男性脊髓損傷患者代謝症候群的研究

The improvement of medical care and
rehabilitation has greatly prolonged the life
expectancy of subjects with spinal cord
injury (SCI). Thus, cardiovascular disease
has become the leading cause of death in
person with SCI. The epidemiologic study
had shown SCI had higher prevalence and
mortality rate of cardiovascular disease
(CVD). The risk factors of CVD included
hyperlipidemia, hypertension, insulin
resistance and obesity; they also known as
metabolic syndrome. In papers review, SCI
people had higher ratio of hyperlipidemia,
insulin resistance and increased adiposity.
Recently various adipocytokines such
as leptin and adiponectin are implicated in
the pathogenesis of insulin resistance.
Furthermore, in vitro and in vivo studies
have confirmed the antidiabetic and
antiatherosclertic activity of adiponectin.
We recruited sixty-two male subjects
with SCI for this study. After overnight fast,
various anthropology data such as body
height, weight, waist circumference are
collected, as well as blood pressure. Then,
blood is drawn for the measurement of
fasting plasma glucose, insulin, high density
lipoprotein (HDL), triglycerol, leptin,
adiponectin. HOMA was calculated to reveal
insulin sensitivity. Multiple regression
analysis will be performed to analyze the
relation among these factors.
Men with SCI have significantly higher
serum leptin levels than able-body controls
and the serum leptin levels correlate with the
degree of neurological deficit. SCI subjects
had a tendency of higher serum adiponectin
level than able-body controls. We found that
8% of SCI subjects had obesity, 6%
hypertension, 11% hyperglycemia, elevated
triglycerol >50%, decreased HDL >50% and 29% with insulin resistance. The HOMA
value was higher than reference level. The
criteria of metabolic syndrome in general
population seemed hard to apply in SCI.