Metabolic syndrome and the phenotype of multiple sclerosis

Rev Neurol (Paris). 2024 Sep;180(7):673-681. doi: 10.1016/j.neurol.2024.03.009. Epub 2024 May 9.

Abstract

Background: Comorbidities, particularly vascular comorbidities, have been shown to exacerbate the progression of disability in multiple sclerosis (MS). Metabolic syndrome (MetS) is a cluster of conditions including abdominal obesity, insulin resistance, atherogenic dyslipidemia, and vascular dysfunction, which contribute to vascular morbidity and chronic inflammation.

Objective: To describe the characteristics of MetS in a cohort of MS patients and evaluate its relationship with the MS phenotype.

Methods: A monocentric cohort study was conducted on MS patients, collecting demographic, clinical, radiological, and therapeutic data, as well as metabolic data including waist circumference, blood pressure, serum triglycerides, high-density lipoprotein cholesterol, and fasting blood glucose.

Results: Among the 84 patients included in the study, 27% were diagnosed with MetS. MetS was found to be associated with secondary progressive MS (SPMS). Patients with SPMS had a higher prevalence of MetS compared to those with relapsing-remitting MS (RRMS), even after adjusting for disease duration. While MetS was associated with Expanded Disability Status Scale (EDSS) progression in the 3-year period according to univariate analysis, it did not show a significant association with disease activity.

Conclusion: This study provides evidence supporting the connection between MetS and the progression of disability in MS, independent of disease relapse activity.

Keywords: Abdominal obesity; Metabolic syndrome; Multiple sclerosis; Relapsing-remitting multiple sclerosis; Secondary progressive multiple sclerosis; Waist circumference.

MeSH terms

  • Adult
  • Cohort Studies
  • Comorbidity
  • Disease Progression*
  • Female
  • Humans
  • Male
  • Metabolic Syndrome* / complications
  • Metabolic Syndrome* / epidemiology
  • Middle Aged
  • Multiple Sclerosis* / complications
  • Multiple Sclerosis* / epidemiology
  • Multiple Sclerosis, Chronic Progressive / blood
  • Multiple Sclerosis, Chronic Progressive / epidemiology
  • Multiple Sclerosis, Relapsing-Remitting / blood
  • Multiple Sclerosis, Relapsing-Remitting / complications
  • Multiple Sclerosis, Relapsing-Remitting / epidemiology
  • Phenotype*
  • Prevalence