{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,25]],"date-time":"2026-07-25T01:57:43Z","timestamp":1784944663389,"version":"3.55.0"},"reference-count":92,"publisher":"American Spinal Injury Association","issue":"1","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2021]]},"abstract":"<jats:p>Over two-thirds of persons with spinal cord injury (SCI) experience neurogenic obesity-induced cardiometabolic syndrome (CMS) and other chronic comorbidities. Obesity is likely to impede social and recreational activities, impact quality of life, and impose additional socioeconomic burdens on persons with SCI. Advances in imaging technology facilitate the mapping of adiposity and its association with the cardiometabolic profile after SCI. Central adiposity or central obesity is characterized by increased waist (WC) and abdominal circumferences (AC) as well as visceral adipose tissue (VAT). A number of studies, while relying on expensive imaging techniques, have reported direct associations of both central obesity and VAT in imposing significant health risks after SCI. The mechanistic role of central obesity on cardiometabolic heath in persons with SCI has yet to be identified, despite the knowledge that it has been designated as an independent risk factor for cardiometabolic dysfunction and premature mortality in other clinical populations. In persons with SCI, the distribution of adipose tissue has been suggested to be a function of sex, level of injury, and age. To date, there is no SCI-specific WC or AC cutoff value to provide anthropometric prediction of VAT and diagnostic capability of persons at risk for central obesity, CMS, and cardiovascular disease after SCI. The purpose of the current review is to summarize the factors contributing to visceral adiposity in persons with SCI and to develop an SCI-specific anthropometric prediction equation for this population. Furthermore, a proposed WC cutoff will be discussed as a surrogate index for central obesity, CMS, and cardiovascular disorders after SCI.<\/jats:p>","DOI":"10.46292\/sci20-00055","type":"journal-article","created":{"date-parts":[[2021,3,19]],"date-time":"2021-03-19T13:49:32Z","timestamp":1616161772000},"page":"23-35","source":"Crossref","is-referenced-by-count":10,"title":["Anthropometric Prediction of Visceral Adiposity in Persons With Spinal Cord Injury"],"prefix":"10.46292","volume":"27","author":[{"given":"Ashraf S.","family":"Gorgey","sequence":"first","affiliation":[{"name":"Spinal Cord Injury and Disorders Center, Central Virginia VA Health Care System, Richmond, Virginia"},{"name":"Department of Physical Medicine and Rehabilitation, Virginia Commonwealth University, Richmond, Virginia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Areej N.","family":"Ennasr","sequence":"additional","affiliation":[{"name":"Spinal Cord Injury and Disorders Center, Central Virginia VA Health Care System, Richmond, Virginia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gary J.","family":"Farkas","sequence":"additional","affiliation":[{"name":"Department of Physical Medicine and Rehabilitation, University of Miami Miller School of Medicine, Miami, Florida"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"David R.","family":"Gater","sequence":"additional","affiliation":[{"name":"Department of Physical Medicine and Rehabilitation, University of Miami Miller School of Medicine, Miami, Florida"},{"name":"Department of Physical Medicine and Rehabilitation, Virginia Commonwealth University, Richmond, Virginia"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"25425","reference":[{"key":"i1082-0744-27-1-23-b1","series-title":"Circulation","first-page":"433","article-title":"Definition of metabolic syndrome: report of the National Heart, Lung, and Blood Institute\/American Heart Association conference on scientific 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 Y,\n            \n            \n              Hosoya\n              T.\n            \n          \n          Serum leptin, abdominal obesity and the metabolic syndrome in individuals with chronic spinal cord injury.\n\t\t\t\t\tSpinal Cord.\n\t\t\t\t\t2008;\n\t\t\t\t\t46:\n\t\t\t\t\t494\u2013\n\t\t\t\t\t9."},{"key":"i1082-0744-27-1-23-b35","series-title":"J Spinal Cord Med","first-page":"765","article-title":"The relationship between the postprandial lipemic response and lipid composition in persons with spinal cord injury","volume":"37","year":"2014","unstructured":"Emmons\n              RR,\n            \n            \n              Cirnigliaro\n              CM,\n            \n            \n              Kirshblum\n              SC,\n            \n            \n              Bauman\n              WA.