Cardiometabolic risk clustering in spinal cord injury: Results of exploratory factor analysis

Alexander Libin, Emily A. Tinsley, Mark S. Nash, Armando J. Mendez, Patricia Burns, Matt Elrod, Larry F. Hamm, Suzanne L. Groah

Research output: Contribution to journalArticlepeer-review

42 Scopus citations


Background: Evidence suggests an elevated prevalence of cardiometabolic risks among persons with spinal cord injury (SCI); however, the unique clustering of risk factors in this population has not been fully explored. Objective: The purpose of this study was to describe unique clustering of cardiometabolic risk factors differentiated by level of injury. Methods: One hundred twenty-one subjects (mean 37 ± 12 years; range, 18-73) with chronic C5 to T12 motor complete SCI were studied. Assessments included medical histories, anthropometrics and blood pressure, and fasting serum lipids, glucose, insulin, and hemoglobin A1c (HbA1c). Results: The most common cardiometabolic risk factors were overweight/obesity, high levels of low-density lipoprotein (LDL-C), and low levels of high-density lipoprotein (HDL-C). Risk clustering was found in 76.9% of the population. Exploratory principal component factor analysis using varimax rotation revealed a 3-factor model in persons with paraplegia (65.4% variance) and a 4-factor solution in persons with tetraplegia (73.3% variance). The differences between groups were emphasized by the varied composition of the extracted factors: Lipid Profile A (total cholesterol [TC] and LDL-C), Body Mass-Hypertension Profile (body mass index [BMI], systolic blood pressure [SBP], and fasting insulin [FI]); Glycemic Profile (fasting glucose and HbA1c), and Lipid Profile B (TG and HDL-C). BMI and SBP formed a separate factor only in persons with tetraplegia. Conclusions: Although the majority of the population with SCI has risk clustering, the composition of the risk clusters may be dependent on level of injury, based on a factor analysis group comparison. This is clinically plausible and relevant as tetraplegics tend to be hypo- to normotensive and more sedentary, resulting in lower HDL-C and a greater propensity toward impaired carbohydrate metabolism.

Original languageEnglish (US)
Pages (from-to)183-194
Number of pages12
JournalTopics in Spinal Cord Injury Rehabilitation
Issue number3
StatePublished - May 1 2013


  • body composition
  • cardiometabolic syndrome
  • cardiovascular disease
  • diabetes
  • dyslipidemia
  • factor analysis
  • spinal cord injury

ASJC Scopus subject areas

  • Clinical Neurology
  • Rehabilitation
  • Physical Therapy, Sports Therapy and Rehabilitation


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