{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,10]],"date-time":"2026-09-10T05:51:03Z","timestamp":1789019463169,"version":"build-2803163510"},"reference-count":43,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2021,2,3]],"date-time":"2021-02-03T00:00:00Z","timestamp":1612310400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/100005191","name":"Craig H. Neilsen Foundation","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100005191","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Physiol."],"abstract":"<jats:p>Spinal cord injury (SCI) results in disordered fat metabolism. Autonomic decentralization might contribute to dyslipidemia in SCI, in part by influencing the uptake of dietary fats through the gut-lymph complex. However, the neurogenic contributions to dietary fat metabolism are unknown in this population. We present a subset of results from an ongoing registered clinical trial (NCT03691532) related to dietary fat absorption. We fed a standardized (20 kcal\u22c5kgFFM<jats:sup>\u20131<\/jats:sup>) liquid meal tolerance test (50% carb, 35% fat, and 15% protein) that contained stable isotope lipid tracer (5 mg\u22c5kgFFM<jats:sup>\u20131<\/jats:sup> [U-<jats:sup>13<\/jats:sup>C]palmitate) to persons with and without motor complete thoracic SCI. Blood samples were collected at six postprandial time points over 400 min. Changes in dietary fatty acid incorporated into the triacylglycerol (TAG) pool (\u201cexogenous TAG\u201d) were used as a marker of dietary fat absorption. This biomarker showed that those with paraplegia had a lower amplitude than non-injured participants at Post<jats:sub>240<\/jats:sub> (52.4 \u00b1 11.0 vs. 77.5 \u00b1 16.0 \u03bcM), although this failed to reach statistical significance (<jats:italic>p<\/jats:italic> = 0.328). However, group differences in the time course of absorption were notable. The injury level was also strongly correlated with time-to-peak exogenous TAG concentration (<jats:italic>r<\/jats:italic> = \u22120.806, <jats:italic>p<\/jats:italic> = 0.012), with higher injuries resulting in a slower rise in exogenous TAG. This time course documenting exogenous TAG change is the first to show a potential neurogenic alteration in SCI dietary fat absorption.<\/jats:p>","DOI":"10.3389\/fphys.2021.626003","type":"journal-article","created":{"date-parts":[[2021,2,3]],"date-time":"2021-02-03T07:01:26Z","timestamp":1612335686000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":7,"title":["Effect of Paraplegia on the Time Course of Exogenous Fatty Acid Incorporation Into the Plasma Triacylglycerol Pool in the Postprandial State"],"prefix":"10.3389","volume":"12","author":[{"given":"David W.","family":"McMillan","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gregory C.","family":"Henderson","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mark S.","family":"Nash","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kevin A.","family":"Jacobs","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2021,2,3]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","DOI":"10.1016\/j.celrep.2019.05.050","article-title":"A distinct role of the autonomic nervous system in modulating the function of lymphatic vessels under physiological and tumor-draining conditions.","volume":"27","author":"Bachmann","year":"2019","journal-title":"Cell Rep."},{"key":"B2","doi-asserted-by":"publisher","first-page":"485","DOI":"10.1038\/sj.sc.3100862","article-title":"Is immobilization associated with an abnormal lipoprotein profile? Observations from a diverse cohort.","volume":"37","author":"Bauman","year":"1999","journal-title":"Spinal Cord."},{"key":"B3","doi-asserted-by":"publisher","first-page":"359","DOI":"10.1179\/2045772313Y.0000000151","article-title":"Body composition of women and men with complete motor paraplegia.","volume":"37","author":"Beck","year":"2014","journal-title":"J. Spinal Cord Med."},{"key":"B4","doi-asserted-by":"publisher","first-page":"118","DOI":"10.1310\/sci2303-188","article-title":"Nutritional health considerations for persons with spinal cord injury.","volume":"23","author":"Bigford","year":"2017","journal-title":"Top. Spinal Cord. Inj Rehabil."