Background: Evidence suggests an elevated prevalence of cardiometabolic risks among persons with spinal cord injury (SCI); however, the unique clustering of risk factors in this population has not been fully explored. Objective: The purpose of this study was to describe unique clustering of cardiometabolic risk factors differentiated by level of injury. Methods: One hundred twenty-one subjects (mean 37 ± 12 years; range, 18–73) with chronic C5 to T12 motor complete SCI were studied. Assessments included medical histories, anthropometrics and blood pressure, and fasting serum lipids, glucose, insulin, and hemoglobin A1c (HbA1c). Results: The most common cardiometabolic risk factors were overweight/obesity, high levels of low-density lipoprotein (LDL-C), and low levels of high-density lipoprotein (HDL-C). Risk clustering was found in 76.9% of the population. Exploratory principal component factor analysis using varimax rotation revealed a 3-factor model in persons with paraplegia (65.4% variance) and a 4-factor solution in persons with tetraplegia (73.3% variance). The differences between groups were emphasized by the varied composition of the extracted factors: Lipid Profile A (total cholesterol [TC] and LDL-C), Body Mass-Hypertension Profile (body mass index [BMI], systolic blood pressure [SBP], and fasting insulin [FI]); Glycemic Profile (fasting glucose and HbA1c), and Lipid Profile B (TG and HDL-C). BMI and SBP formed a separate factor only in persons with tetraplegia. Conclusions: Although the majority of the population with SCI has risk clustering, the composition of the risk clusters may be dependent on level of injury, based on a factor analysis group comparison. This is clinically plausible and relevant as tetraplegics tend to be hypo- to normotensive and more sedentary, resulting in lower HDL-C and a greater propensity toward impaired carbohydrate metabolism.
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Original Article|
July 27 2013
Cardiometabolic Risk Clustering in Spinal Cord Injury: Results of Exploratory Factor Analysis
Alexander Libin;
Alexander Libin
1
MedStar National Rehabilitation Hospital, Washington DC
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Emily Tinsley;
Emily Tinsley
1
MedStar National Rehabilitation Hospital, Washington DC
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Mark Nash;
Mark Nash
2
Miller School of Medicine, University of Miami, Miami, Florida
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Armando Mendez;
Armando Mendez
2
Miller School of Medicine, University of Miami, Miami, Florida
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Patricia Burns;
Patricia Burns
2
Miller School of Medicine, University of Miami, Miami, Florida
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Matt Elrod;
Matt Elrod
3
American Physical Therapy Association, Alexandria, Virginia
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Larry Hamm;
Larry Hamm
4
School of Public Health and Health Services, George Washington University Medical Center, Washington, DC
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Suzanne Groah
Suzanne Groah
1
MedStar National Rehabilitation Hospital, Washington DC
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Top Spinal Cord Inj Rehabil (2013) 19 (3): 183–194.
Citation
Alexander Libin, Emily Tinsley, Mark Nash, Armando Mendez, Patricia Burns, Matt Elrod, Larry Hamm, Suzanne Groah; Cardiometabolic Risk Clustering in Spinal Cord Injury: Results of Exploratory Factor Analysis. Top Spinal Cord Inj Rehabil 1 July 2013; 19 (3): 183–194. doi: https://doi.org/10.1310/sci1903-183
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