Establishing a threshold to predict risk of cardiovascular disease from the serum triglyceride and high-density lipoprotein concentrations in persons with spinal cord injury.

摘要

Retrospective cohort. This report identified the serum triglyceride (TG) concentrations in persons with spinal cord injury (SCI) and able-bodied (AB) individuals that the serum high-density lipoprotein cholesterol (HDL-C) equaled 40?mg/dl, a concentration below which is an independent risk factor for coronary artery disease. Retrospective analysis was performed on 578 participants: 223 with SCI at or proximal to the 4th thoracic vertebrae (↑T4), 178 with SCI at or distal to the 5th thoracic vertebrae (↓T5), and 177 AB. Different statistical modeling approaches identified the intersecting serum TG concentration with a serum HDL-C concentration equal to 40?mg/dl. Participants were dichotomized into subgroups by TG concentration exceeding (supra) or falling below (sub) the intersecting value and the TG/HDL-C ratios were compared. Linear regression analysis revealed that the serum TG concentration that intersects with serum HDL-C concentration at 40?mg/dl was 121?mg/dl in SCI ↑T4 and 137?mg/dl in SCI ↓T5 group. A ROC curve identified the optimal TG concentration as 115?mg/dl in SCI ↑T4 and 137?mg/dl in SCI ↓T5 group with the latter concentration being similar to the AB group (e.g., 137?mg/dl). The TG/HDL-C ratios in the respective ↑T4, ↓T5, and AB supra and subgroups were similar within each group. A lower TG concentration appears to be associated with dyslipidemia in persons with SCI than AB individuals. These findings should prompt clinicians to screen for and consider instituting lifestyle or pharmacological interventions at lower TG concentrations to reduce risk of CVD.