Editorial
Copyright ©The Author(s) 2015. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Orthop. Sep 18, 2015; 6(8): 567-576
Published online Sep 18, 2015. doi: 10.5312/wjo.v6.i8.567
Adiposity and spinal cord injury
Ashraf S Gorgey, Kathryn M Wells, Timothy L Austin
Ashraf S Gorgey, Kathryn M Wells, Timothy L Austin, Spinal Cord Injury and Disorder Service, Hunter Holmes McGuire VA Medical Center, Richmond, VA 23249, United States
Ashraf S Gorgey, Department of Physical Medicine and Rehabilitation, Virginia Commonwealth University, Richmond, VA 23298, United States
Kathryn M Wells, Timothy L Austin, College of Health and Human Performance, Virginia Commonwealth University, Richmond, VA 23284, United States
Author contributions: Gorgey AS developed the concept and the rationale of the editorial, helped in writing the editorial; Wells KM and Austin TL helped in image analysis and writing of the editorial.
Supported by The Department of Veteran Affairs, Veteran Health Administration, Rehabilitation Research and Development Service (B7867-W).
Conflict-of-interest statement: The authors have nothing disclose relevant to the current submission.
Open-Access: This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Correspondence to: Ashraf S Gorgey, MPT, PhD, FACSM, Director of Spinal Cord Injury Research, Spinal Cord Injury and Disorder Service, Hunter Holmes McGuire VA Medical Center, 1201 Broad Rock Boulevard, Richmond, VA 23249, United States. ashraf.gorgey@va.gov
Telephone: +1-804-6755000 Fax: +1-804-6755223
Received: January 23, 2015
Peer-review started: January 26, 2015
First decision: March 6, 2015
Revised: June 10, 2015
Accepted: July 16, 2015
Article in press: July 17, 2015
Published online: September 18, 2015
Processing time: 238 Days and 15.8 Hours
Abstract

The drastic changes in body composition following spinal cord injury (SCI) have been shown to play a significant role in cardiovascular and metabolic health. The pattern of storage and distribution of different types of adipose tissue may impact metabolic health variables similar to carbohydrate, lipid and bone metabolism. The use of magnetic resonance imaging provides insights on the interplay among different regional adipose tissue compartments and their role in developing chronic diseases. Regional adipose tissue can be either distributed centrally or peripherally into subcutaneous and ectopic sites. The primary ectopic adipose tissue sites are visceral, intramuscular and bone marrow. Dysfunction in the central nervous system following SCI impacts the pattern of distribution of adiposity especially between tetraplegia and paraplegia. The current editorial is focused primarily on introducing different types of adipose tissue and establishing scientific basis to develop appropriate dietary, rehabilitation or pharmaceutical interventions to manage the negative consequences of increasing adiposity after SCI. We have also summarized the clinical implications and future recommendations relevant to study adiposity after SCI.

Keywords: Adiposity; Magnetic resonance imaging; Dual-energy X-ray absorptiometry; Ectopic adiposity; Visceral and subcutaneous adiposity; Intramuscular fat; Spinal cord injury

Core tip: The focus of this current editorial is to introduce different adipose tissue types that may impose significant health risks to individuals with spinal cord injury (SCI). Accurate measuring of this depot of ectopic adipose tissue may require special knowledge; however, it is important considering the dramatic changes in body composition and the extensive loss in skeletal muscle tissue below the level of injury. The clinical implications of studying adipose tissue may encourage further research to decipher the mechanistic links with the metabolic profile after SCI. Our current knowledge is limited and rehabilitation strategies are still pre-mature in targeting ectopic adiposity after SCI.