Gender Dimorphism in Central Adiposity May Explain Metabolic Dysfunction After Spinal Cord Injury.

BACKGROUND: Increase in visceral adipose tissue (VAT) is an independent risk for mortality and other health-related comorbidities.

OBJECTIVE: To examine the gender differences in VAT and subcutaneous adipose tissue (SAT) cross-sectional areas (CSA) between men and women with chronic spinal cord injury (SCI). The differences in the distribution of central adiposity were used to determine the association of VAT and SAT to metabolic dysfunction after SCI.

DESIGN: Cross-sectional design.

SETTING: Hospital-based study.

PARTICIPANTS: Sixteen individuals (8 men and 8 women) with motor complete SCI were matched based on age, time since injury, and level of injury.

METHODS: Anthropometrics, dual x-ray absorptiometry (DXA), and magnetic resonance imaging were captured to measure lean mass, fat mass (FM), percentage FM, VAT, and SAT CSAs. Basal metabolic rate was measured, and intravenous glucose tolerance test and lipid panel were performed.

MAIN OUTCOME MEASUREMENTS: VAT, SAT, and metabolic profile.

RESULTS: SAT CSA was 1.6 -1.75 times greater in the upper and lower trunks in women compared to men with SCI (P < .05). VAT CSA was 1.8-2.6 times greater in the upper and lower trunks in men compared to women with SCI (P < .05). VAT adjusted to body weight was greater in men compared to women with SCI. High-density lipoprotein cholesterol (HDL-C) was positively related to SAT and negatively related to VAT. Glucose effectiveness was negatively related to lower trunk SAT (r = -0.60, P = .02). HDL-C ratio and triglycerides were positively related to upper VAT, lower VAT, and VAT:SAT ratio.

CONCLUSION: Magnetic resonance imaging demonstrated that there is a gender dimorphism in central adiposity in persons with chronic SCI. This gender dimorphism in central adipose tissue distribution may explain the higher prevalence of metabolic dysfunction in men with SCI, especially, the decrease in the HDL-C profile.

LEVEL OF EVIDENCE: IV.