Cardiometabolic Risk, Obesity and Cardiovascular Disease in People With Spinal Cord Injury

The safety and scientific validity of this study is the responsibility of the study sponsor and investigators. Listing a study does not mean it has been evaluated by the U.S. Federal Government. Read our disclaimer for details. Identifier: NCT01204632
Recruitment Status : Completed
First Posted : September 17, 2010
Last Update Posted : February 18, 2016
MedStar National Rehabilitation Network
Information provided by (Responsible Party):
Mark S. Nash, Ph.D., FACSM, University of Miami

Brief Summary:
The purpose of this study is to develop and field-test new tools for diagnosis and hazard assessment of cardiometabolic risk (CMR) in people with chronic spinal cord injury (SCI) and to advance the evidence base with much needed information on CMR and cardiovascular disease (CVD) burden in people with SCI. These data can be used to develop screening guidelines for early identification and prevention of CMR in SCI, as well as targeted approaches to primary disease management.

Condition or disease
Spinal Cord Injury

Detailed Description:

Unlike current assessments utilizing lipid scores, the new system will be anchored in more reliable measurements of cardiovascular disease (CVD) burden using contemporary surrogate end points of coronary artery calcium (CAC) score, coronary CT angiography and carotid intima media thickness (CIMT). By the end of the 5-year funding cycle we will develop an updatable web-based cardiometabolic risk assessment tool (RISK) that will allow clinicians and SCI consumers to quantify risk for a cardiovascular sentinel event (stroke, non-fatal heart attack, or death) and will also provide a body mass index (BMI) table adjusted for SCI.

Specific Aims:

  1. Examine the relationships among surrogates of cardiovascular disease burden in persons with SCI and established cardiometabolic risks.
  2. Identify significant predictors of cardiometabolic risk (CMR) that are unique to persons with specific levels of SCI.
  3. Develop and validate SCI CMR assessment tool (RISK) based on cardiometabolic risk scores.
  4. Develop and validate an adjusted BMI table for SCI.

Study Type : Observational
Actual Enrollment : 74 participants
Observational Model: Cohort
Time Perspective: Prospective
Official Title: Cardiometabolic Risk, Obesity and Cardiovascular Disease in People With Spinal Cord Injury
Study Start Date : March 2010
Actual Primary Completion Date : December 2015
Actual Study Completion Date : December 2015

Resource links provided by the National Library of Medicine

Primary Outcome Measures :
  1. Body composition [ Time Frame: 1 visit ]
    The percent of muscle and fat in each participants' body will be measured by dual x-ray absorptiometry (DEXA) scan.

Secondary Outcome Measures :
  1. Carotid Intima-Media Thickness [ Time Frame: 1 visit ]
    Carotid intima-media thickness (IMT) measurements will be generated using B-mode external vascular ultrasound.

  2. Coronary Artery Calcium [ Time Frame: 1 visit ]
    Non-contrast cardiac CT will be used to measure coronary artery calcium, as the presence of any calcium detected in the coronary tree is diagnostic of atherosclerosis. The volume of calcium is quantified, providing a score of plaque burden analogous to a physiologic stress test. Coronary calcium scores directly correlate with risk of cardiac events, with higher scores indicating greater plaque burden and greater risk of cardiac events.

  3. Atherosclerotic plaques [ Time Frame: 1 visit ]
    Noninvasive CT angiography will be used in visualizing both calcified and non-calcified atherosclerotic plaques. This technique provides much finer anatomic detail and provides an opportunity to further identify latent atherosclerosis risk through the detection of both calcified and noncalcified atherosclerosis.

  4. Area Under the Curve (AUC)for lipemia [ Time Frame: 1 visit ]
    Lipemia is assessed by the AUC for triglycerides during an oral glucose tolerance test.

  5. Area Under the Curve (AUC) for glycemia [ Time Frame: 1 visit ]
    Glycemia is assessed by the AUC for glucose and insulin during an oral glucose tolerance test.

  6. Area Under the Curve (AUC)for vascular inflammation [ Time Frame: 1 visit ]
    The pro-atherogenic inflammatory mediators are AUCs for C-reactive protein and Interleukin-6 during an oral glucose tolerance test.

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Ages Eligible for Study:   18 Years to 65 Years   (Adult, Older Adult)
Sexes Eligible for Study:   All
Accepts Healthy Volunteers:   No
Sampling Method:   Non-Probability Sample
Study Population
Community sample of healthy persons with spinal cord injury

Inclusion Criteria:

  • traumatic spinal cord injury between C4 and T12
  • have a motor complete injury as classified as American Spinal Injury Association Impairment Scale (AIS) grade A or B
  • injury for more than 1 year
  • no known history of traumatic brain injury, cardiovascular disease or diabetes
  • not currently taking any medications to treat cardiovascular disease or diabetes
  • have multiple (i.e., 2+) of the following cardiometabolic risk factors:

    1. fasting triglyceride > 150 mg/dL
    2. HDLC < 40 mg/dL
    3. hs-CRP > 3.0
    4. body fat (by DEXA) >25% for males and 33% for females

Exclusion Criteria:

  • history of allergy or hypersensitivity to fish and/or nuts
  • undergoing anticoagulant therapies

Information from the National Library of Medicine

To learn more about this study, you or your doctor may contact the study research staff using the contact information provided by the sponsor.

Please refer to this study by its identifier (NCT number): NCT01204632

United States, Florida
The Miami Project to Cure Paralysis
Miami, Florida, United States, 33136
Sponsors and Collaborators
University of Miami
MedStar National Rehabilitation Network
Principal Investigator: Mark S Nash, PhD University of Miami Miller School of Medicine, The Miami Project to Cure Paralysis

Responsible Party: Mark S. Nash, Ph.D., FACSM, Professor, University of Miami Identifier: NCT01204632     History of Changes
Other Study ID Numbers: TMP-MN-008
First Posted: September 17, 2010    Key Record Dates
Last Update Posted: February 18, 2016
Last Verified: February 2016

Additional relevant MeSH terms:
Wounds and Injuries
Cardiovascular Diseases
Spinal Cord Injuries
Spinal Cord Diseases
Central Nervous System Diseases
Nervous System Diseases
Trauma, Nervous System