},{"key":"B5","doi-asserted-by":"publisher","first-page":"4042","DOI":"10.1172\/JCI76509","article-title":"Intravital imaging of intestinal lacteals unveils lipid drainage through contractility.","volume":"125","author":"Choe","year":"2015","journal-title":"J. Clin. Invest."},{"key":"B6","doi-asserted-by":"publisher","first-page":"1811","DOI":"10.1002\/oby.21194","article-title":"Visceral adiposity in persons with chronic spinal cord injury determined by dual energy X-ray absorptiometry.","volume":"23","author":"Cirnigliaro","year":"2015","journal-title":"Obesity"},{"key":"B7","doi-asserted-by":"publisher","first-page":"2106","DOI":"10.1016\/j.apmr.2005.06.013","article-title":"A comparison of hydrostatic weighing and air displacement plethysmography in adults with spinal cord injury.","volume":"86","author":"Clasey","year":"2005","journal-title":"Arch. Phys. Med. Rehabil."},{"key":"B8","doi-asserted-by":"publisher","first-page":"1743","DOI":"10.1152\/japplphysiol.00095.2013","article-title":"Postprandial triglyceride and free fatty acid metabolism in obese women after either endurance or resistance exercise.","volume":"114","author":"Davitt","year":"2013","journal-title":"J. Appl. Physiol."},{"key":"B9","doi-asserted-by":"publisher","first-page":"468","DOI":"10.1179\/2045772314Y.0000000199","article-title":"Effects of prandial challenge on triglyceridemia, glycemia, and pro-inflammatory activity in persons with chronic paraplegia.","volume":"38","author":"Ellenbroek","year":"2014","journal-title":"J. Spinal Cord Med."},{"key":"B10","doi-asserted-by":"publisher","first-page":"765","DOI":"10.1179\/2045772314Y.0000000231","article-title":"The relationship between the postprandial lipemic response and lipid composition in persons with spinal cord injury.","volume":"37","author":"Emmons","year":"2014","journal-title":"J. Spinal Cord Med."},{"key":"B11","doi-asserted-by":"publisher","first-page":"476","DOI":"10.1080\/07315724.2010.10719884","article-title":"The influence of visceral fat on the postprandial lipemic response in men with paraplegia.","volume":"29","author":"Emmons","year":"2010","journal-title":"J. Am. Coll. Nutr."},{"key":"B12","doi-asserted-by":"publisher","first-page":"3","DOI":"10.1038\/s41393-018-0218-4","article-title":"Nutritional status in chronic spinal cord injury: a systematic review and meta-analysis.","volume":"57","author":"Farkas","year":"2019","journal-title":"Spinal Cord"},{"key":"B13","doi-asserted-by":"publisher","first-page":"52","DOI":"10.1016\/S1566-0702(00)00261-7","article-title":"Neural mechanisms involved in the delay of gastric emptying and gastrointestinal transit of liquid after thoracic spinal cord transection in awake rats.","volume":"87","author":"Gondim","year":"2001","journal-title":"Auton. Neurosci. Basic Clinical."},{"key":"B14","doi-asserted-by":"publisher","first-page":"107","DOI":"10.1139\/H10-091","article-title":"Regional and relative adiposity patterns in relation to carbohydrate and lipid metabolism in men with spinal cord injury.","volume":"36","author":"Gorgey","year":"2011","journal-title":"Appl. Physiol. Nutr. Metab."},{"key":"B15","doi-asserted-by":"publisher","first-page":"99","DOI":"10.1179\/107902610X12911165975106","article-title":"Influence of motor complete spinal cord injury on visceral and subcutaneous adipose tissue measured by multi-axial magnetic resonance imaging.","volume":"34","author":"Gorgey","year":"2011","journal-title":"J. Spinal Cord Med."},{"key":"B16","doi-asserted-by":"publisher","first-page":"G725","DOI":"10.1152\/ajpgi.00340.2019","article-title":"Organ-specific lymphatics play distinct roles in regulating HDL trafficking and composition.","volume":"318","author":"Gracia","year":"2020","journal-title":"Am. J. Physiol. Gastrointes Liver Physiol."