학술논문
Insulin resistance in tetraplegia but not in mid-thoracic paraplegia: is the mid-thoracic spinal cord involved in glucose regulation?
Document Type
Article
Author
Source
Subject
*BLOOD sugar analysis
*CERVICAL vertebrae injuries
*SYMPATHETIC nervous system physiology
*THORACIC vertebrae injuries
*ANALYSIS of variance
*CARDIOVASCULAR disease diagnosis
*COMPUTER software
*INSULIN
*INSULIN resistance
*PARAPLEGIA
*QUADRIPLEGIA
*REHABILITATION centers
*RESEARCH funding
*SPINAL cord injuries
*STATISTICS
*TILT table
*DATA analysis
*REPEATED measures design
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Language
ISSN
1362-4393
Abstract
Study design:Controlled experimental human study.Objectives:To assess insulin resistance (IR) in tetraplegia and paraplegia, and the role of the spinal cord (SC) in glucose regulation.Setting:Laboratory of Spinal Research, Loewenstein Rehabilitation Hospital.Methods:Glucose and insulin levels and the heart rate variation spectral components LF (low frequency), HF (high frequency) and LF/HF were studied at supine rest, head-up tilt and after a standard meal in three groups: 13 healthy subjects, 7 patients with T4-T6 paraplegia and 11 patients with C4-C7 tetraplegia.Results:Glucose and insulin increased significantly after the meal in all groups (P<0.001). Glucose increased significantly more in the tetraplegia than in the other groups (P<0.01). Increases in insulin level tended to accompany increases in LF/HF after the meal in the tetraplegia and control groups but not in the paraplegia group.Conclusion:Post-prandial IR appears in C4-C7 but not in T4-T6 SC injury. The results of the study, combined with previously published findings, are consistent with the hypotheses that IR is related to activation of the sympathetic nervous system, and that below T4 the mid-thoracic SC is involved in the regulation of glucose and insulin levels. [ABSTRACT FROM AUTHOR]