Certain conditions are linked to multiple sclerosis disease progression.
Obesity and high cholesterol appear to increase the likelihood of disease progression in multiple sclerosis (MS) patients, and high triglycerides and obesity make disease relapse more likely.
Those are the key findings of a new Australian study. The corresponding author was Prudence Tettey of the Menzies Institute for Medical Research at the University of Tasmania, Hobart. The senior author was Ingrid van der Mei, Phd (photo), associate professor at the university.
However, the researchers could not find any link between those same factors and the conversion rate from a first demyelinating event to full MS.
The study sought to find evidence that might help doctors better understand the progression from a first demyelinating event (FDE) and MS. FDEs are considered to be the earliest clinical stage in the development of MS. Once patients experience an FDE, a doctor generally can diagnose MS based upon a second demyelinating event and other paraclinical evidence. If scientists could learn more about which patients were likely to proceed to MS, it might be easier to treat at-risk patients more quickly, and also might lead to potential therapeutic targets, the researchers noted.
To examine the matter, the researchers followed 279 patients from first demyelinating event diagnosis to their 5-year reviews. Patient disability progression was measured using the Expanded Disability Status Scale (EDSS).
Recent research has indicated some overlap between obesity-related symptoms and MS, but in their study, the Australian scientists noted that the existing research has been short on firm conclusions.
“The evidence suggests an increased risk of MS onset in people with a high BMI during childhood or adolescence but not adulthood,” the authors wrote. “In relation to whether high BMI is associated with disability or progression in disability, studies in this area are scarce and results have been inconsistent.”
Therefore, the authors carefully tailored their study to fill in research gaps. First, since BMI isn’t a wholly reliable indicator of adiposity, the researchers also used height, weight, and waist and hip circumference as key metrics.
Also, since poor lipid profiles and increased disability can become a chicken-and-egg question, the researchers made sure to take a lipid profile at the beginning of the study, thus establishing a patient-specific baseline before the disease progressed.
After 5 years, the data showed clear results.
“Overweight and obese people had a 60% increased risk of experiencing an annualized change in EDSS greater than 0.5 and those with a TC/HDL ratio level greater than 4.0 had a doubling risk of experiencing an annualized change in EDSS greater than 0.5 points,” the researchers found.
Likewise, overweight people had double the risk of disease relapse, as did people with high triglyceride levels. This contradicts a 2013 study from the University of Buffalo, a difference the Australian researchers say might be due to the fact that their study began following patients earlier in the disease progression than the earlier study did.
The scientists say they weren’t able to determine precisely why the correlation exists. Further research will be required to hash out a number of possible theories, they said.
The study was first published March 20 in The Journal of Neurology, Neurosurgery, and Psychology. It is titled “An adverse lipid profile and increased levels of adiposity significantly predict clinical course after a first demyelinating event.”