Search

BACKGROUND Early screening is important in individuals with spinal cord injury (SCI) as they were deemed high-risk for cardiometabolic diseases. Few studies explored changes in cardiometabolic risk profile in the early phase of the injury. Thus, it remains unclear how early the cardiometabolic status deteriorates after injury. OBJECTIVE We determined the longitudinal changes in the cardiometabolic risk profile and examined the association between injury characteristics and cardiometabolic status in subacute SCI. SETTING Multicenter Swiss Spinal Cord Injury Cohort. PARTICIPANTS Adults with traumatic SCI without history of cardiovascular disease or type 2 diabetes. MAIN OUTCOME MEASURES Blood pressure (BP), lipid profile, fasting glucose, waist circumference (WC), weight, body mass index (BMI) and Framingham risk score (FRS) were compared across time and according to the injury characteristics. RESULTS We analyzed the data of 258 individuals with traumatic SCI (110 tetraplegia and 148 paraplegia, 122 motor complete and 136 incomplete). The median age was 50 years (IQR 32-60), with 76.36% (n=197) of the population being male. The median rehabilitation duration was 5.5 months (IQR 3.2-7.1). At admission to rehabilitation, fully-adjusted linear regression models showed higher baseline weight (β 0.06, 95% CI 0.005, 0.11), systolic BP (β 0.05, 95% CI 0.008, 0.09), diastolic BP (β 0.05 95% CI 0.004, 0.10), and triglycerides (β 0.27 95% CI 0.13, 0.42) in paraplegia than tetraplegia. Systolic BP, diastolic BP, HDL-C were higher in incomplete than complete injury. In our main analysis, we observed an increase in cholesterol and HDL-C and lipid ratio when comparing the beginning and end of rehabilitation. Individuals with paraplegia had a higher increase in BMI than tetraplegia, while no differences in other cardiometabolic risk factors were detected when comparing motor incomplete and complete injury. Trajectories of each participant showed that the majority of individuals with SCI decreased FRS score at follow-up compared to baseline and no significant changes in prevalence of cardiometabolic syndrome were observed. At discharge, one-third of study participants were classified as moderate to high risk of CVD, 64% were overweight, and 39.45% had cardiometabolic syndrome. CONCLUSION We observed a modest improvement in lipid profile and FRS during the first inpatient rehabilitation hospitalization. Injury characteristics, such as level and completeness, were not associated with changes in cardiometabolic risk factors in the subacute phase of the injury. Despite this, a significant proportion of study participants remained at risk of cardiometabolic disease at discharge, suggesting that early cardiometabolic preventive strategies may be initiated as early as during the first inpatient rehabilitation hospitalization. This article is protected by copyright. All rights reserved.

Objective To determine the longitudinal changes in the cardiometabolic risk profile and examine the association between injury characteristics and cardiometabolic status in subacute SCI. Setting Multicenter Swiss Spinal Cord Injury Cohort. Participants Adults with traumatic SCI without a history of cardiovascular disease or type 2 diabetes. Main Outcome Measures Blood pressure (BP), lipid profile, fasting glucose, waist circumference (WC), weight, body mass index (BMI), and Framingham risk score (FRS) were compared across time and according to the injury characteristics. Results We analyzed the data of 258 individuals with traumatic SCI (110 tetraplegia and 148 paraplegia, 122 motor complete, and 136 incomplete). The median age was 50 years (interquartile range [IQR] 32-60), with 76.4% (n = 197) of the population being male. The median rehabilitation duration was 5.5 months (IQR 3.2-7.1). At admission to rehabilitation, fully adjusted linear regression models showed higher baseline weight (β 0.06, 95% confidence interval [CI] 0.005 to 0.11), systolic BP (β 0.05, 95% CI 0.008 to 0.09), diastolic BP (β 0.05, 95% CI 0.004 to 0.10), and triglycerides (β 0.27, 95% CI 0.13 to 0.42) in paraplegia than tetraplegia. Systolic BP, diastolic BP, high-density lipoprotein cholesterol (HDL-C) levels were higher in incomplete than complete injury. In our main analysis, we observed an increase in cholesterol and HDL-C and lipid ratio when comparing the beginning and end of rehabilitation. Individuals with paraplegia had a higher increase in BMI than individuals with tetraplegia, whereas no differences in other cardiometabolic risk factors were detected when comparing motor incomplete and complete injury. Trajectories of each participant showed that the majority of individuals with SCI decreased FRS score at follow-up compared to baseline and no significant changes in the prevalence of cardiometabolic syndrome were observed. At discharge, one third of study participants were classified as moderate to high risk of cardiovascular disease (CVD), 64% were overweight, and 39.4% had cardiometabolic syndrome. Conclusion We observed a modest improvement in lipid profile and FRS during the first inpatient rehabilitation hospitalization. Injury characteristics, such as level and completeness, were not associated with changes in cardiometabolic risk factors in the subacute phase of the injury. Despite this, a significant proportion of study participants remained at risk of cardiometabolic disease at discharge, suggesting that early cardiometabolic preventive strategies may be initiated as early as during the first inpatient rehabilitation hospitali, + ID der Publikation: unilu_64227 + Sprache: Englisch + Letzte Aktualisierung: 2023-07-04 11:56:13

