Glucose

Bauman et al. 1999
USA
D&B=19
Case series
N=201

Population: Mean age=39yrs; Gender: males=169, females=32; Mean duration of injury=13yrs; Mean weight=75.9kg; Mean BMI=25; Level of injury: tetraplegia=81; paraplegia=120; Severity of injury: complete=140, incomplete=61
Treatment: Oral glucose tolerance testing was performed on SCI individuals attending routine annual physical examination.
Outcome Measures: Serum glucose concentration, plasma insulin levels, hyperinsulinemia, serum uric acid

1. Individuals with complete tetraplegia had higher values for serum glucose concentration at 60 min, 90 min and 120 min and for plasma insulin at 90 min and 120 min after a standard oral glucose load.
2. Levels of serum glucose were similar in both men and women; however plasma insulin levels were greater in men than women at all time points (p<0.05).
3. Individuals with complete tetraplegia also had an increased frequency of DM compared to others.
4. Individuals with tetraplegia had a significantly higher rate of hyperinsulinemia than individuals with paraplegia, p<0.05.
5. A significant relationship was found between serum uric acid and BMI (p<0.0001), peak serum glucose (p=0.001) and peak plasma insulin (p=0.01).

Bennegard & Karlsson 2008
Sweden
D&B=19
Prospective controlled trial
N=19

Population: SCI (n=9): Mean age=40.8yrs; Mean weight=71.2kg; Level of injury: cervical=2, thoracic=7; Severity of injury: AIS A=8, B=1; Able bodied controls (n=10): Mean age=31.9yrs; weight=75.9kg
Treatment: Blood flow and glucose levels were analyzed after overnight fasting by individuals in the SCI group compared to those in the able bodied control group.
Outcome Measures: Glucose uptake, plasma flow, lean tissue mass, lactate

1. SCI individuals were found to have significantly higher glucose uptake than those in the control group (p<0.05).
2. Plasma flow was higher in legs of SCI individuals than the controls.
3. Control subjects had higher lean tissue mass in their legs compared to the SCI subjects who only had 2/3 of the lean mass of the control subjects.
4. Glucose uptake was lower in legs than arms in the control group; while venous glucose concentration was higher in the leg (p<0.05). However SCI group found no such difference.
5. Control subjects had a higher lactate production in arms than legs (p<0.05), while SCI subjects did not.

Lipid

Ketover et al. 1996
USA
D&B=19
Prospective controlled trial
N=58

Population: Able bodied controls (n=29): Mean age=36yrs; Gender: males=13, females=16;Obseity (BMI greater than 27)=14; SCI (n=29): Mean age=51yrs; Gender: males=28, females=1; Obesity (BMI greater than 27)=11
Treatment: SCI individuals and able bodied controls were administered a 20g fat liquid meal to quantify gallbladder emptying response.
Outcome Measures: Gallbladder emptying

1. No significant difference was seen in gallbladder emptying and volumes between SCI individuals and able bodied subjects.
2. In SCI subjects with diabetes and obesity poor gallbladder emptying was seen.
3. Age and injury level had no effect on gallbladder emptying.