Marcus W Koch1,2, Jop Mostert3, Pavle Repovic4, James D Bowen4, Eva Strijbis5, Bernard Uitdehaag5, Gary Cutter6. 1. Department of Clinical Neurosciences, University of Calgary, Calgary, Canada. mwkoch@ucalgary.ca. 2. Department of Community Health Sciences, University of Calgary, Calgary, Canada. mwkoch@ucalgary.ca. 3. Department of Neurology, Rijnstate Hospital, Arnhem, The Netherlands. 4. Multiple Sclerosis Center, Swedish Neuroscience Institute, Seattle, USA. 5. Department of Neurology, MS Center Amsterdam, Amsterdam University Medical Centers, Amsterdam, The Netherlands. 6. Department of Biostatistics, University of Alabama at Birmingham, Birmingham, USA.
Abstract
BACKGROUND: Smoking and obesity are recognized modifiable risk factors associated with a higher MS incidence, but their impact on physical and cognitive disability worsening is less clear. OBJECTIVE: To investigate the impact of smoking and obesity on disability worsening in primary progressive MS (PPMS). METHODS: We used data from INFORMS (clinicaltrials.gov identifier: NCT00731692), a large randomized-controlled trial in PPMS to compare significant worsening on the EDSS, T25FW, NHPT, and PASAT between smokers and non-smokers, and between BMI groups, at 12, 24, and 33 months of follow-up. We investigated the association of smoking and BMI at screening and the risk of disability worsening with logistic regression models. RESULTS: Smokers had significantly higher EDSS scores throughout the trial. EDSS was not significantly different between BMI categories. No other outcome measure was significantly different between smokers and non-smokers and between BMI categories throughout the trial. Neither smoking status nor BMI were associated with significant worsening on any outcome measure at any time point during follow-up. CONCLUSION: Despite the known effects on MS incidence, smoking and BMI were not associated with the risk of physical and cognitive disability worsening over 3 years in this well-characterized PPMS trial cohort.
BACKGROUND: Smoking and obesity are recognized modifiable risk factors associated with a higher MS incidence, but their impact on physical and cognitive disability worsening is less clear. OBJECTIVE: To investigate the impact of smoking and obesity on disability worsening in primary progressive MS (PPMS). METHODS: We used data from INFORMS (clinicaltrials.gov identifier: NCT00731692), a large randomized-controlled trial in PPMS to compare significant worsening on the EDSS, T25FW, NHPT, and PASAT between smokers and non-smokers, and between BMI groups, at 12, 24, and 33 months of follow-up. We investigated the association of smoking and BMI at screening and the risk of disability worsening with logistic regression models. RESULTS: Smokers had significantly higher EDSS scores throughout the trial. EDSS was not significantly different between BMI categories. No other outcome measure was significantly different between smokers and non-smokers and between BMI categories throughout the trial. Neither smoking status nor BMI were associated with significant worsening on any outcome measure at any time point during follow-up. CONCLUSION: Despite the known effects on MS incidence, smoking and BMI were not associated with the risk of physical and cognitive disability worsening over 3 years in this well-characterized PPMS trial cohort.
Authors: Miguel A Hernán; Susan S Jick; Giancarlo Logroscino; Michael J Olek; Alberto Ascherio; Hershel Jick Journal: Brain Date: 2005-03-09 Impact factor: 13.501
Authors: Brian C Healy; Eman N Ali; Charles R G Guttmann; Tanuja Chitnis; Bonnie I Glanz; Guy Buckle; Maria Houtchens; Lynn Stazzone; Jennifer Moodie; Annika M Berger; Yang Duan; Rohit Bakshi; Samia Khoury; Howard Weiner; Alberto Ascherio Journal: Arch Neurol Date: 2009-07
Authors: Fred Lublin; David H Miller; Mark S Freedman; Bruce A C Cree; Jerry S Wolinsky; Howard Weiner; Catherine Lubetzki; Hans-Peter Hartung; Xavier Montalban; Bernard M J Uitdehaag; Martin Merschhemke; Bingbing Li; Norman Putzki; Fonda C Liu; Dieter A Häring; Ludwig Kappos Journal: Lancet Date: 2016-01-28 Impact factor: 79.321
Authors: Milena A Gianfrancesco; Pernilla Stridh; Brooke Rhead; Xiaorong Shao; Edison Xu; Jennifer S Graves; Tanuja Chitnis; Amy Waldman; Timothy Lotze; Teri Schreiner; Anita Belman; Benjamin Greenberg; Bianca Weinstock-Guttman; Gregory Aaen; Jan M Tillema; Janace Hart; Stacy Caillier; Jayne Ness; Yolanda Harris; Jennifer Rubin; Meghan Candee; Lauren Krupp; Mark Gorman; Leslie Benson; Moses Rodriguez; Soe Mar; Ilana Kahn; John Rose; Shelly Roalstad; T Charles Casper; Ling Shen; Hong Quach; Diana Quach; Jan Hillert; Maria Bäärnhielm; Anna Hedstrom; Tomas Olsson; Ingrid Kockum; Lars Alfredsson; Catherine Metayer; Catherine Schaefer; Lisa F Barcellos; Emmanuelle Waubant Journal: Neurology Date: 2017-03-29 Impact factor: 9.910
Authors: Adam E Handel; Alexander J Williamson; Giulio Disanto; Ruth Dobson; Gavin Giovannoni; Sreeram V Ramagopalan Journal: PLoS One Date: 2011-01-13 Impact factor: 3.240