Sarcopenic Obesity in Adults with Chronic Spinal Cord Injury: A Cross-Sectional Study

Publication date: Available online 7 June 2016
Source:Archives of Physical Medicine and Rehabilitation
Author(s): Chelsea A. Pelletier, Masae Miyatani, Lora Giangregorio, B. Catharine Craven
ObjectivesTo describe the frequency and utility of clinically relevant spinal cord injury (SCI)-specific and general population thresholds for obesity and sarcopenic obesity; to describe the fat and lean soft tissue distributions based on neurological level of injury (NLI) and ASIA Impairment Scale (AIS).DesignCross-sectional.SettingTertiary SCI rehabilitation hospital.Participants136 adult men (n = 100) and women (n = 36) with chronic [mean (±SD) 15.6±11.3 years post injury] tetraplegia (n = 66) or paraplegia (n = 70).InterventionsNot applicable.Main Outcome MeasuresBody composition was assessed with anthropometrics and whole body dual-energy X-ray absorptiometry (DXA). Muscle atrophy was quantified using a sarcopenia threshold of appendicular lean mass index (ALMI; males: ≤7.26kg/m², females: ≤5.5kg/m²). Obesity was defined by percentage body fat (males: ≥25%; females: ≥35%), visceral adipose tissue (VAT; ≥130cm²) and SCI-specific obesity thresholds (BMI ≥22kg/m²; waist circumference ≥94cm). Sarcopenic obesity was defined as the presence of both sarcopenia and obesity. Groups were compared based on impairment characteristics using an ANCOVA.ResultsSarcopenic obesity was prevalent in 41.9% of the sample. ALMI was lower among participants with motor-complete (6.2±1.3 kg/m²) versus motor-incomplete (7.5±1.6kg/m²) injuries (p<0.01). Whole body fat was greater among participants with tetraplegia (28.8±11.2kg) versus paraplegia (24.1 ± 8.7kg; p<0.05). Compared to general population guidelines (20.6%), SCI-specific BMI thresholds identified all of the participants with obesity (77.9%) based on percentage body fat (72.1%).ConclusionsThe observed frequency of sarcopenic obesity in this sample of individuals with chronic SCI is very high, and identification of obesity and sarcopenic obesity is dissimilar when using SCI-specific versus general population criteria.



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