\n            \n          \n          The relationship between the postprandial lipemic response and lipid composition in persons with spinal cord injury.\n\t\t\t\t\tJ Spinal Cord 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  MP,\n            \n            \n              Lester\n              RM,\n            \n            \n              Khan\n              MR,\n            \n            \n              Gorgey\n              AS.\n            \n          \n          Semi-automated segmentation of magnetic resonance images for thigh skeletal muscle and fat using threshold technique after spinal cord injury.\n\t\t\t\t\tNeural Regen Res.\n\t\t\t\t\t2018;\n\t\t\t\t\t13:\n\t\t\t\t\t1787\u2013\n\t\t\t\t\t1795."},{"key":"i1082-0744-27-1-23-b44","series-title":"Appl Physiol Nutr Metab","first-page":"139","article-title":"Participation in moderate-to-vigorous leisure time physical activity is related to decreased visceral adipose tissue in adults with spinal cord injury","volume":"43","year":"2018","unstructured":"Pelletier\n              CA,\n            \n            \n              Omidvar\n              M,\n            \n            \n              Miyatani\n              M,\n            \n            \n      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  T.\n            \n          \n          Dietary manipulation and testosterone replacement therapy may explain changes in body composition after spinal cord injury: A retrospective case report.\n\t\t\t\t\tWorld J Clin Cases.\n\t\t\t\t\t2019;\n\t\t\t\t\t7:\n\t\t\t\t\t2427\u2013\n\t\t\t\t\t2437."},{"key":"i1082-0744-27-1-23-b46","series-title":"Arch Phys Med Rehabil","first-page":"1061","article-title":"Differences in glucose metabolism among women with spinal cord injury may not be fully explained by variations in body composition","volume":"100","year":"2019","unstructured":"Li\n              J,\n            \n            \n              Hunter\n              GR,\n            \n            \n              Chen\n              Y,\n            \n            \n              McLain\n              A,\n            \n            \n              Smith\n              DL,\n            \n            \n              Yarar-Fisher\n              C.\n            \n          \n          Differences in glucose metabolism among women with spinal cord injury may not be fully explained by variations in body composition.\n\t\t\t\t\tArch Phys Med Rehabil.\n\t\t\t\t\t2019;\n\t\t\t\t\t100:\n\t\t\t\t\t1061\u2013\n\t\t\t\t\t1067."},{"key":"i1082-0744-27-1-23-b1","series-title":"Circulation","first-page":"433","article-title":"Definition of metabolic syndrome: report of the National Heart, Lung, and Blood Institute\/American Heart Association conference on scientific issues related to definition","volume":"109","year":"2004","unstructured":"Grundy\n              SM,\n            \n            \n              Brewer\n              HB\n              Jr.\n            \n            \n              Cleeman\n              JI,\n            \n          \n          .\n\t\t\t\t\tDefinition of metabolic syndrome: report of the National Heart, Lung, and Blood Institute\/American Heart Association conference on scientific issues related to definition.\n\t\t\t\t\tCirculation.\n\t\t\t\t\t2004;\n\t\t\t\t\t109:\n\t\t\t\t\t433\u2013\n\t\t\t\t\t438."},{"key":"i1082-0744-27-1-23-b2","series-title":"PLoS One","first-page":"e0236752","article-title":"Waist circumference cutoff identifying risks of obesity, metabolic syndrome, and cardiovascular disease in men with spinal cord injury","volume":"15","year":"2020","unstructured":"Gill\n              S,\n            \n            \n              Sumrell\n              RM,\n            \n            \n              Sima\n              A,\n            \n            \n              Cifu\n              DX,\n            \n            \n              Gorgey\n              AS.\n            \n          \n          Waist circumference cutoff identifying risks of obesity, metabolic syndrome, and cardiovascular disease in men with spinal cord injury.\n\t\t\t\t\tPLoS One.\n\t\t\t\t\t2020;\n\t\t\t\t\t15:\n\t\t\t\t\te0236752."},{"issue":"Suppl 1","key":"i1082-0744-27-1-23-b3","series-title":"J 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.\n\t\t\t\t\tDiabetes mellitus in individuals with spinal cord injury or disorder.\n\t\t\t\t\tJ Spinal Cord Med.\n\t\t\t\t\t2006;\n\t\t\t\t\t29:\n\t\t\t\t\t387\u2013\n\t\t\t\t\t395."},{"key":"i1082-0744-27-1-23-b5","series-title":"J Spinal Cord Med","first-page":"86","article-title":"Prevalence of metabolic syndrome in veterans with spinal cord injury","volume":"42","year":"2019","unstructured":"Gater\n              DR\n              Jr.