Postprandial Lipid Tracer and Exercise in Spinal Cord Injury
| Status: | Active, not recruiting |
|---|---|
| Conditions: | Hospital, Hospital, Orthopedic |
| Therapuetic Areas: | Orthopedics / Podiatry, Other |
| Healthy: | No |
| Age Range: | 18 - 60 |
| Updated: | 10/3/2018 |
| Start Date: | May 30, 2018 |
| End Date: | July 2020 |
Postprandial Fat Metabolism Following an Acute Exercise Bout in Persons With Spinal Cord Injuries
This study investigates the effect of upper extremity exercise on postprandial lipemia (PPL)
in persons with spinal cord injury (SCI). Participants are measured at rest and fed a
standardized meal following seated rest (CON) or arm cycling exercise (ACE). The meal is
infused with "stable isotope lipid tracers" that allow for determination of the end fates of
the fat in the meal.
in persons with spinal cord injury (SCI). Participants are measured at rest and fed a
standardized meal following seated rest (CON) or arm cycling exercise (ACE). The meal is
infused with "stable isotope lipid tracers" that allow for determination of the end fates of
the fat in the meal.
Spinal cord injury (SCI) results in dysregulation of fat metabolism that increases the risk
of morbidity and mortality from cardioendocrine disease. Excessive accumulation of visceral
fat after SCI is a serious risk component for cardioendocrine disease and results in part
from pronounced hypertriglyceridemia following ingestion of fat-containing meals (i.e.,
exaggerated postprandial lipemia; PPL). Although exaggerated PPL is well documented in
persons with SCI, its etiology is unknown. Specifically, it remains to be determined to what
extent exaggerated PPL in those with SCI results from impairments in the use of exogenous
(dietary) and/or endogenous (stored) fats. Additionally, it is not known if exercise improves
postprandial fat use in a manner that alleviates the exaggerated PPL in this population and
reduces the risk of cardioendocrine disease.
The objective of the this study is to examine the mechanisms of exaggerated PPL in those with
SCI and the effects of an acute pre-meal exercise bout by employing novel stable isotope
tracer techniques. In persons without SCI, it is well established that pre-meal exercise
lowers PPL in part by improving the use of exogenous and endogenous fats. While muscle
atrophy and blunted sublesional sympathetic activity following SCI may hinder fat use,
preliminary data indicate that fat use is increased during recovery from exercise in the
postabsorptive (fasted) state in this population. Thus, the investigators hypothesize that
decreased use of exogenous and endogenous fats contributes to exaggerated PPL in SCI, and
that pre-meal exercise will reduce PPL due to increased use of both fat sources.
of morbidity and mortality from cardioendocrine disease. Excessive accumulation of visceral
fat after SCI is a serious risk component for cardioendocrine disease and results in part
from pronounced hypertriglyceridemia following ingestion of fat-containing meals (i.e.,
exaggerated postprandial lipemia; PPL). Although exaggerated PPL is well documented in
persons with SCI, its etiology is unknown. Specifically, it remains to be determined to what
extent exaggerated PPL in those with SCI results from impairments in the use of exogenous
(dietary) and/or endogenous (stored) fats. Additionally, it is not known if exercise improves
postprandial fat use in a manner that alleviates the exaggerated PPL in this population and
reduces the risk of cardioendocrine disease.
The objective of the this study is to examine the mechanisms of exaggerated PPL in those with
SCI and the effects of an acute pre-meal exercise bout by employing novel stable isotope
tracer techniques. In persons without SCI, it is well established that pre-meal exercise
lowers PPL in part by improving the use of exogenous and endogenous fats. While muscle
atrophy and blunted sublesional sympathetic activity following SCI may hinder fat use,
preliminary data indicate that fat use is increased during recovery from exercise in the
postabsorptive (fasted) state in this population. Thus, the investigators hypothesize that
decreased use of exogenous and endogenous fats contributes to exaggerated PPL in SCI, and
that pre-meal exercise will reduce PPL due to increased use of both fat sources.
Inclusion Criteria:
- Males and females aged 18-60 years.
- For the spinal cord injury subgroups, the participant's injury will be:
- neurologically stable,
- American Spinal Injury Association (ASIA) Impairment Scale A-C,
- and will have occurred > 1 year from the testing date.
Exclusion Criteria:
- Existing diagnosis of cardiovascular disease or diabetes.
- Contraindication to exercise (ACSM Guideline, 10th edition).
- Lower extremity fracture or dislocation within 6 months of participation.
- History of head injury or seizures.
- Inability to consent.
- Restrictions in upper extremity range of motion that would prevent an individual from
achieving an unhindered arm cycling motion or moving throughout a range needed to
perform resistance maneuvers.
- A pressure ulcer at ischial/gluteus, trochanteric, sacral, or heel sites within the
last 3 months.
- Pregnancy determined by urine testing in sexually active females.
- Imprisonment in state or federal jail or prison.
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