Cardiometabolic factors in middle-aged people with long-term cervical and upper thoracic spinal cord injuries.

OBJECTIVE: To describe arterial stiffness, ankle-brachial index (ABI), advanced glycation end products (AGE) and glycosylated hemoglobin (HbA1c) in middle-aged people with cervical and upper thoracic SCI, and compare findings with the general population. DESIGN: Cross-sectional study with matched controls. SETTING: Tertiary outpatient SCI unit in southern Sweden. PARTICIPANTS: Participants (n = 25) in the Swedish Spinal Cord Injury Study on Cardiopulmonary and Autonomic Impairment (SPICA) (20% women, mean age 58 years, mean time since injury 28 years, injury levels C2-T6, American Spinal Injury Association Impairment Scale A-C). Controls (n = 250; ratio 10:1) from the general population were obtained from the Swedish CArdioPulmonary bioImage Study (SCAPIS). OUTCOME MEASURES: Aortic augmentation index at heart rate of 75 bpm (Aortic Aix@75), pulse wave velocity, ABI, AGE, HbA1c and anthropometry. RESULTS: The participants had significantly higher measures of Aortic Aix@75 (mean 35 vs 21, P = 0.004) and AGE (mean 2.6 vs 2.1, P < 0.001), and lower ABI (mean 1.07 vs 1.26, P < 0.001) and HbA1c (mean 36 vs 37, P = 0.007) than the controls. An abnormal HbA1c level (<31 or >46) was present in eight (32%) and 23 (9%) of the participants with SCI and controls, respectively (P = 0.003). Pulse wave velocity was similar between participants with SCI and controls (mean 8.6 m/s vs 8.5 m/s, P = 0.53). CONCLUSIONS: The difference in cardiometabolic factors between middle-aged people with long-term cervical and upper thoracic SCI and the general population implies that their cardiometabolic health is compromised. Further studies are needed to determine the prognostic significance of these differences.Trial registration: ClinicalTrials.gov identifier: NCT03515122.