\n            \n            \n              Farkas\n              GJ,\n            \n            \n              Berg\n              AS,\n            \n            \n              Castillo\n              C.\n            \n          \n          Prevalence of metabolic syndrome in veterans with spinal cord injury.\n\t\t\t\t\tJ Spinal Cord Med.\n\t\t\t\t\t2019;\n\t\t\t\t\t42;\n\t\t\t\t\t86\u2013\n\t\t\t\t\t93."},{"key":"i1082-0744-27-1-23-b6","series-title":"PLoS One","first-page":"e0203049","article-title":"Anthropometric cutoffs and associations with 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     .\n\t\t\t\t\tIdentification and management of cardiometabolic risk after spinal cord injury.\n\t\t\t\t\tJ Spinal Cord Med.\n\t\t\t\t\t2019;\n\t\t\t\t\t42:\n\t\t\t\t\t643\u2013\n\t\t\t\t\t677."},{"key":"i1082-0744-27-1-23-b8","series-title":"Metabolism","first-page":"843","article-title":"Central adiposity associations to carbohydrate and lipid metabolism in individuals with complete motor spinal cord injury","volume":"60","year":"2011","unstructured":"Gorgey\n              AS,\n            \n            \n              Mather\n              KJ,\n            \n            \n              Gater\n              DR.\n            \n          \n          Central adiposity associations to carbohydrate and lipid metabolism in individuals with complete motor spinal cord injury.\n\t\t\t\t\tMetabolism.\n\t\t\t\t\t2011;\n\t\t\t\t\t60:\n\t\t\t\t\t843\u2013\n\t\t\t\t\t851."},{"key":"i1082-0744-27-1-23-b9","series-title":"PM R","first-page":"440","article-title":"A preliminary report on the 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   \n              Gater\n              DR.\n            \n          \n          Gender dimorphism in central adiposity may explain metabolic dysfunction after spinal cord injury.\n\t\t\t\t\tPM R.\n\t\t\t\t\t2018;\n\t\t\t\t\t10:\n\t\t\t\t\t338\u2013\n\t\t\t\t\t348."},{"key":"i1082-0744-27-1-23-b11","series-title":"J Spinal Cord Med","first-page":"407","article-title":"The influence of level of spinal cord injury on adipose tissue and its relationship to inflammatory adipokines and cardiometabolic profiles","volume":"41","year":"2018","unstructured":"Farkas\n              GJ,\n            \n            \n              Gorgey\n              AS,\n            \n            \n              Dolbow\n              DR,\n            \n            \n              Berg\n              AS,\n            \n            \n              Gater\n              DR.\n            \n          \n          The influence of level of spinal cord injury on adipose tissue and its relationship to inflammatory 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\n          .\n\t\t\t\t\tThe influence of visceral fat on the postprandial lipemic response in men with paraplegia.\n\t\t\t\t\tJ Am Coll Nutr.\n\t\t\t\t\t2010;\n\t\t\t\t\t29:\n\t\t\t\t\t476\u2013\n\t\t\t\t\t481."},{"key":"i1082-0744-27-1-23-b16","series-title":"J Clin Densitom","first-page":"63","article-title":"Measurement of visceral adipose tissue in persons with spinal cord injury by magnetic resonance imaging and dual X-ray absorptiometry: generation and application of a predictive equation","volume":"23","year":"2020","unstructured":"McCauley\n              LS,\n            \n            \n              Ghatas\n              MP,\n            \n            \n              Sumrell\n              RM,\n            \n          \n          .\n\t\t\t\t\tMeasurement of visceral adipose tissue in persons with spinal cord injury by magnetic resonance imaging and dual X-ray absorptiometry: generation and application of a predictive equation.\n\t\t\t\t\tJ Clin 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to the impairment of glucose and lipid metabolism in human obesity.\n\t\t\t\t\tMetabolism.\n\t\t\t\t\t1987;\n\t\t\t\t\t36:\n\t\t\t\t\t54\u2013\n\t\t\t\t\t59."},{"key":"i1082-0744-27-1-23-b20","series-title":"J Spinal Cord Med","first-page":"430","article-title":"Sex dimorphism in the distribution of adipose tissue and its influence on proinflammatory adipokines and cardiometabolic profiles in motor complete spinal cord injury","volume":"42","year":"2019","unstructured":"Farkas\n              GJ,\n            \n            \n              Gorgey\n              AS,\n            \n            \n              Dolbow\n              DR,\n            \n            \n              Berg\n              AS,\n            \n            \n              Gater\n              DR.\n            \n          \n          Sex dimorphism in the distribution of adipose tissue and its influence on proinflammatory adipokines and cardiometabolic profiles in motor complete spinal cord injury.\n\t\t\t\t\tJ Spinal 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