Authors' objectives: To assess the prevalence of carbohydrate and lipid disorders in adults with chronic spinal cord injury and evaluate their risk contribution to cardiovascular diseases and the potential impact of exercise and pharmacologic and dietary therapies to alter these disorders and reduce cardiovascular disease risk.

Authors' results and conclusions: The quality of evidence regarding the prevalence, impact, and outcomes of carbohydrate and lipid disorders in adults with chronic spinal cord injuries is weak. Evidence is limited by relatively few studies, small sample size, lack of appropriate control groups, failure toadjust for known confounding variables, and variation in reported outcomes. However, the existing evidence does not indicate that adults with spinal cord injuries are at markedly greater risk for carbohydrate and lipid disorders or subsequent cardiovascular morbidity and mortality than able-bodied adults. Body mass index is not reliable for assessing body composition, especially percent body fat, in adults with spinal cord injury. There are no high quality studies evaluating the impact of exercise, diet, or pharmacologic therapies on these disorders.

Authors' recommendations: Evidence does not support using different thresholds to define or treat abnormal lipid and carbohydrate measures or to incorporate other markers to assess risk (e.g., insulin resistance, impaired fasting glucose, or impaired glucose tolerance) for individuals with spinalcord injuries compared to able-bodied adults. Due to physiologic differences between adults with spinal cord injuries and able-bodied individuals, caution may be required when extrapolating findings from studies conducted in able-bodied adults. The role of exercise in individuals with spinal cord injuries represents a unique challenge and requires further exploration into the benefits, harms, and resource implications of broad-based spinal cord injury exercise programs.

Authors' methods: Review

Project Status: Completed

URL for project: http://www.ahrq.gov/clinic/tp/carbliptp.htm

Year Published: 2008

URL for published report: https://www.ahrq.gov/downloads/pub/evidence/pdf/carblipspinal/carblip.pdf

English language abstract: An English language summary is available

Publication Type: Not Assigned

Country: United States

Organisation Name: Agency for Healthcare Research and Quality

Contact Address: Center for Outcomes and Evidence Technology Assessment Program, 540 Gaither Road, Rockville, MD 20850, USA. Tel: +1 301 427 1610; Fax: +1 301 427 1639;

Contact Name: martin.erlichman@ahrq.hhs.gov

Contact Email: martin.erlichman@ahrq.hhs.gov

Copyright: Agency for Healthcare Research and Quality (AHRQ)