Study: Obesity May Exacerbate Inflammation, Disability in Multiple Sclerosis

Obesity may increase severity of disability in patients with relapsing-remitting multiple sclerosis.

Obesity can worsen inflammation and disability in patients with relapsing-remitting multiple sclerosis (RRMS), suggesting a relationship between lipid metabolism and disease severity, according to a study published in Multiple Sclerosis Journal.

In previous studies, high body mass index (BMI), particularly in adolescence, has been linked to an increased risk of developing MS later in life.

For this study, the researchers examined whether increased serum lipids and BMI affected cerebrospinal fluid (CSF) inflammation and disease severity in 140 patients with RRMS. Patients underwent clinical assessment, BMI evaluation, magnetic resonance imaging scan, and blood and CSF collection before drug treatment.

At the time of diagnosis, patients who were obese had a greater risk of presenting a higher Expanded Disability Status Scale (EDSS) score, according to the researchers.

In the analysis of CSF, patients who were obese had higher levels of interleukin-6 (IL-6) and leptin, both of which are known to promote inflammation. Conversely, interleukin-13 (IL-13), which produces anti-inflammatory action, was reduced in these patients.

Furthermore, the researchers concluded a positive correlation between BMI and EDSS score. Patients who were obese demonstrated higher clinical disability, increased CSF levels of IL-6 and leptin, and reduced concentrations of IL-13. The serum levels of triglycerides and total cholesterol/high-density lipoprotein cholesterol ratio showed a positive correlation with IL-6 CSF concentrations, according to the study.

The results indicate that excessive body weight may be associated with increased central inflammation, which leads to worsened clinical expression of MS, the researchers noted.

“It is important to precisely define the relationship between obesity, blood lipids, and multiple sclerosis,” Diego Centonze, MD, PhD, full professor of neurology at the Tor Vergata University and head of the neurology unit at Neuromed, said in a press release. “Body weight and dyslipidemias are implicated in various chronic inflammatory conditions, but they are also factors that strictly depend on lifestyle.”

Dr Centonze suggested specific strategies, such as diet or increased physical activity, as a means to potentially improve the condition of obese patients with RRMS and reduce disability progression.

“Increased adipocytokines and lipids can mediate the negative impact of high adiposity on RRMS course,” the researchers wrote.

References

Stampanoni Bassi M, Iezzi E, Buttari F, et al. Obesity worsens central inflammation and disability in multiple sclerosis. Multiple Sclerosis Journal. 2019. https://doi.org/10.1177/1352458519853473