男性脊髓損傷患者代謝症候群的研究

Abstract

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.