Juan Manuel Escobar1, Marianna Cortese2, Gilles Edan3, Mark S Freedman4, Hans-Peter Hartung5, Xavier Montalbán6, Rupert Sandbrink7, E-W Radü8, Frederik Barkhof9, Eva-Maria Wicklein10, Ludwig Kappos8, Alberto Ascherio11, Kassandra L Munger2. 1. Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, MA, USA/Department of Neurology, La Paz University Hospital, Madrid, Spain. 2. Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, MA, USA. 3. CHU Hôpital Pontchaillou, Rennes, France. 4. University of Ottawa and Ottawa Hospital Research Institute, Ottawa, ON, Canada. 5. Department of Neurology, Medical Faculty, Heinrich-Heine-Universität, Düsseldorf, Germany. 6. Multiple Sclerosis Centre of Catalonia (Cemcat), Vall d'Hebron University Hospital, Barcelona, Spain. 7. Topas Therapeutics GmbH, Hamburg, Germany/VICO Therapeutics, Leiden, The Netherlands. 8. Neurologic Clinic and Policlinic, Departments of Medicine, Biomedicine and Clinical Research, University Hospital Basel, University of Basel, Basel, Switzerland. 9. Institute of Neurology, University College London, London, UK. 10. Bayer AG, Berlin, Germany. 11. Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, MA, USA/Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA, USA/Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA, USA.
Abstract
BACKGROUND: There is a lack of studies on the association between obesity and conversion from a clinically isolated syndrome (CIS) to multiple sclerosis (MS). OBJECTIVE: The aim of this study was to determine whether obesity predicts disease activity and prognosis in patients with CIS. METHODS: Body mass index (BMI) at baseline was available for 464 patients with CIS in BENEFIT. Obesity was defined as BMI ⩾ 30 kg/m2 and normal weight as 18.5 ⩽ BMI < 25. Patients were followed up for 5 years clinically and by magnetic resonance imaging. Hazard of conversion to clinically definite (CDMS) or to 2001 McDonald criteria (MDMS) MS, annual rate of relapse, sustained progression on Expanded Disability Status Scale (EDSS), change in brain and lesion volume, and development of new brain lesions were evaluated. RESULTS: Obese individuals were 39% more likely to convert to MDMS (95% CI: 1.02-1.91, p = 0.04) and had a 59% (95% CI: 1.01-2.31, p = 0.03) higher rate of relapse than individuals with normal weight. No associations were observed between obesity and conversion to CDMS, sustained progression on EDSS or magnetic resonance imaging (MRI) outcomes, except for a larger reduction of brain volume in obese smokers as compared to normal weight smokers (-0.82%; 95% CI: -1.51 to -0.12, p = 0.02). CONCLUSION: Obesity was associated with faster conversion to MS (MDMS) and a higher relapse rate.
BACKGROUND: There is a lack of studies on the association between obesity and conversion from a clinically isolated syndrome (CIS) to multiple sclerosis (MS). OBJECTIVE: The aim of this study was to determine whether obesity predicts disease activity and prognosis in patients with CIS. METHODS: Body mass index (BMI) at baseline was available for 464 patients with CIS in BENEFIT. Obesity was defined as BMI ⩾ 30 kg/m2 and normal weight as 18.5 ⩽ BMI < 25. Patients were followed up for 5 years clinically and by magnetic resonance imaging. Hazard of conversion to clinically definite (CDMS) or to 2001 McDonald criteria (MDMS) MS, annual rate of relapse, sustained progression on Expanded Disability Status Scale (EDSS), change in brain and lesion volume, and development of new brain lesions were evaluated. RESULTS: Obese individuals were 39% more likely to convert to MDMS (95% CI: 1.02-1.91, p = 0.04) and had a 59% (95% CI: 1.01-2.31, p = 0.03) higher rate of relapse than individuals with normal weight. No associations were observed between obesity and conversion to CDMS, sustained progression on EDSS or magnetic resonance imaging (MRI) outcomes, except for a larger reduction of brain volume in obese smokers as compared to normal weight smokers (-0.82%; 95% CI: -1.51 to -0.12, p = 0.02). CONCLUSION: Obesity was associated with faster conversion to MS (MDMS) and a higher relapse rate.
Authors: C M Poser; D W Paty; L Scheinberg; W I McDonald; F A Davis; G C Ebers; K P Johnson; W A Sibley; D H Silberberg; W W Tourtellotte Journal: Ann Neurol Date: 1983-03 Impact factor: 10.422
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