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Sex dimorphism in the distribution of adipose tissue and its influence on proinflammatory adipokines and cardiometabolic profiles in motor complete spinal cord injury
Authors:Gary J. Farkas  Ashraf S. Gorgey  David R. Dolbow  Arthur S. Berg  David R. Gater
Affiliation:1. Department of Physical Medicine and Rehabilitation, Penn State College of Medicine, Hershey, Pennsylvania, USA;2. Spinal Cord Injury and Disorders Center, Hunter Holmes McGuire VA Medical Center, Richmond, Virginia, USA;3. School of Kinesiology, University of Southern Mississippi, Hattiesburg, Mississippi, USA;4. Department of Public Health Sciences, Penn State College of Medicine, Hershey, Pennsylvania, USA
Abstract:Objective: We aimed to examine the influence of sex on the distribution of adipose tissue, as well as proinflammatory adipokine and cardiometabolic profiles, in chronic motor complete spinal cord injury (SCI).

Design: Cross-sectional and correlational study.

Setting: Academic rehabilitation hospital.

Participants: Forty-seven individuals with chronic motor complete SCI classified according to sex (males: age 44.0?±?10.9 y, body mass index (BMI) 27.2?±?5.8, level of injury (LOI) C4 - L1; females: 42.0?±?13.5 y, BMI 27.8?±?6.6, LOI C4 - T11).

Intervention: Not applicable.

Outcome Measures: Visceral (VAT), subcutaneous (SAT), and total trunk (TTAT) adipose tissue volumes were assessed utilizing magnetic resonance imaging and a VAT:SAT ratio was calculated. Proinflammatory adipokines (tumor neurosis factor-α, interleukin-6, plasminogen activator inhibitor-1, thrombin-activatable fibrinolysis inhibitor, and high sensitivity c-reactive protein) and cardiovascular, carbohydrate, and lipid profiles were evaluated according to standard techniques.

Results: VAT and VAT:SAT ratio were significantly greater in male participates with SCI (P?≤?0.002), while SAT volume was significantly greater in female participants with SCI (P?=?0.001). No difference was noted in TTAT between groups (P?=?0.341). Male participants with SCI demonstrated lower high-density lipoprotein-cholesterol (HDLC) profiles and an elevated total cholesterol to HDLC ratio (P?≤?0.003) compared with females. No other significant differences were found between groups concerning cardiometabolic profiles or proinflammatory adipokines; however, males exhibited poorer profiles overall. Proinflammatory adipokines significantly correlated with adipose tissue depots by sex (P?

Conclusion: The results show that sex influences the distribution of adipose tissue, and may influence proinflammatory and cardiometabolic profiles following SCI. The findings of this study highlight the need for further research with dietary modification and exercise to decrease health risks.

Keywords:Spinal cord injury  Obesity  Adipose tissue  sex  Proinflammatory adipokines
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