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Longitudinal BMI trajectories in multiple sclerosis: Sex differences in association with disease severity

  • Author Footnotes
    1 Co-first authors
    R. Bove
    Footnotes
    1 Co-first authors
    Affiliations
    Partners Multiple Sclerosis Center, Department of Neurology, Brigham and Women's Hospital, Brookline, MA 02445, USA

    Harvard Medical School, Boston, MA 02115, USA
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  • Author Footnotes
    1 Co-first authors
    A. Musallam
    Footnotes
    1 Co-first authors
    Affiliations
    Partners Multiple Sclerosis Center, Department of Neurology, Brigham and Women's Hospital, Brookline, MA 02445, USA
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  • Z. Xia
    Affiliations
    Partners Multiple Sclerosis Center, Department of Neurology, Brigham and Women's Hospital, Brookline, MA 02445, USA

    Harvard Medical School, Boston, MA 02115, USA
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  • N. Baruch
    Affiliations
    Partners Multiple Sclerosis Center, Department of Neurology, Brigham and Women's Hospital, Brookline, MA 02445, USA

    Partners Pediatric Multiple Sclerosis Center, Massachusetts General Hospital, Boston, MA 02114, USA
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  • S. Messina
    Affiliations
    Partners Multiple Sclerosis Center, Department of Neurology, Brigham and Women's Hospital, Brookline, MA 02445, USA

    Department G.F. Ingrassia, Section of Neurosciences, University of Catania, Italy
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  • B.C. Healy
    Affiliations
    Partners Multiple Sclerosis Center, Department of Neurology, Brigham and Women's Hospital, Brookline, MA 02445, USA

    Harvard Medical School, Boston, MA 02115, USA

    Massachusetts General Hospital Biostatistics Center, Boston, MA 02114, USA
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  • T. Chitnis
    Correspondence
    Correspondence to: Partners Multiple Sclerosis Center, Department of Neurology, Brigham and Women's Hospital, 1 Brookline Place, Suite 602, Brookline, MA 02445, USA.
    Affiliations
    Partners Multiple Sclerosis Center, Department of Neurology, Brigham and Women's Hospital, Brookline, MA 02445, USA

    Harvard Medical School, Boston, MA 02115, USA

    Partners Pediatric Multiple Sclerosis Center, Massachusetts General Hospital, Boston, MA 02114, USA
    Search for articles by this author
  • Author Footnotes
    1 Co-first authors

      Highlights

      • Within 2 years of first MS symptoms, 57% of our patients had a BMI in the overweight or obese ranges.
      • Individuals with MS showed negligible age-related increases in BMI (0.021 kg/m2 per year, or 1 BMI unit over 50 years).
      • Higher BMI was associated with higher disease severity in women, but with lower disease severity in men.

      Abstract

      Background

      Adolescent obesity is a risk factor for multiple sclerosis (MS), but little is known about changes in body mass index (BMI) after MS onset.

      Objective

      To assess the relationship between MS and longitudinal changes in BMI.

      Methods

      We analyzed prospectively collected BMIs in a cohort of patients with adult-onset MS and matched adult healthy controls (HC) gathered from the same hospital network central clinical data registry.

      Results

      We made three main observations. First, at baseline MS patients had a significantly higher BMI than HC (age- and sex- adjusted mean difference=0.57; 95% CI: 0.15, 0.99; p=0.008). Second, a significant age by MS status interaction was observed (p<0.0001), such that in MS, BMIs did not increase significantly higher in older individuals, whereas BMIs in HCs were higher with increasing age. Third, we observed sex-specific associations with disease severity: higher BMI was associated with higher cross-sectional EDSS in women, but with lower EDSS in men (p=0.003, N=758). There were no longitudinal associations between BMI and EDSS in either sex or in the entire cohort (p=0.65, N=772).

      Conclusion

      After MS onset, patients may not experience age-expected increases in BMI. BMI may have sex-specific associations with MS disability scores. More refined measures of body composition are warranted in future studies to distinguish adiposity from muscle mass.

      Keywords

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