THE EFFECT OF RESIDUAL NEUROLOGICAL DEFICIT OIL SERUM-LIPOPROTEINS ININDIVIDUALS WITH CHRONIC SPINAL-CORD INJURY

Subjects with spinal cord injury (SCI) have been shown to have an adve rse lipid profile. Prior studies performed with smaller numbers of sub jects have not been able to demonstrate any relationship between the l evel and degree of the neurological deficit and plasma lipid levels. O ver a 2 year period we investigated the lipid profiles in 541 subjects from Rancho Los Amigos Medical Center, Downey, California. Subjects w ere grouped by tetraplegia (Tetra; n=247) or paraplegia (Para; n=294) and by subgroup for degree of neurological deficit: complete Tetra (n= 156), incomplete Tetra (n=91), complete Para (n=206) and incomplete Pa ra (n=88). The serum high-density lipoprotein (HDL) cholesterol level was lower in the Tetra than in the Para group (38+/-0.7 vs 45+/-0.8, P <0.01). The group with Tetra had a higher percentage of subjects with serum HDL cholesterol values <35 mg/dL [an independent risk factor for coronary heart disase (CHD)] than those with Para (38% vs 21%, P<0.00 01). A significant inverse relationship was found for degree of neurol ogical deficit and mean serum HDL cholesterol level (r=0.19, P<0.001), with the greater the deficit, the lower the serum HDL cholesterol lev el. Serum total cholesterol levels were higher in the Para group than in the Tetra group (198+/-2.6 vs 184+/-2.6, P<0.01). However, the rati o of total cholesterol to HDL cholesterol (a discriminator of risk for CHD) was significantly lower in the Para group than the Tetra group ( 4.8 vs 5.2%, P<0.01). Thus, in persons with SCI a spectrum of depresse d serum HDL cholesterol levels and increased cardiovascular risk occur , with the most adverse lipid changes correlating with the severity of neurological deficit.