Interleukin-18 (IL-18), a proinflammatory and proatherogenic cytokine, has been associated with type 2 diabetes, metabolic syndrome, stroke and coronary artery disease. Some studies have indicated that the IL-18 promoter -137 G/C polymorphism seems to be associated with changes in the IL-18 expression and may contribute to the development of cardiovascular disease (CVD). The aim of this study was to evaluate the association between -137 G/C polymorphism and the levels of IL-18, biochemical markers for cardiovascular disorders, anthropometric profile and cardiovascular disease in Brazilian patients with type 2 diabetes (T2DM).Study subjects comprised 125 T2DM patients undergoing follow-up at a reference endocrinology service in northeastern Brazil. The -137G/C polymorphism in the IL-18 gene and serum IL-18 levels were determined by using allele-specific polymerase chain reaction (PCR) and enzyme-linked immune assay (ELISA), respectively. The anthropometric parameters were assessed using a Body Composition Monitor with Scale, and the laboratory data were measured using an automatic analyzer as well as spectrophotometric analysis.The genotype distribution of IL-18 -137 G/C genetic polymorphism was significantly different among T2DM patients with and without CVD. The results show an association between the CC genotype of -137G/C polymorphism and CVD in T2DM patients (p 0.001). Serum levels of IL-18 were significantly higher in CC carriers (843.1 pg/mL) compared with GG or GC carriers (303.6 pg/mL and 292.0 pg/mL, respectively). In addition, the present study showed that carriers of the CC genotype also had significantly higher concentrations of creatinine and albuminuria than carriers of the GG or GC genotypes (p 0.05 in both).These results suggest that Brazilian T2DM patients with the CC genotype seem to show a predisposition to CVD, as well as an elevation in markers of renal function.

Objective: The Functional Independence Measure (FIM���) and spinal cord injury (SCI)-specific Spinal Cord Independence Measure (SCIM) are commonly used tools for outcome measurement and quality reporting in rehabilitation. The objective of this study was to investigate the psychometric properties of FIM��� and SCIM and to equate the 2 scales. Methods: First, content equivalence of FIM��� and SCIM was established through qualitative linking with the International Classification for Functioning, Disability and Health (ICF). Secondly, a Rasch analysis of overlapping contents determined the metric properties of the scales and provided the empirical basis for scale equating. Furthermore, a transformation table for FIM��� and SCIM was created and evaluated. Subjects: Patients with SCI in Swiss inpatient rehabilitation in 2017���18. Results: The ICF linking and a separate Rasch analysis of FIM��� restricted the analysis to the motor scales of FIM��� and SCIM. The Rasch analysis of these scales showed good metric properties. The co-calibration of FIM��� and SCIM motor scores was supported with good fit to the Rasch model. The operational range of SCIM is larger than for FIM��� motor scale. Discussion: This study supports the advantage of using SCIM compared with FIM��� for assessing the functional independence of patients with SCI in rehabilitation., + ID der Publikation: unilu_58483 + Sprache: Englisch + Letzte Aktualisierung: 2022-03-02 15:34:56

Background and objectives: Single Nucleotide Polymorphisms (SNP) are promising atherosclerosis indicators. The APOAI gene polymorphism variant rs670 shows that G (Guanine) allele is the most frequent and the A (Adenine) allele is the rarest, with both being associated with HDL-c variations in different ethnicities. In the APOB variant rs693, the C (Cytosine) allele is the most frequent, while the T (Timine) allele is the rarest and associated with dyslipidemia and cardiovascular risk. This study aims to evaluate biochemical and genetic risk factors for CVD development in young Brazilians and Africans.Methods: Anthropometric parameters were used for measurement. Blood Samples were collected to evaluate Total cholesterol, triglycerides, HDL-cholesterol, LDL-cholesterol, Apolipoproteins A-I and B, ApoB/ApoA-I ratio, and high-sensitive C-reactive protein (hs-CRP) quantification. The antioxidant capacity of HDL was evaluated by the LagTime assay and the serum enzyme Paraoxonase 1 (PON1) activity. Genetic Analysis was made through DNA extraction from whole blood leukocytes and genotyping of the rs670 and rs693 polymorphisms using the real-time PCR (q-PCR) technique. Results: G allele and homozygous GG genotype of rs670 were the most frequent in both ethnicities. Among Brazilians, the A allele and GA genotype were associated with higher cardiovascular risk. Regarding the rs693 polymorphism, the C allele was the most frequent in both ethnicities, and the T allele was more frequent between Africans. Also, the CC genotype was the most frequent among Brazilians, and the CT genotype the most frequent among Africans, which presented higher TT frequency. T allele and TT genotype were associated with higher cardiovascular risk factors in both populations. Conclusion: Brazilians are doubly affected by these variables, while Africans are more susceptible to risks due to changes in the rs693 polymorphism.