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 language | English |
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Pages (from-to) | 648-652 |
Number of pages | 5 |
Journal | Spinal Cord |
Volume | 49 |
Issue number | 5 |
DOIs | |
State | Published - May 2011 |
Keywords
- head-up tilt
- insulin resistance
- spectral analysis
- spinal cord injury
- sympatho-vagal balance
- thoracic spinal cord