Advertisement

Elevated cardiovascular risk factors in multiple sclerosis

  • Charly Keytsman
    Correspondence
    Correspondence to: REVAL Rehabilitation Center, Biomedical Research Institute (BIOMED), Hasselt University, Agoralaan Building A, B-3590 Diepenbeek, Belgium.
    Affiliations
    REVAL Rehabilitation Research Center, BIOMED Biomedical Research Institute, Faculty of Medicine and Life Sciences, Hasselt University, Agoralaan Building A, Diepenbeek, Belgium
    Search for articles by this author
  • Bert O. Eijnde
    Affiliations
    REVAL Rehabilitation Research Center, BIOMED Biomedical Research Institute, Faculty of Medicine and Life Sciences, Hasselt University, Agoralaan Building A, Diepenbeek, Belgium
    Search for articles by this author
  • Dominique Hansen
    Affiliations
    REVAL Rehabilitation Research Center, BIOMED Biomedical Research Institute, Faculty of Medicine and Life Sciences, Hasselt University, Agoralaan Building A, Diepenbeek, Belgium
    Search for articles by this author
  • Kenneth Verboven
    Affiliations
    REVAL Rehabilitation Research Center, BIOMED Biomedical Research Institute, Faculty of Medicine and Life Sciences, Hasselt University, Agoralaan Building A, Diepenbeek, Belgium
    Search for articles by this author
  • Inez Wens
    Affiliations
    REVAL Rehabilitation Research Center, BIOMED Biomedical Research Institute, Faculty of Medicine and Life Sciences, Hasselt University, Agoralaan Building A, Diepenbeek, Belgium
    Search for articles by this author
Published:August 17, 2017DOI:https://doi.org/10.1016/j.msard.2017.08.011

      Highlights

      • Multiple sclerosis (MS) is related with an elevated cardiovascular (CVD) mortality.
      • Persons with MS present several altered cardiovascular risk factors.
      • In MS, fat mass appears to be an important risk factor.
      • Normalizing fat mass in MS should be an important part of CVD prevention.

      Abstract

      Background

      Multiple sclerosis (MS) is associated with elevated cardiovascular mortality. To prevent this a better understanding of their CVD risk factors and interrelations is necessary.

      Methods

      MS patients (n = 52) and healthy controls (HC, n = 24) were matched for age, height, weight, body mass index and physical activity. Body composition, resting blood pressure (BP), resting heart rate (HR), glucose tolerance, HbA1c, blood lipids (HDL, LDL, total cholesterol, triglyceride concentrations) and c-reactive protein concentrations were analyzed. Regression analyses identified independent CVD risk factors and their interrelations in MS.

      Results

      In MS and compared to HC, fat mass (25.1 ± 1.2 kg vs. 17.9 ± 1 kg), fat percentage (33.8 ± 1.2% vs. 28.4 ± 1.5%), systolic (130 ± 1.8 mmHg vs. 120 ± 2.9 mmHg) and diastolic (79 ± 1.1 mmHg vs. 71 ± 1.9 mmHg) BP, resting HR (72 ± 1.4 bpm vs. 60 ± 2 bpm), blood triglycerides (113.8 ± 8.6 mg/dl vs. 98.2 ± 17.4 mg/dl), fasting (13.5 ± 2.9 mU/l vs. 7.2 ± 0.8 mU/l) and 2 h insulin (71.9 ± 12.5 mU/l vs. 35.8 ± 8.1 mU/l), 2 h glucose (6.3 ± 0.5 mmol/l vs. 4.8 ± 0.5 mmol/l) and HOMA index (3.7 ± 1.1 vs. 1.7 ± 0.2) were significantly (p < 0.05) elevated. Total cholesterol, blood HDL and LDL concentrations did nog differ between groups (p < 0.05). Regression analyses indicated that MS is independently associated with elevated fat mass/percentage, systolic and diastolic BP and HR and in MS fat mass appears to be an independent contributor of the other measured CVD risk factors in MS.

      Conclusion

      Persons with MS have an increased risk for CVD and fat mass appears to be an important risk factor. Therefore, normalizing whole body fat should be an essential part of MS treatment.

      Keywords

      To read this article in full you will need to make a payment

      Purchase one-time access:

      Academic & Personal: 24 hour online accessCorporate R&D Professionals: 24 hour online access
      One-time access price info
      • For academic or personal research use, select 'Academic and Personal'
      • For corporate R&D use, select 'Corporate R&D Professionals'

      Subscribe:

      Subscribe to Multiple Sclerosis and Related Disorders
      Already a print subscriber? Claim online access
      Already an online subscriber? Sign in
      Institutional Access: Sign in to ScienceDirect