},{"key":"B17","doi-asserted-by":"publisher","first-page":"25","DOI":"10.1080\/10790268.2009.11760749","article-title":"Nutrient intake and body habitus after spinal cord injury: an analysis by sex and level of injury.","volume":"32","author":"Groah","year":"2009","journal-title":"J. Spinal Cord Med."},{"key":"B18","doi-asserted-by":"publisher","first-page":"E732","DOI":"10.1152\/ajpendo.00409.2006","article-title":"Dietary fatty acids make a rapid and substantial contribution to VLDL-triacylglycerol in the fed state.","volume":"292","author":"Heath","year":"2007","journal-title":"Am. J. Physiol. Endocrinol. Metab."},{"key":"B19","doi-asserted-by":"publisher","first-page":"E64","DOI":"10.1152\/ajpendo.90730.2008","article-title":"Differences in partitioning of meal fatty acids into blood lipid fractions: a comparison of linoleate, oleate, and palmitate.","volume":"296","author":"Hodson","year":"2009","journal-title":"Am. J. Physiol. Endocriol. Metab."},{"key":"B20","author":"Horning","year":"1998","journal-title":"Arterial vs. \u201cArterialized\u201d Sampling Sites Do Not Change Isotopic Enrichment Using [6, 6-D-glucose] and [1, 1, 2, 3, 3-D-glycerol]. FASEB JOURNAL."},{"key":"B21","doi-asserted-by":"publisher","first-page":"37","DOI":"10.1017\/S0007114599000124","article-title":"Effect of fatty acid chain length and saturation on the gastrointestinal handling and metabolic disposal of dietary fatty acids in women.","volume":"81","author":"Jones","year":"1999","journal-title":"Br. J. Nutr."},{"key":"B22","doi-asserted-by":"publisher","first-page":"1512","DOI":"10.1023\/A:1026690305537","article-title":"Gastric emptying in spinal cord injury patients.","volume":"44","author":"Kao","year":"1999","journal-title":"Dig. Dis. Sci."},{"key":"B23","doi-asserted-by":"publisher","first-page":"383","DOI":"10.1038\/sj.sc.3100867","article-title":"Autonomic dysreflexia.","volume":"37","author":"Karlsson","year":"1999","journal-title":"Spinal Cord"},{"key":"B24","doi-asserted-by":"publisher","first-page":"535","DOI":"10.1179\/204577211X13207446293695","article-title":"International standards for neurological classification of spinal cord injury (revised 2011).","volume":"34","author":"Kirshblum","year":"2011","journal-title":"J Spinal Cord Med."},{"key":"B25","doi-asserted-by":"publisher","first-page":"1498","DOI":"10.1093\/jn\/136.6.1498","article-title":"The elevation of ingested lipids within plasma chylomicrons is prolonged in men compared with women.","volume":"136","author":"Knuth","year":"2006","journal-title":"J. Nutr."},{"key":"B26","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0173934","article-title":"Effect of functional sympathetic nervous system impairment of the liver and abdominal visceral adipose tissue on circulating triglyceride-rich lipoproteins.","volume":"12","author":"La Fountaine","year":"2017","journal-title":"PLoS One"},{"key":"B27","doi-asserted-by":"publisher","first-page":"183","DOI":"10.1310\/sci1903-183","article-title":"Cardiometabolic risk clustering in spinal cord injury: results of exploratory factor analysis.","volume":"19","author":"Libin","year":"2013","journal-title":"Top. Spinal Cord Inj Rehabil."},{"key":"B28","doi-asserted-by":"publisher","first-page":"400","DOI":"10.1179\/2045772315Y.0000000032","article-title":"Deep venous thrombosis in patients with chronic spinal cord injury.","volume":"39","author":"Mackiewicz-Milewska","year":"2016","journal-title":"J. Spinal Cord Med."},{"key":"B29","first-page":"1229","article-title":"Gastrointestinal motility, part 1: esophageal transit and gastric emptying.","volume":"56","author":"Maurer","year":"2015","journal-title":"J. Nuclear Med."},{"key":"B30","doi-asserted-by":"publisher","DOI":"10.1186\/s13063-019-3583-1","article-title":"Influence of upper-body continuous, resistance or high-intensity interval training (CRIT) on postprandial responses in persons with spinal cord injury: study protocol for a randomised controlled trial.","volume":"20","author":"McMillan","year":"2019","journal-title":"Trials"},{"key":"B31","doi-asserted-by":"publisher","first-page":"142","DOI":"10.1097\/PHM.0b013e31802f0247","article-title":"Cardiovascular disease in spinal cord injury: an overview of prevalence, risk, evaluation, and management.","volume":"86","author":"Myers","year":"2007","journal-title":"Am. J. Phys. Med. Rehabil."