Metabolic syndrome and the phenotype of multiple sclerosis

H Gauthier; M Zedet; A Wahab; S Baldé; B Bapst; C Lafont; A Créange

doi:10.1016/j.neurol.2024.03.009

Metabolic syndrome and the phenotype of multiple sclerosis

Rev Neurol (Paris). 2024 May 9:S0035-3787(24)00502-2. doi: 10.1016/j.neurol.2024.03.009. Online ahead of print.

Authors

H Gauthier¹, M Zedet², A Wahab², S Baldé³, B Bapst⁴, C Lafont⁵, A Créange⁶

Affiliations

¹ Service de neurologie, hôpital Henri-Mondor, centre hospitalier universitaire Henri-Mondor, AP-HP, 51, avenue du Maréchal-de-Lattre-de-Tassigny, 94010 Créteil, France; CRC SEP Grand-Paris-Est, hôpital Henri-Mondor, AP-HP, Créteil, France.
² Service de neurologie, hôpital Henri-Mondor, centre hospitalier universitaire Henri-Mondor, AP-HP, 51, avenue du Maréchal-de-Lattre-de-Tassigny, 94010 Créteil, France; CRC SEP Grand-Paris-Est, hôpital Henri-Mondor, AP-HP, Créteil, France; EA4391, université Paris-Est, Créteil, France.
³ CRC SEP Grand-Paris-Est, hôpital Henri-Mondor, AP-HP, Créteil, France.
⁴ EA4391, université Paris-Est, Créteil, France; Service de neuroradiologie, hôpital Henri-Mondor, AP-HP, Créteil, France.
⁵ IMRB, Inserm, université Paris-Est-Créteil, 94010 Créteil, France; Service de santé publique, hôpital Henri-Mondor, AP-HP, 94010 Créteil, France.
⁶ Service de neurologie, hôpital Henri-Mondor, centre hospitalier universitaire Henri-Mondor, AP-HP, 51, avenue du Maréchal-de-Lattre-de-Tassigny, 94010 Créteil, France; CRC SEP Grand-Paris-Est, hôpital Henri-Mondor, AP-HP, Créteil, France; EA4391, université Paris-Est, Créteil, France. Electronic address: alain.creange@aphp.fr.

PMID: 38729781
DOI: 10.1016/j.neurol.2024.03.009

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.