It has been a well-studied fact that persons with spinal cord injuries (SCI) are at higher risk for heart disease.  This has been attributed to the fact that lack of exercise leads to a decrease in "the good kind of cholesterol" (HDL-C).  Research is now showing that it may not be as simple as that.

A study published in January of 2008 reported the results of research done to determine if people with SCI have elevated C-reactive protein (CRP) and to examine the association of CRP with HDL-C.  CRP is produced by the liver in response to inflammation.  When a blood test reveals increased CRP, it is an indication that some inflammatory process is going on somewhere in the body.  It doesn't tell you what or where.  It can be due to infection, heart attack, cancer, arthritis, etc.

Participants in this study were men with SCI who were free of infection and hadn't had any recent use of anti-inflammatory medications.  They were age- and race-matched with able-bodied men from the 1999-2002 National Health and Nutrition Examination Surveys.  

The study concluded that men with SCI were more likely to have elevated CRP levels.  The fact that they had low HDL-C was not as significant as high CRP when everything else was factored in (age, smoking, physical activity, waist circumference, and weight).  This led the authors to conclude that high CRP, common in SCI, is possibly more of a risk factor than just having low HDL-C.  Apparently chronic inflammation renders HDL-C less effective in its protective role.  This results in the build-up of fats in and on the artery walls (atherosclerosis).

The authors also addressed whether level and completeness of injury played a part in the CRP/HDL-C connection.  CRP levels were higher in complete versus incomplete injury.  However, no conclusion could be reached regarding level of injury and CRP.  The authors suggest further research to determine risk factors and prevention of cardiovascular disease in persons with SCI.

For further information, refer to: "Elevated C-Reactive Protein Associated With Decreased High-Density Lipoprotein Cholesterol in Men With Spinal Cord Injury," Liang, H MD PhD; Mojtahedi, M MS; Chen, D MD; Braunschweig, C PhD RD, Archives of Physical Medicine and Rehabilitation, January, 2008

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