Insulin resistance in tetraplegia but not in mid-thoracic paraplegia: Is the mid-thoracic spinal cord involved in glucose regulation

V. Bluvshtein, A. D. Korczyn, I. Pinhas, Y. Vered, I. Gelernter, A. Catz*

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

9 Scopus citations

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 T 4-T 6 paraplegia and 11 patients with C 4-C 7 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 C 4-C 7 but not in T 4-T 6 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 T 4 the mid-thoracic SC is involved in the regulation of glucose and insulin levels.

Original languageEnglish
Pages (from-to)648-652
Number of pages5
JournalSpinal Cord
Volume49
Issue number5
DOIs
StatePublished - May 2011

Keywords

  • head-up tilt
  • insulin resistance
  • spectral analysis
  • spinal cord injury
  • sympatho-vagal balance
  • thoracic spinal cord

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