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Cited by 38Multiple Sclerosis Research StudiesPolyomavirus and related diseasesPsoriasis: Treatment and Pathogenesis

Body mass index as a predictor of MS activity and progression among participants in BENEFIT

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Manuel Escobar, Juan, Cortese, Marianna, Edan, Gilles, Freedman, Mark S, Hartung, Hans-Peter, Montalbán, Xavier, Sandbrink, Rupert, Radü, E-W +5 more·2022·Multiple Sclerosis Journal
DOI 10.1177/13524585211061861PMC PMC9187580
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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/m 2 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.

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  • The null MR result for BMI agrees with a recent prospective study that found no association between BMI and clinical disability.

    “This agrees with the inconclusive results of randomized trials of vitamin D supplementation in MS46 and a recent prospective study that found no association between BMI and clinical disability47.”

    From Locus for severity implicates CNS resilience in progression of multiple sclerosis (2023) · cites this paper as [47]

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Authors
Manuel Escobar, J., Cortese, M., Edan, G., Freedman, M. S., Hartung, H.-P., Montalbán, X., Sandbrink, R., Radü, E.-W., Barkhof, F., Wicklein, E.-M., Kappos, L., Ascherio, A., & Munger, K. L.
Affiliations
  • Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, MA, USA/Department of Neurology, La Paz University Hospital, Madrid, Spain
  • Harvard University (US)
  • Hôpital Pontchaillou (FR)
  • University of Ottawa (CA)
  • Heinrich Heine University Düsseldorf (DE)
  • Vall d'Hebron Hospital Universitari (ES)
  • Topas Therapeutics GmbH, Hamburg, Germany/VICO Therapeutics, Leiden, The Netherlands
  • Neurologic Clinic and Policlinic, Departments of Medicine, Biomedicine and Clinical Research, University Hospital Basel, University of Basel, Basel, Switzerland
  • UCL Queen Square Institute of Neurology (GB)
  • Bayer (Germany) (DE)
  • University of Basel (CH)
  • Brigham and Women's Hospital (US)
Corresponding author
Munger, Kassandra L
ORCID
Venue
Multiple Sclerosis Journal
Publisher
SAGE Publications
Published
2022-01-07
Volume
28
Issue
8
Pages
1277-1285
ISSN
  • 1352-4585 (ISSN-L)
  • 1477-0970
DOI
10.1177/13524585211061861
PMC
PMC9187580
OpenAlex
W4206659757
Cited by
38
References
1
Citations by year
2026: 9 · 2025: 11 · 2024: 6 · 2023: 8 · 2022: 4
FWCI
4.92
Type
journal article
Language
en
Open access
Licence
Locations
  • Multiple Sclerosis Journal (publishedVersion)
  • PubMed (publishedVersion)
  • Pure Amsterdam UMC (publishedVersion, other-oa)
  • Amsterdam UMC (VU Amsterdam) - Institutional Repository (publishedVersion)
  • PubMed Central (acceptedVersion)
  • UCL Discovery (University College London) (submittedVersion)
  • Data Archiving and Networked Services (DANS) (submittedVersion)
Funders
  • National Institute of Neurological Disorders and Stroke (NS0721082)
  • Deutsche Forschungsgemeinschaft (CO 2129/1-1)
  • national multiple sclerosis society (RG4296A4/2)
Topics
  • Health Sciences › Medicine › Pathology and Forensic Medicine › Multiple Sclerosis Research Studies
  • Health Sciences › Medicine › Oncology › Polyomavirus and related diseases
  • Life Sciences › Immunology and Microbiology › Immunology › Psoriasis: Treatment and Pathogenesis
Keywords
obesity, body mass index, clinically isolated syndrome, multiple sclerosis, conversion to multiple sclerosis, disease activity, relapse rate, disability progression, brain volume, brain lesions, smoking, BENEFIT trial
MeSH terms
Demyelinating Diseases, Humans, Magnetic Resonance Imaging, Multiple Sclerosis, Obesity, Recurrence, Body Mass Index, Disease Progression

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