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- Title
Neurogenic Obesity and Skeletal Pathology in Spinal Cord Injury.
- Authors
McMillan, David W.; Nash, Mark S.; Gater Jr, David R.; Valderrábano, Rodrigo J.
- Abstract
Spinal cord injury (SCI) results in dramatic changes in body composition, with lean mass decreasing and fat mass increasing in specific regions that have important cardiometabolic implications. Accordingly, the recent Consortium for Spinal Cord Medicine (CSCM) released clinical practice guidelines for cardiometabolic disease (CMD) in SCI recommending the use of compartmental modeling of body composition to determine obesity in adults with SCI. This recommendation is guided by the fact that fat depots impact metabolic health differently, and in SCI adiposity increases around the viscera, skeletal muscle, and bone marrow. The contribution of skeletal muscle atrophy to decreased lean mass is self-evident, but the profound loss of bone is often less appreciated due to methodological considerations. General-population protocols for dual-energy x-ray absorptiometry (DXA) disregard assessment of the sites of greatest bone loss in SCI, but the International Society for Clinical Densitometry (ISCD) recently released an official position on the use of DXA to diagnose skeletal pathology in SCI. In this review, we discuss the recent guidelines regarding the evaluation and monitoring of obesity and bone loss in SCI. Then we consider the possible interactions of obesity and bone, including emerging evidence suggesting the possible influence of metabolic, autonomic, and endocrine function on bone health in SCI.
- Subjects
ENDOCRINE system physiology; AUTONOMIC nervous system physiology; OBESITY; BODY composition; SPINAL cord injuries; BONES; PHOTON absorptiometry; LEAN body mass; HEALTH status indicators; MEDICAL protocols; LIPIDS; ADIPOSE tissues
- Publication
Topics in Spinal Cord Injury Rehabilitation, 2021, Vol 27, Issue 1, p57
- ISSN
1082-0744
- Publication type
Article
- DOI
10.46292/sci20-00035