Clinical Factors Associated with C - Reactive Protein in Chronic Spinal Cord Injury

Study Design Cross-sectional study. Objectives: Determine clinical factors associated with plasma C-reactive protein (CRP) in persons with chronic spinal cord injury (SCI). Setting: Veterans Affairs Medical Center in Boston, MA. Methods: Participants provided a blood sample, completed a respiratory health questionnaire, and underwent dual x-ray absorptiometry (DXA) to assess total and regional body fat. Linear regression models were used to assess cross-sectional associations with plasma CRP. Results: In multivariable models, factors associated with a higher CRP included a greater BMI, urinary catheter use, a respiratory illness in the past week, and non-white race. Mean CRP also increased with decreasing mobility (motorized wheel chair >hand propelled wheel chair > walk with an assistive device > walk independently). Results were similar when adjusting for % android, gynoid, trunk, or total fat mass in place of BMI. Level and completeness of SCI was not associated with CRP in multivariable models. Conclusions: Clinical characteristics common in chronic SCI are associated with plasma CRP. These factors are more important than level and completeness of SCI and some are potentially modifiable

FEV1 and FVC and systemic inflammation in a spinal cord injury cohort

Background: Systemic inflammation has been associated with reduced pulmonary function in individuals with and without chronic medical conditions. Individuals with chronic spinal cord injury (SCI) have clinical characteristics that promote systemic inflammation and also have reduced pulmonary function. We sought to assess the associations between biomarkers of systemic inflammation with pulmonary function in a chronic SCI cohort, adjusting for other potential confounding factors. Methods: Participants (n = 311) provided a blood sample, completed a respiratory health questionnaire, and underwent spirometry. Linear regression methods were used to assess cross-sectional associations between plasma C-reactive protein (CRP) and interleukin-6 (IL-6) with forced expiratory volume in one second (FEV1), forced vital capacity (FVC), and FEV1/FVC. Results: There were statistically significant inverse relationships between plasma CRP and IL-6 assessed in quartiles or continuously with FEV1 and FVC. In fully adjusted models, each interquartile range (5.91 mg/L) increase in CRP was associated with a significant decrease in FEV1 (−55.85 ml; 95% CI: -89.21, −22.49) and decrease in FVC (−65.50 ml; 95% CI: -106.61, −24.60). There were similar significant findings for IL-6. There were no statistically significant associations observed with FEV1/FVC. Conclusion: Plasma CRP and IL-6 in individuals with chronic SCI are inversely associated with FEV1 and FVC, independent of SCI level and severity of injury, BMI, and other covariates. This finding suggests that systemic inflammation associated with chronic SCI may contribute to reduced pulmonary function. Electronic supplementary material The online version of this article (doi:10.1186/s12890-017-0459-6) contains supplementary material, which is available to authorized users

Additional file 1: Table S1. of FEV1 and FVC and systemic inflammation in a spinal cord injury cohort

Univariate adjusted mean levels of FEV1 by quartile of inflammatory biomarkers and associations per IQR change. (DOCX 48 kb

Associations between vitamin D, adiposity, and respiratory symptoms in chronic spinal cord injury

<p>Persons with chronic spinal cord injury (SCI) have an increased risk of respiratory-related morbidity and mortality and chronic respiratory symptoms are clinical markers of future respiratory disease. Therefore, we sought to assess potentially modifiable factors associated with respiratory symptoms, with a focus on circulating vitamin D and measures of body fat.</p> <p>Cross-sectional study.</p> <p>Veterans Affairs Medical Center.</p> <p>Three hundred forty-three participants (282 men and 61 women) with chronic SCI participating in an epidemiologic study to assess factors influencing respiratory health recruited from VA Boston and the community.</p> <p>Participants provided a blood sample, completed a respiratory health questionnaire, and underwent dual x-ray absorptiometry (DXA) to assess % body fat. Logistic regression was used to assess cross-sectional associations between respiratory symptoms and plasma vitamin D and measures of body fat with adjustment for a number of potential confounders.</p> <p>Chronic cough, chronic phlegm, any wheeze, persistent wheeze.</p> <p>After adjustment for a number of confounders (including smoking), participants with greater %-android, gynoid, trunk, or total body fat had increased odds ratios for any wheeze and suggestive associations with persistent wheeze, but not with chronic cough or phlegm. Vitamin D levels were not associated with any of the respiratory symptoms.</p> <p>Increased body fat, but not vitamin D, was associated with wheeze in chronic SCI independent of a number of covariates.</p