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H-FABP, cardiovascular risk factors, and functional status in asymptomatic spinal cord injury patients

H-FABP, kardiovaskuläre Risikofaktoren und Funktionsstatus bei asymptomatischen Patienten mit Rückenmarksverletzungen

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Abstract

Background

This was a cross-sectional study in the setting of a rehabilitation hospital.

Objective

The aim of the study was to determine the serum levels of heart-type fatty acid-binding protein (H-FABP) in patients with spinal cord injury (SCI). A further goal was to examine whether there is a relationship between H-FABP levels and Functional Ambulation Classification (FAC) scale, Functional Independence Measure (FIM) score, American Spinal Injury Association (ASIA) status, and metabolic syndrome (MetS).

Methods

The study included 56 SCI patients and 37 age- and sex-matched healthy control subjects who had not been diagnosed with coronary artery disease in the past.

Results

Serum H-FABP levels were significantly higher in patients with SCI than in control subjects: paraplegia group, 18.5 ± 11.4; tetraplegia group, 16.3 ± 9.1; control group, 6.7 ± 5.1 ng/ml (p < 0.001). There was no difference between the other cardiac enzymes (troponin I, AST, ALT, CK, CK-MB, and LDH) among the groups. The relationship between the serum H-FABP levels and FAC status was examined. There was a negative correlation between FAC status and H-FABP levels (p < 0.001, r = − 0.581). Patients with complete SCI were divided into two groups according to the level of the lesion: (lesion levels in C6–T6, n = 25; lesion levels in T7–L2, n = 11). In patients with complete motor injury, H-FABP levels were higher in subjects with injuries above T6 than in those with injuries below T6 (24.21 ± 10.1 and 14.1 ± 10.4, respectively; p = 0.011). Serum levels of H-FABP were higher in SCI patients with MetS (n = 10) than in those without MetS (n = 46; 25.8 ± 11.6 ng/ml vs. 16.42 ± 10.3 ng/ml, respectively; p = 0.014). Patients were then divided into two groups according to SCI duration: < 12 months (n = 27) and > 12 months (n = 29). H-FABP levels showed statistically significant differences between the two groups (14.8 ± 11.7 ng/dl and 20.9 ± 9.9 ng/dl, respectively; p = 0.036).

Conclusion

H-FABP is related to MetS and FAC status in asymptomatic SCI patients.

Zusammenfassung

Hintergrund

Es handelt sich um eine Querschnittsstudie in einer Klinik für Rehabilitation.

Ziel

Ziel der Studie war die Bestimmung der Konzentrationen von H-FABP (herzspezifisches fettsäurebindendes Protein, „heart-type fatty acid-binding protein“) im Serum von Patienten mit Rückenmarksverletzung („spinal cord injury“, SCI). Untersucht werden sollte, ob eine Beziehung zwischen H-FABP-Konzentrationen und funktionellem Gehstatus („functional ambulation classification“, FAC), funktioneller Selbstständigkeit, ASIA(American Spinal Injury Association)-Status und metabolischem Syndrom besteht.

Methoden

In die Studie eingeschlossen wurden insgesamt 56 Patienten sowie 37 gesunde, alters- und geschlechtsgematchte Kontrollpersonen ohne diagnostizierte koronare Herzerkrankung.

Ergebnisse

Die Serum-H-FABP-Konzentrationen waren signifikant höher bei SCI-Patienten als bei den Kontrollen; Paraplegie-: 18,5 ± 11,4, Tetraplegie-: 16,3 ± 9,1, Kontrollgruppe: 6,7 ± 5,1 ng/ml (p < 0,001). Keine Unterschiede zwischen den Gruppen zeigten sich bei den anderen kardialen Enzymen (Troponin I, AST, ALT, CK, CK-MB, LDH). Die Beziehung zwischen Serum-H-FABP-Konzentration und FAC wurde untersucht. Es bestand eine negative Korrelation (p < 0,001, r=− 0,581). Patienten mit vollständiger SCI wurden nach der Höhe der Läsion in 2 Gruppen eingeteilt: Läsion im Bereich C6–T6, n = 25, im Bereich T7–L2, n = 11. Bei vollständiger motorischer Schädigung waren die H-FABP-Konzentrationen höher bei Patienten mit einer Läsion oberhalb von T6 im Vergleich mit denen mit einer Läsion unterhalb von T6 (24,21 ± 10,1 vs. 14,1 ± 10,4 ng/ml, p=0,011). Serum-H-FABP-Konzentrationen waren bei SCI-Patienten mit metabolischem Syndrom (n=10) höher als bei Patienten ohne metabolisches Syndrom (n=46; 25,8 ± 11,6 ng/ml vs. 16,42 ± 10,3 ng/ml, p=0,014). Nach der Dauer der SCI waren die Patienten in 2 Gruppen eingeteilt: < 12 Monate, n=27, und > 12 Monate, n=29. Zwischen diesen Gruppen unterschieden sich die H-FABP–Konzentrationen statistisch signifikant (14,8 ± 11,7 vs. 20,9 ± 9,9 ng/ml, p=0,036).

Fazit

Bei asymptomatischen SCI-Patienten besteht eine Beziehung zwischen H-FABP und metabolischem Syndrom sowie funktionellem Gehstatus.

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On behalf of all authors, the corresponding author states that there are no conflicts of interest.

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Authors and Affiliations

  1. Department of Physical Medicine and Rehabilitation, Çanakkale Onsekiz Mart UniversityEducation and Research Hospital, 17100 , Kepez, Çanakkale, Turkey

    A. Akbal

  2. Ankara Physical Medicine and Rehabilitation Training and Research Hospital, Ministry of Health, Ankara, Turkey

    A. Kurtaran, B. Selçuk & M. Akyüz

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  1. A. Akbal
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  3. B. Selçuk
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  4. M. Akyüz
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Correspondence to A. Akbal.

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Akbal, A., Kurtaran, A., Selçuk, B. et al. H-FABP, cardiovascular risk factors, and functional status in asymptomatic spinal cord injury patients. Herz 38, 629–635 (2013). https://doi.org/10.1007/s00059-013-3779-1

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