paraplegia (aged > 55 years), prev-
alence of HTN was similar to that
of men in the general population.
Serum lipids and their fractions
have been studied in patients with
SCI by several investigators. 5-15 The
most frequent finding was a decreased level of high-density lipoprotein cholesterol (HDL-C). 10, 12, 14, 15
Total serum cholesterol concentration and low-density lipoprotein
choloesterol (LDL-C), including
triglycerides (TGs), were less affected. 10, 12 This study focused on
the general abnormalities of lipids,
namely, serum cholesterol and TGs.
The study observation supported
previous findings by others and indicated that in patients with SCI,
regardless of patient’s age for more
accurate determination of lipid abnormalities and associated risk factors, the diagnosis of DL should
include determination of cholesterol
fractions HDL-C and LDL-C. 10, 12
In 1980, when insulin measure-
ments in serum became available,
Duckworth and co-investigators
used the oral glucose tolerance test
in patients with SCI to study car-
bohydrate metabolism after SCI. 16
These authors found an insulin re-
sistance in patients with SCI that
correlated with the duration of
SCI. These findings were later con-
firmed by Bauman and colleagues
in 1994 and 1999.17,18 In addition
to insulin resistance, Bauman and
colleagues documented a higher
prevalence of DM after SCI. 19 In the
first study, they found prevalence
of DM of 22%; in the second study,
a prevalence of 13%. 17,18 In addi-
tion, 29% of veterans were found
to have impaired glucose toler-
ance by World Health Organization
criteria.18 The authors compared
their results with the results of
prevalence of DM in the general
population (aged 20 to 70 years,
reported by Harris and colleagues)
and found a marked difference of
2- to 3-fold higher prevalence of
DM in patients with SCI than that
in the general population with the
prevalence of 6.6%. 19 The age strat-
ification was not addressed in these
studies, and an older SCI popula-
tion was evaluated with a younger
general population. Prevalence of
DM in patients with SCI was also
studied by a group of investiga-
tors from different SCI centers in
the U.S., using data obtained in a
cross-sectional survey in 2003 of
18,372 individuals. 20 These re-
sults were compared with data
published by the CDC in 2003 for
the general population in the U.S.
An overall prevalence of DM in
patients not stratified by age was
20%, 3 times higher than that in
the general population.
The authors report no actual or po-
tential conflicts of interest with re-
gard to this article.
The opinions expressed herein are
those of the authors and do not nec-
essarily reflect those of Federal
Practitioner, Quadrant HealthCom
Inc., a division of Frontline Medi-
cal Communications, Inc., the U.S.
Government, or any of its agencies.
This article may discuss unlabeled or
investigational use of certain drugs.
Please review complete prescribing
information for specific drugs or
drug combinations—including indi-
cations, contraindications, warnings,
and adverse effects—before adminis-
tering pharmacologic therapy to pa-
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3. Weaver FM, Collins EG, Kurichi J, et al. Prevalence of obesity and high blood pressure in
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