There is currently limited understanding of the factors affecting a person’s risk of converting from the early stages of multiple sclerosis (MS) to definite disease, and of the risk of experiencing relapses following a diagnosis of MS. A recent study investigated the effects of lifestyle factors on the clinical course of MS.1
This clinical cohort study followed a group of people with MS-related demyelinating events for a minimum of 5 years. As part of this study, the researchers looked at a subgroup of 169 people with relapsing–remitting MS, all of whom had a first demyelinating event (the earliest stage in the development of MS) just prior to joining the cohort. The researchers investigated if relationships exist between the risk of converting to definite MS (defined by the occurrence of a second demyelinating event), and the risk of relapse, and several lifestyle factors: body mass index (BMI), waist and hip circumference and fats (lipids) in the blood.
The study found no evidence of an association between BMI, waist and hip circumference and fats in the blood, and conversion to MS after accounting for confounding factors. However, participants who were overweight or obese (BMI of > 25 kg/m2) had a significantly increased risk of relapse compared with those of normal BMI (18.5–25 kg/m2). Being obese (BMI of > 30 kg/m2) was associated with a relapse risk that was almost double that for a person with a normal BMI. High hip circumference, but not high waist circumference, was also associated with a significantly increased relapse risk compared with low hip circumference.
The researchers found no evidence that most types of lipid affect a person’s risk of relapse; but, high levels of one type of blood lipid – triglycerides – were significantly associated with relapse risk. After accounting for confounding factors, people with levels of triglycerides that are considered to be high-risk for developing cardiovascular disease (≥ 2.30 mmol/L) were shown to have a 2.22-times greater risk of relapse than those with lower levels.
The authors concluded that losing weight into the healthy range and improving the lipid profile could protect against relapses in MS. Further research into the effects of changing these lifestyle factors is needed to confirm these suggestions.
Tettey P, Simpson S, Taylor B et al. An adverse lipid profile and increased levels of adiposity significantly predict clinical course after a first demyelinating event. J Neurol Neurosurg Psychiatry 2017;88:395–401; doi:10.1136/jnnp-2016-315037.