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Effect of Estimated Blood Volume and Body Mass Index on GFAP and NfL Levels in the Serum and CSF of Patients With Multiple Sclerosis
Open accessAbstract
Background and Objectives To increase the validity of biomarker measures in multiple sclerosis (MS), factors affecting their concentration need to be identified. Here, we test whether the volume of distribution approximated by the patients9 estimated blood volume (BV) and body mass index (BMI) affect the serum concentrations of glial fibrillary acidic protein (GFAP). As a control, we also determine the relationship between BV/BMI and GFAP concentrations in CSF. To confirm earlier findings, we test the same hypotheses for neurofilament light chain (NfL). Methods NfL and GFAP concentrations were measured in serum and CSF (sNFL/sGFAP and cNFL/cGFAP) in 157 patients (n = 106 with MS phenotype and n = 51 with other neurologic/somatoform diseases). Using multivariate linear regressions, BV was tested in the MS cohort as a predictor for each of the biomarkers while controlling for age, sex, MS phenotype, Expanded Disability Status Scale score, gadolinium-enhancing lesions, and acute relapse. In addition, overweight/obese patients (BMI ≥25 kg/m2) were compared with patients with BMI <25 kg/m2 using the general linear model. The analyses were repeated including the neurologic/somatoform controls. Results In the MS cohort, BV predicted sGFAP (ß = −0.301, p = 0.014). Overweight/obese patients with MS had lower sGFAP concentrations compared with patients with MS and BMI <25 kg/m2 (F = 4.732, p = 0.032). Repeating the analysis after adding patients with other neurologic/somatoform diseases did not change these findings (ß = −0.276, p = 0.009; F = 7.631, p = 0.006). Although sNfL was inversely correlated with BV (r = −0.275, p = 0.006) and body weight (r = −0.258, p = 0.010), those results did not remain significant after adjusting for covariates. BV and BMI were not associated with cGFAP or cNfL concentrations. Discussion These findings support the notion that the volume of distribution of sGFAP approximated by BV and BMI is a relevant variable and should therefore be controlled for when measuring sGFAP in MS, while this might not be necessary when measuring cGFAP concentrations.
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Levels of NfL and GFAP vary with demographic and physiologic factors such as age, BMI, renal function, and hemoglobin A1C.
“Levels vary with demographic and physiologic factors such as age, body mass index (BMI), renal function, and hemoglobin A1C.9–11”
From Establishing demographic-based normative values for neurofilament light chain and glial fibrillary acidic protein in serum and plasma samples (2026) · cites this paper as [11]
The Results (page not supplied) identify age and BMI as predictors of serum GFAP in this cohort, and the Discussion reports prior evidence linking BMI to serum NfL while noting that this study did not confirm that association after adjustment. The cited paper does not establish the claimed variation with renal function or hemoglobin A1C. (LLM, conf=0.86)
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Faul, F., Erdfelder, E., Lang, A.-G., & Buchner, A. (2007) · Behavior Research Methods · doi:10.3758/bf03193146 · Cited by 65,971
Mid‐life adiposity factors relate to blood–brain barrier integrity in late life
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Metadata
- Authors
- Yalachkov, Y., Schäfer, J. H., Jakob, J., Friedauer, L., Steffen, F., Bittner, S., Foerch, C., & Schaller-Paule, M. A.
- Affiliations
- University Hospital Frankfurt (DE)
- From the Department of Neurology (Y.Y., J.H.S., L.F., C.F., M.A.S.-P.), University Hospital Frankfurt; and Department of Neurology (J.J., F.S., S.B.), Universitätsmedizin Mainz, Germany.
- Corresponding author
- Yalachkov, Yavor
- Venue
- Neurology Neuroimmunology & Neuroinflammation
- Published
- 2023-01
- Volume
- 10
- Issue
- 1
- ISSN
- 2332-7812 (ISSN-L)
- PMC
- PMC9673750
- OpenAlex
- W4307884750
- Cited by
- 49
- References
- 2
- Citations by year
- 2026: 16 · 2025: 12 · 2024: 13 · 2023: 7
- FWCI
- 5.59
- Type
- journal article
- Language
- en
- Open access
- gold
- doi.org
- Licence
- cc-by-nc-nd
- Locations
- Neurology Neuroimmunology & Neuroinflammation (publishedVersion, cc-by-nc-nd)
- PubMed Central (publishedVersion, cc-by-nc-nd)
- PubMed (publishedVersion)
- Topics
- Health Sciences › Medicine › Clinical Neurology › Multiple Sclerosis Research Studies
- Health Sciences › Medicine › Clinical Neurology › Peripheral Neuropathies and Disorders
- Health Sciences › Health Professions › Medical Laboratory Technology › Clinical Laboratory Practices and Quality Control
- Keywords
- multiple sclerosis, glial fibrillary acidic protein, neurofilament light chain, body mass index, volume of distribution, serum biomarkers, cerebrospinal fluid biomarkers, obesity, overweight, disease-modifying therapy response, neurodegeneration, neuroinflammation, somatoform disorders, MS phenotype, Expanded Disability Status Scale, gadolinium-enhancing lesions
- MeSH terms
- Blood Volume, Glial Fibrillary Acidic Protein, Humans, Intermediate Filaments, Multiple Sclerosis, Obesity, Biomarkers, Body Mass Index, Overweight
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