Intramuscular fat and glucose tolerance after spinal cord injury – a cross-sectional study

Abstract

Study design: Survey. Objective: Determine intramuscular fat (IMF) in affected skeletal muscle after complete spinal cord injury using a novel analysis method and determine the correlation of IMF to plasma glucose or plasma insulin during an oral glucose tolerance test. Setting: General community of Athens, GA, USA. Methods: A total of 12 nonexercise-trained complete spinal cord injured (SCI) persons (10 males and two females 4012 years old (meanSD), range 26–71 years, and 85 years post SCI) and nine nonexercise-trained nondisabled (ND) controls 299 years old, range 23–51 years, matched for height, weight, and BMI, had T₁ magnetic resonance images of their thighs taken and underwent an oral glucose tolerance test (OGTT) after giving consent. Results: Average skeletal muscle cross-sectional area (CSA) (meanSD) was 58.621.6 cm² in spinal cord subjects and 94.132.5 cm² in ND subjects. Average IMF CSA was 14.56.0 cm² in spinal cord subjects and 4.72.5 cm² in nondisabled subjects, resulting in an almost four-fold difference in IMF percentage of 17.34.4% in spinal cord subjects and 4.62.6% in nondisabled subjects. The 60, 90 and 120 min plasma glucose or plasma insulin were higher in the SCI group. IMF (absolute and %) was related to the 90 or 120 min plasma glucose or plasma insulin (r ²=0.71–0.40). Conclusions: IMF is a good predictor of plasma glucose during an OGTT and may be a contributing factor to the onset of impaired glucose tolerance and type II diabetes, especially in SCI. In addition, reports of skeletal muscle CSA should be corrected for IMF.