Lipoproteins and free plasma catecholamines in spinal cord injured men with different injury levels

Persons with spinal cord injury (SCI) are especially prone to atherogenesis . This is partly explained by an unfavourable lipoprotein profile in these individuals. The impairment of the sympathetic nervous system, and the fact that SCI subjects are subject to extreme physical inactivity, may have an influence on their lipid profile and lipoprotein(a) concentration. We made a detailed investigation of the lipid profile as well as serum levels of ad renaline and noradrenaline in 80 men with SCI ranging from tetraplegia to l ow paraplegia and in 16 control subjects. The lipid profile of tetraplegics was characterized by elevated very low-density lipoprotein cholesterol and triglyceride levels and reduced high-density lipoprotein levels. In contra st, paraplegics had significantly higher low-density lipoprotein and total cholesterol levels. Tetraplegics had lower and the low-lesion paraplegics h ad higher adrenaline and noradrenaline levels than the high-lesion parapleg ics and the control subjects. High-lesion SCI subjects also showed an extre me reduction in VO2max. The lipoprotein profile was dependent on the injury level and serum catecholamine concentrations. The lower the noradrenaline values, the lower the high-density lipoprotein cholesterol. The low-density lipoprotein also correlated to catecholamines and particularly adrenaline values. Despite the correlation between lipoprotein(a) and adrenaline, no s ignificant differences in lipoprotein(a) were found within SCI individuals as well as between SCI individuals and control subjects, indicating the pre dominantly genetic determination of lipoprotein(a) and thus the cardiovascu lar risk. Different serum catecholamine levels due to impairment of sympath etic nervous system and VO2max levels were observed in SCI subjects. This w as associated with a higher lipid risk profile for cardiovascular diseases; however, the risk profile is dependent on the lesion level.