Exaggerated Postprandial Triglyceride Response Identified In Individuals With Spinal Cord Injury With Cardiac Risk Factors

Abstract

Able-bodied individuals who have a greater number of cardiac risk factors and greater abdominal adiposity have increased difficulty in metabolizing fat loads, resulting in prolonged elevation of postprandial triglyceride. The lipemic response to a high fat meal and its relationship to abdominal adiposity and coronary heart disease (CHD) is unknown in individuals with spinal cord injury (SCI). PURPOSE: To compare the postprandial lipemic (PPTG) responses, abdominal adiposity and CHD factors between able-bodied (AB) and individuals with SCI. METHODS: Twenty-five men with SCI (13 paraplegia, 12 tetraplegia) and 13 able-bodied (AB) men participated. The CHD risk factors were determined and subjects were stratified as having low risk (2 or less risk factors) or elevated risk (3+ risk factors). Following a 10-hour fast, a high-fat milkshake was consumed to deliver approximately 1.3 g fat, 1.2 g carbohydrate, and 0.2 g protein per kilogram body mass. Blood samples were drawn at baseline, 2, 4, and 6 hours to measure PPTG, determined as the area under the curve. Total abdominal fat (TAF) was measured by abdominal ultrasonography. RESULTS: SCI and AB subjects were similar in age, height, and weight. In AB and SCI subjects, TAF was significantly related to PPTG responses (R=0.49, P=0.02). TAF in low risk SCI was significantly less in AB with elevated risk (P=0.02) and SCI with elevated risk (P=0.01). SCI with elevated risk had the greatest PPTG response compared to low and elevated risk AB (2053±911 vs. 1356±633, and 1725±981 units, respectively), which was significantly greater than low risk SCI (1016±333 units, P=0.01). When controlling for TAF, the groups with SCI at low and elevated CHD risk had a PPTG response that was greater by 183±83 and 366±83 units, respectively, than the low risk AB group (P=0.001). CONCLUSIONS: Individuals with SCI appear to exhibit a greater postprandial response after a fat load than their able-bodied counterparts. An exaggerated postprandial response may be associated with greater overall cardiac risk in SCI. Supported by RR&D Center of Excellence on the Medical Consequences of Spinal Cord Injury # B2648C