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Letter to the editor: Racial differences in serological markers across the first year of injury in spinal cord injury: a retrospective analysis of a multicenter interventional study by Jia Li et al.

Spinal Cord volume 63, page 449 (2025)Cite this article

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TO THE EDITOR:

We read the article “Racial differences in serological markers across the first year of injury in spinal cord injury: a retrospective analysis of a multicenter interventional study” by Jia Li et al. [1] with great interest and discussed it at length in our academic club. We seek the author’s comments on our salient and pertinent queries:

  1. 1.

    The article briefly touches on socioeconomic status as a potential confounder in the analysis of racial disparities. However, it does not delve deeply into how socioeconomic factors may influence health outcomes post-SCI. Can the authors clarify how they controlled for these variables in the studies reviewed? Research indicates that socioeconomic status significantly impacts health outcomes [2].

  2. 2.

    The article does not address the role of cultural competence in healthcare delivery for racial and ethnic minority patients with SCI. How might cultural differences in health beliefs and practices affect treatment adherence and outcomes? Literature suggests that culturally competent care can improve health outcomes for minority populations [3].

  3. 3.

    The findings suggest that Black individuals had higher levels of creatine kinase and calcium, while White individuals had higher BUN/creatine ratios. What are the clinical implications of these differences in the context of SCI recovery? Understanding how these biomarkers correlate with recovery outcomes could provide valuable insights for tailored treatment approaches. Research has shown that elevated creatine kinase can indicate muscle damage, which may have different implications for recovery in different racial groups [4].

  4. 4.

    The article highlights the need for race-specific reference intervals for laboratory tests. How do the authors propose to establish these reference ranges, and what methodologies would be employed to ensure their accuracy and applicability across diverse populations? Previous research has emphasized the importance of considering ethnic differences in laboratory values [5].

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References

  1. Li J, Farrow M, Ibrahim K. Racial differences in serological markers across the first year of injury in spinal cord injury: a retrospective analysis of a multi-center interventional study. Spinal Cord. 2024;62:486–94.

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  2. Williams DR, Rucker TD. Understanding and addressing racial disparities in health care. Health Care Financ Rev. 2000;21:75–90.

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  3. George MD, McGill NK, Baker JF. Creatine kinase in the U.S. population: impact of demographics, comorbidities, and body composition on the normal range. Medicine. 2016;95:e4344.

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  4. Paragond S, Dhatt SS, Kumar V, Zohmangaihi D, Gaurav A, Neradi D, et al. Prognosticating acute traumatic spinal cord injury using neurofilament (NF), neuron specific enolase (NSE), matrix metalloproteinases (MMPs), and S-100B as biomarkers. Ir J Med Sci. 2024;193:769–75.

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  5. Coates S, Wang D, Pierscionek T. Time- and race-specific haematological reference intervals for healthy volunteer trials: a retrospective analysis of pooled data from multiple phase I trials. Front Pharm. 2020;11:314.

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Authors and Affiliations

  1. Department of Orthopaedics PGIMER, Chandigarh, India

    Vishal Kumar & Sharath Raj

Authors
  1. Vishal Kumar
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  2. Sharath Raj
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Contributions

Sharath raj: Original writing and draft, Vishal kumar: supervision.

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Correspondence to Sharath Raj.

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Kumar, V., Raj, S. Letter to the editor: Racial differences in serological markers across the first year of injury in spinal cord injury: a retrospective analysis of a multicenter interventional study by Jia Li et al.. Spinal Cord 63, 449 (2025). https://doi.org/10.1038/s41393-025-01095-9

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