Comparison of Bone Loss and Associated Risk Factors in Men with Spinal Cord Injury and Community-dwelling Adults

Abstract

Abstract Study Design: retrospective chart audit Objectives: In individuals with spinal cord injury (SCI), bone loss proceeds rapidly to the area below the level of injury, leading to increased risk of fracture. However, there are limited data on the degree of bone loss in individuals with SCI and associated factors in comparison with community-dwelling adults. Settings: rehabilitation center in Seoul, Republic of Korea; community in Republic of Korea Methods: Data from men with SCI who underwent Dual-energy X-ray Absorptiometry at the National Rehabilitation Center (2008 to 2020) between 12 and 36 months after injury were analyzed. Data from community-dwelling men in the Korea National Health and Nutrition Examination Survey (KNHANES, 2008–2011) were 1:1 matched for age, height, and weight as the control group. Results: Among 226 men (SCI, n = 113; control, n = 113), femoral neck (-1.9 versus [vs.] -0.6) and total hip T-scores (-1.6 vs. -0.1; all, p <0.001) were significantly lower in the SCI group than in the KNHANES group, whereas the lumbar spine T-score did not differ between groups (-1.1 vs. -0.8, p = 0.105). The group difference in the femoral neck T-score remained significant after adjustment for covariates (adjusted β: -1.27, vs. KNHANES, p<0.001). Among men with SCI, low body mass index and cervical level of injury (vs. thoracolumbar level) were negatively correlated with femoral neck bone mineral density. Conclusions: Men with SCI had lower femoral neck and total hip T-score than community-dwelling men, independent of age, BMI, and other covariates.