Comparison of the prevalence of metabolic syndrome between individuals with spinal cord injury and the general population based on the cutoff values of abdominal obesity

Background

Metabolic syndrome (MetS) is a cluster of cardiovascular disease (CVD) risk factors. Accurate diagnosis, in spinal cord injury (SCI) patients, is vital for effective CVD prevention.

Objective

This study aimed to identify factors related to MetS prevalence by comparing MetS prevalence trends in SCI and the general population (GP) and to examine differences in MetS prevalence in patients with SCI according to the cutoff reference value for abdominal obesity.

Methods

This retrospective cohort study analyzed data from the National Health Insurance Corporation from 2015 to 2019. MetS was defined using the National Cholesterol Education Program criteria with an adjusted waist circumference of 81.3 cm for patients with SCI. Data were collected on age, gender, smoking, alcohol consumption, BMI, waist circumference, lipid profiles, blood pressure, fasting glucose, and socioeconomic status. Each year, SCI patients (n = 3,140, n = 3,201, n = 3,503, n = 1,590, n = 1544) were matched with GP individuals (m = 31,400, m = 32,040, m = 35,030, m = 15,900, m = 15,440).

Results

Over 5 years, MetS prevalence increased in both groups, consistently higher in the SCI group. Older age and lower income were risk factors in both groups (p < 0.05). Smoking and alcohol intake were significant only in the GP (p < 0.0001). Using the adjusted obesity criterion, MetS prevalence was 1.4 times higher in SCI patients than in the GP (p < 0.0001).

Conclusions

Exclusively relying on GP criteria for diagnosing MetS in patients with SCI may lead to an underestimation of MetS prevalence and overlooked opportunities for CVD prevention. Therefore, the development of diagnostic and preventive strategies for MetS considering SCI characteristics is needed.