Body composition and metabolic parameters in men with chronic traumatic paraplegia – A pilot study from India

ObjectiveTo study body composition, measures of insulin resistance and dyslipidemia in Indian men with paraplegia as compared to age and body mass index (BMI) matched able-bodied men.DesignCross sectional studySettingDepartments of Physical Medicine and Rehabilitation and EndocrinologyParticipantsMales aged 18–45 years with chronic traumatic paraplegia versus age and BMI-matched able-bodied menInterventionsNoneMain outcome measuresMeasures of body composition such as total body fat, lean mass, regional adiposity using dual energy x-ray absorptiometry (DXA), metabolic profile and insulin resistanceResultsSubjects with paraplegia (n = 43), compared to controls (n = 36), had higher %Fat mass (FM) (25.5 (21.2–28.9) vs 20.2 (15.9–22.2); P < 0.01), lower trunk to leg ratio (0.66 (0.51–0.73) vs 0.87 (0.72–0.94); P < 0.01), lower lean mass index (14.38 (2.57) vs 17.80 (2.34); P < 0.01) and lower appendicular lean mass index (5.81 ± 1.26 vs 8.17 ± 1.12; P < 0.01). Fasting blood glucose (mg/dl) was higher (89.0(81.5–96.5) vs 80.0 (74.5–88.2); P < 0.01), Homeostasis model assessment of insulin resistance was higher (1.33 (1.03–2.12) vs 0.94 (0.52–1.78); P = 0.02), Quantitative insulin sensitivity check index (QUICKI) was lower (0.36 ± 0.04 vs 0.38 ± 0.05; P = 0.02) and HDL-C was lower (33.00 (30.00–42.75) vs 38.50 (33.00–43.25); P < 0.02) in cases compared to controls. QUICKI correlated positively with HDL-C and negatively with %FM, estimated VAT volume and TG. Trunk to leg ratio correlated positively with TG even after controlling for %FM.ConclusionMen with chronic paraplegia had lower lean mass, higher total and regional fat mass, increased insulin resistance and low HDL-C when compared with BMI-matched able-bodied controls. Both total and regional adiposity correlated with poor metabolic profile.