Fitness, inflammation, and the metabolic syndrome in men with paraplegia.

OBJECTIVE: To determine the relations among peak aerobic capacity, physical activity, functional ability, components of the metabolic syndrome (high-density lipoprotein cholesterol [HDL-C], triglycerides [TG], glucose, insulin, abdominal obesity, high blood pressure), and inflammatory factors (interleukin-6 [IL-6], C-reactive protein [CRP]) in men with paraplegia.

DESIGN: Cross-sectional exploratory design.

SETTING: University research laboratory.

PARTICIPANTS: Twenty-two men (age, 39+/-9y; duration of injury, 17+/-9y; level of injury, T2-L2) with functionally complete paraplegia volunteered to participate.

INTERVENTIONS: Not applicable.

MAIN OUTCOME MEASURES: Peak aerobic capacity was measured using a graded peak exercise test with an arm ergometer, and physical activity was assessed by the Physical Activity and Disability Scale. Functional ability was assessed by the Self-Report Functional Measure. Circulating glucose, insulin, HDL-C, TG, total cholesterol, IL-6, and CRP levels were determined by specific enzyme or immunologic assays. Body fat was determined by dual-energy x-ray absorptiometry, and central obesity was estimated from abdominal sagittal diameters.

RESULTS: Lower peak aerobic capacities were associated with lower HDL-C and lower physical activity levels ( P <.014). Lower physical activity levels were associated with higher fasting glucose, lower HDL-C level, and larger abdominal sagittal diameters ( P <.036). Larger abdominal sagittal diameters were associated with higher fasting glucose, higher fasting and postload insulin, lower HDL-C, higher TG, and higher CRP levels ( P <.05).

CONCLUSIONS: Diet and exercise trials are needed to determine the efficacy and effectiveness of lifestyle interventions aimed at slowing the progression of the metabolic syndrome in people with spinal cord injury.