The relationships among serum glucose, albumin concentrations and carotid atherosclerosis in men with spinal cord injury

• Published in: Atherosclerosis 2009-10, Vol.206 (2), p.528-534
• Main Authors: Wang, Yen-Ho, Chen, Ssu-Yuan, Wang, Tzung-Dau, Hwang, Bao-Show, Huang, Tien-Shang, Su, Ta-Chen
• Format: Article
• Language: English
• Subjects: Adult; Atherosclerosis (general aspects, experimental research); Biological and medical sciences; Blood and lymphatic vessels; Blood Glucose - metabolism; C-Reactive Protein - analysis; Cardiology. Vascular system; Cardiovascular; Carotid Artery Diseases - blood; Carotid Artery Diseases - diagnostic imaging; Carotid Artery, Common - chemistry; Carotid Artery, Common - diagnostic imaging; Carotid atherosclerosis; Humans; Impaired glucose tolerance; Insulin Resistance; Male; Medical sciences; Middle Aged; Neurosurgery; Serum albumin; Serum Albumin - metabolism; Skull, brain, vascular surgery; Spinal Cord Injuries - blood; Spinal Cord Injuries - complications; Spinal cord injury; Surgery (general aspects). Transplantations, organ and tissue grafts. Graft diseases; Taiwan; Tunica Intima - chemistry; Tunica Media - chemistry; Ultrasonography
• ISSN: 0021-9150; 1879-1484
• DOI: 10.1016/j.atherosclerosis.2009.02.035

Abstract Limited information is available that examines the interrelationships between glucose tolerance, serum albumin, subclinical inflammation, and carotid atherosclerosis (CA) in patients with spinal cord injury (SCI). We prospectively recruited 110 male patients with traumatic SCI, 57 with SCI at thoracic level 6 or above (SCI-T6) and 53 with SCI at T7 or below (SCI-T7), and 62 age-matched able-bodied controls from the National Taiwan University Hospital. The associations among glucose levels after oral glucose tolerance tests (OGTT), serum albumin, high-sensitivity C-reactive protein (hs-CRP), and CA in terms of the extracranial carotid artery (ECCA) plaque score and common carotid artery (CCA) intima-media thickness (IMT) were examined. Results showed significantly higher post-challenge glucose levels and carotid plaque scores and lower serum albumin in the SCI-T6 patients. In addition, serum albumin was negatively associated with CA and post-challenge glucose levels. The higher post-challenge glucose levels at 120 min (Glu120) were associated with higher serum hs-CRP levels and lower serum albumin levels. In addition, lower serum albumin levels were associated with a thicker CCA IMT and a higher prevalence of ECCA plaque. Mixed models revealed that body mass index, age, LDL-cholesterol, Glu120, homeostasis model assessment for insulin resistance (HOMA-IR), lower serum albumin and smoking habits were positively associated with CCA IMT. Age, HOMA-IR, LDL-cholesterol, and lower serum albumin were identified as the important factors for the presence of carotid plaque by multiple linear regression analyses. In conclusion, post-challenge hyperglycemia and serum albumin levels are important indicators of CV health in men with SCI.