Abstract
In able-bodied individuals, an increase in body mass index (BMI) enhances the risk of glucose tolerance deterioration and diabetes mellitus (DM). This relationship can be altered after spinal cord injury (SCI) due to muscle atrophy and the potential effects of autonomic dysfunction on glucose metabolism, which are more exaggerated in those with tetraplegia (TP) compared to paraplegia (PP). Here, we investigated the relationship between longitudinal changes in BMI and glycated haemoglobin (HbA1c), as well as the effect of level of injury (LOI) on this relationship, among nondiabetic patients with SCI. In a retrospective cohort of veterans with SCI, electronic data of BMI, LOI, glucose concentration and HbA1c were obtained from Jan 2001 to Dec 2021. A total of 728 patients without DM at baseline were identified (LOI: 350 TP/378 PP, age: 52±15 years, sex: 690 male/38 female), and followed up for a mean of 94 months (TP) and 114 months (PP). At baseline, using the SCI-specific BMI classification (normal weight BMI<22 kg/m2, obesity BMI> 25 kg/m2), 48% of TP and 65% of PP were obese at baseline (BMI TP: 25.6±5.9 kg/m2; PP: 28.0±6.6 kg/m2,; p<0.001). HbA1c at baseline was similar between TP and PP (5.21±0.59% vs 5.27±0.70%, p = 0.175). At the end of follow-up, BMI was increased to a larger extent in PP compared with TP (-0.02±4.11 kg/m2 in TP, +0.55±4.31 kg/m2 in PP; p = 0.05). However, HbA1c changes did not differ between TP versus PP (p = 0.323). The final BMI was associated with baseline BMI (p<0.001) and LOI (p = 0.007), but the last HbA1c value was only associated with baseline HbA1c (p<0.001) and not LOI (p = 0.821) or baseline BMI (p = 0.605). Together, these findings indicate that neither LOI nor BMI appear useful predictors of DM development in persons with SCI. Disclosure S. Hoekstra: None. M.J. Mader: None. M. Trbovich: None. M. Salehi: None.
Sign-in/Register to access full text options 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a callDisclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.
