Lipid metabolism after mild cold stress in persons with a cervical spinal cord injury

Study design Experimental study. Objectives To compare lipid metabolism in individuals with a cervical spinal cord injury (SCI C ) and able-bodied (AB) persons in response to mild cold stress. Settings Laboratory of Wakayama Medical University, Japan. Methods Nine males with SCI C and 11 AB wore a water-perfusion suit in a supine position. Following 30-min rest thermoneutrality, the whole body was cooled by perfusing 25 °C water through the suit for 15–20 min (CS). Blood samples were collected before, immediately, and 60 (post-CS60) and 120 min after CS (post-CS120). Concentrations of serum free fatty acid ([FFA] s ), total ketone bodies ([tKB] s ), insulin ([Ins] s ) and plasma adrenaline ([Ad] p ), noradrenaline ([NA] p ) and glucose ([Glc] p ) were assessed. Results [Ad] p in SCI C were lower than AB throughout the study ( p = 0.0002) and remained largely unchanged in both groups. [NA] p increased after cold stress in AB only ( p < 0.0001; GxT p = 0.006). [FFA] s increased by 62% immediately after cold stress in SCI C ( p = 0.0028), without a difference between groups ( p = 0.65). [tKB] s increased by 69% at post-CS60 and 132% at post-CS120 from the start in SCI C with no differences between groups ( p = 0.54). [Glc] p and [Ins] s were reduced in SCIc only (GxT p = 0.003 and p = 0.001, respectively). Conclusion These data indicate that mild cold stress acutely elevates lipid and ketone body metabolism in persons with SCIc, despite the presence of sympathetic dysfunction.