La Fountaine et al. [1] recently compared the lipid profiles of 401 persons with chronic spinal cord injury (SCI) with those of 197 able-bodied controls. In so doing, they found that adverse serum triglyceride (TG) concentrations in people with SCI are lower than in those without, and reiterated previous insights into links between sympathetic nervous system input and circulating lipid levels.

While this article is well reasoned—and each of its authors has substantively contributed to the physiatric literature—the reader is left questioning its clinical relevance. In concluding that clinicians should “consider instituting appropriate dietary, exercise, and/or pharmacological interventions” in patients with elevated TG concentrations, the authors obscure the fact that none of these has been shown to reduce atherosclerotic burden, risk of major adverse coronary events, or cardiac or overall mortality in people with SCI. There are simply no data upon which to base these recommendations.

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