},{"key":"B32","doi-asserted-by":"publisher","first-page":"320","DOI":"10.1080\/10790268.2005.11753827","article-title":"Evidence for an exaggerated postprandial lipemia in chronic paraplegia.","volume":"28","author":"Nash","year":"2005","journal-title":"J. Spinal Cord Med."},{"key":"B33","doi-asserted-by":"publisher","first-page":"379","DOI":"10.1310\/sci2404-379","article-title":"Identification and management of cardiometabolic risk after spinal cord injury: clinical practice guideline for health care providers.","volume":"24","author":"Nash","year":"2019","journal-title":"J. Spinal Cord Med."},{"key":"B34","doi-asserted-by":"publisher","first-page":"D299","DOI":"10.2741\/phan","article-title":"Intestinal lipid absorption and transport.","volume":"6","author":"Phan","year":"2001","journal-title":"Front. Biosci. Landmrk"},{"key":"B35","doi-asserted-by":"publisher","first-page":"1806","DOI":"10.3945\/jn.112.162008","article-title":"Postprandial spillover of dietary lipid into plasma is increased with moderate amounts of ingested fat and is inversely related to adiposity in healthy older men.","volume":"142","author":"Puga","year":"2012","journal-title":"J. Nutr."},{"key":"B36","first-page":"466","article-title":"Gastric-emptying is impaired in patients with spinal-cord injury.","volume":"90","author":"Segal","year":"1995","journal-title":"Am. J. Gastroenterol."},{"key":"B37","doi-asserted-by":"publisher","first-page":"1310","DOI":"10.1152\/jappl.2000.88.4.1310","article-title":"Soft tissue body composition differences in monozygotic twins discordant for spinal cord injury.","volume":"88","author":"Spungen","year":"2000","journal-title":"J. Appl. Physiol."},{"key":"B38","first-page":"1173","author":"Standring","year":"2021","journal-title":"Small Intestine. Gray\u2019s Anatomy"},{"key":"B39","doi-asserted-by":"publisher","first-page":"H206","DOI":"10.1152\/ajpheart.00517.2013","article-title":"The human thoracic duct is functionally innervated by adrenergic nerves.","volume":"306","author":"Telinius","year":"2014","journal-title":"Am. J. Physiol. Heart Circ. Physiol."},{"key":"B40","doi-asserted-by":"publisher","first-page":"489","DOI":"10.2340\/16501977-0541","article-title":"Increased cardiovascular disease risk in swedish persons with paraplegia: the stockholm spinal cord injury study.","volume":"42","author":"Wahman","year":"2010","journal-title":"J. Rehabil. Med."},{"key":"B41","doi-asserted-by":"publisher","first-page":"1223","DOI":"10.1002\/oby.20199","article-title":"Body mass index underestimates adiposity in women with spinal cord injury.","volume":"21","author":"Yarar-Fisher","year":"2013","journal-title":"Obesity"},{"key":"B42","doi-asserted-by":"publisher","first-page":"416","DOI":"10.1016\/j.bbadis.2010.01.006","article-title":"The role of the autonomic nervous liver innervation in the control of energy metabolism.","volume":"1802","author":"Yi","year":"2010","journal-title":"Biochim. Biophys. Acta"},{"key":"B43","first-page":"1856","article-title":"Gastric-emptying rates to liquid or solid meals appear to be unaffected by spinal-cord injury.","volume":"89","author":"Zhang","year":"1994","journal-title":"Am. J. Gastroenterol."}],"container-title":["Frontiers in Physiology"],"original-title":[],"link":[{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fphys.2021.626003\/full","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2021,2,3]],"date-time":"2021-02-03T07:01:32Z","timestamp":1612335692000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fphys.2021.626003\/full"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2021,2,3]]},"references-count":43,"alternative-id":["10.3389\/fphys.2021.626003"],"URL":"https:\/\/doi.org\/10.3389\/fphys.2021.626003","relation":{},"ISSN":["1664-042X"],"issn-type":[{"value":"1664-042X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2021,2,3]]},"article-number":"626003"}}