Body Composition in Quadriplegic Patients

Abstract

The nutritional state of 12 patients with quadriplegia, secondary to spinal cord injury, was assessed by determining body composition with a multiple isotope dilution technique. For comparative purposes, similar measurements were obtained in 25 normal volunteers. The mean duration of quadriplegia was 14.8 ± 8.5 months. All the patients were hospitalized, receiving a regular hospital diet and all were on a similar rehabilitation program. Because skeletal muscle atrophy is extensive in quadriplegics, we had expected a reduced body size, which was otherwise normal in composition, with a comparable decrease in both the body cell mass (BCM) and the extracellular mass (ECM). Instead, a body composition characteristic of malnutrition was observed in an unexpectedly large percentage (58%) of patients. In the normally nourished individual, the BCM and ECM are approximately equal in size. However, in seven of the 12 quadriplegic patients, the body composition was characteristic of malnutrition, with a BCM (13.5 ± 1.6 kg) which was reduced relative to the ECM (28.7 ± 1.9 kg). Their body composition was significantly (p<0.05) different from the body composition of both the healthy volunteers and the other five quadriplegic patients, whose body composition was normal (BCM = 22.9 ± 1.5 kg, ECM = 28.5 ± 1.6 kg). The nutritional state of the quadriplegic patients correlated significantly with the level of spinal cord injury and not with the duration of quadriplegia. (Journal of Parenteral and Enteral Nutrition 10: 364-368, 1986)