Association between mobility mode and C-reactive protein levels in men with chronic spinal cord injury.

OBJECTIVE: To assess clinical determinants of systemic inflammation in persons with chronic spinal cord injury (SCI).

DESIGN: Cross-sectional survey.

SETTING: Veterans Affairs medical center.

PARTICIPANTS: As part of an epidemiologic study assessing SCI-related health conditions, 63 men with chronic SCI provided a blood sample and information regarding locomotive mode and personal habits.

INTERVENTIONS: Not applicable.

MAIN OUTCOME MEASURE: Plasma high-sensitivity C-reactive protein (CRP).

RESULTS: The mean +/- standard deviation age was 56+/-14y, and participants were assessed 21+/-13y after injury. Adjusting for heart disease, hypertension, and body mass index (BMI), the mean CRP in 12 motorized wheelchair users (5.11mg/L) was not significantly greater than 23 participants who used a manual wheelchair (2.19mg/L) (P=.085) but was significantly greater than the 17 who walked with an assistive device (1.41mg/L) (P=.005) and the 12 who walked independently (1.63mg/L) (P=.027). CRP was significantly greater in participants with obesity but was not related to age, smoking, or SCI level and severity. CRP was elevated in participants reporting a urinary tract infection (UTI) or pressure ulcer within a year, but adjustment for this did not account for the elevated CRP in motorized wheelchair users.

CONCLUSIONS: These results suggest that CRP in chronic SCI is independently related to locomotive mode, BMI, and a history of pressure ulcers and UTI. It is suggested that future studies in SCI investigate whether modifying these factors influence systemic inflammation and cardiovascular health.