk in SCI patients by analyzing lipoprotein particle size and number, potentially preventing underestimation of risk based on traditional LDL-C measurements alone.

Targeted Interventions

Therapeutic and lifestyle interventions for SCI patients should focus on reducing insulin resistance, abdominal adiposity, and increasing activity levels, with consideration for lower therapeutic thresholds for serum triglyceride concentrations.

Personalized Treatment Strategies

Clinical management of vascular disease in sedentary populations should consider alternate strategies beyond conventional lipid-lowering therapies, potentially incorporating interventions that address the specific lipoprotein particle abnormalities identified by NMR spectroscopy.

Study Limitations

  • 1
    The level of physical activity of subjects with SCI was not captured.
  • 2
    Dietary habits and food choices were not obtained.
  • 3
    Direct body composition measurements were not included in our analysis.

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