      References

        • Bosnak-Guclu M.
        • Gunduz A.G.
        • Nazliel B.
        • Irkec C.
        Comparison of functional exercise capacity, pulmonary function and respiratory muscle strength in patients with multiple sclerosis with different disability levels and healthy controls.
        J. Rehabil. Med. 2012; 44: 80-86
        • Buchan D.S.
        • Thomas N.E.
        • Baker J.S.
        Novel risk factors of cardiovascular disease and their associations between obesity, physical activity and physical fitness.
        J. Public Health Res. 2012; 1: 59-66
        • Carroll C.C.
        • Gallagher P.M.
        • Seidle M.E.
        • Trappe S.W.
        Skeletal muscle characteristics of people with multiple sclerosis.
        Arch. Phys. Med. Rehabil. 2005; 86: 224-229
        • D'Agostino Sr., R.B.
        • Vasan R.S.
        • Pencina M.J.
        • Wolf P.A.
        • Cobain M.
        • Massaro J.M.
        • Kannel W.B.
        General cardiovascular risk profile for use in primary care: the Framingham Heart Study.
        Circulation. 2008; 117: 743-753
        • D'Orazio P.
        • Burnett R.W.
        • Fogh-Andersen N.
        • Jacobs E.
        • Kuwa K.
        • Kulpmann W.R.
        • Larsson L.
        • Lewenstam A.
        • Maas A.H.
        • Mager G.
        • Naskalski J.W.
        • Okorodudu A.O.
        Approved IFCC recommendation on reporting results for blood glucose: international Federation of Clinical Chemistry and Laboratory Medicine Scientific Division, Working Group on Selective Electrodes and Point-of-Care Testing (IFCC-SD-WG-SEPOCT).
        Clin. Chem. Lab. Med. 2006; 44: 1486-1490
        • Ellis T.
        • Motl R.W.
        Physical activity behavior change in persons with neurologic disorders: overview and examples from Parkinson disease and multiple sclerosis.
        J. Neurol. Phys. Ther. 2013; 37: 85-90
        • Guerrero-Garcia J.J.
        • Carrera-Quintanar L.
        • Lopez-Roa R.I.
        • Marquez-Aguirre A.L.
        • Rojas-Mayorquin A.E.
        • Ortuno-Sahagun D.
        Multiple sclerosis and obesity: possible roles of adipokines.
        Mediat. Inflamm. 2016; 2016: 4036232
        • Kjolhede T.
        • Vissing K.
        • Langeskov-Christensen D.
        • Stenager E.
        • Petersen T.
        • Dalgas U.
        Relationship between muscle strength parameters and functional capacity in persons with mild to moderate degree multiple sclerosis.
        Mult. Scler. Relat. Disord. 2015; 4: 151-158
        • Langeskov-Christensen M.
        • Heine M.
        • Kwakkel G.
        • Dalgas U.
        Aerobic capacity in persons with multiple sclerosis: a systematic review and meta-analysis.
        Sports Med. 2015; 45: 905-923
        • Mahmood S.S.
        • Levy D.
        • Vasan R.S.
        • Wang T.J.
        The Framingham Heart Study and the epidemiology of cardiovascular disease: a historical perspective.
        Lancet. 2014; 383: 999-1008
        • Manouchehrinia A.
        • Tanasescu R.
        • Tench C.R.
        • Constantinescu C.S.
        Mortality in multiple sclerosis: meta-analysis of standardised mortality ratios.
        J. Neurol. Neurosurg. Psychiatry. 2016; 87: 324-331
        • Matsushita Y.
        • Nakagawa T.
        • Yamamoto S.
        • Kato T.
        • Ouchi T.
        • Kikuchi N.
        • Takahashi Y.
        • Yokoyama T.
        • Mizoue T.
        • Noda M.
        Adiponectin and visceral fat associate with cardiovascular risk factors.
        Obesity. 2014; 22: 287-291
        • Moccia M.
        • Lanzillo R.
        • Palladino R.
        • Maniscalco G.T.
        • De Rosa A.
        • Russo C.
        • Massarelli M.
        • Carotenuto A.
        • Postiglione E.
        • Caporale O.
        • Triassi M.
        • Brescia Morra V.
        The Framingham cardiovascular risk score in multiple sclerosis.
        Eur. J. Neurol. 2015; 22: 1176-1183
        • Mosca L.
        • Barrett-Connor E.
        • Wenger N.K.
        Sex/gender differences in cardiovascular disease prevention: what a difference a decade makes.
        Circulation. 2011; 124: 2145-2154
        • Motl R.W.
        • Snook E.M.
        • Wynn D.R.
        • Vollmer T.
        Physical activity correlates with neurological impairment and disability in multiple sclerosis.
        J. Nerv. Ment. Dis. 2008; 196: 492-495
        • Pilutti L.A.
        • Motl R.W.
        Body mass index underestimates adiposity in persons with multiple sclerosis.
        Arch. Phys. Med. Rehabil. 2016; 97: 405-412
        • Sarafidis P.A.
        • Lasaridis A.N.
        • Nilsson P.M.
        • Pikilidou M.I.
        • Stafilas P.C.
        • Kanaki A.
        • Kazakos K.
        • Yovos J.
        • Bakris G.L.
        Validity and reproducibility of HOMA-IR, 1/HOMA-IR, QUICKI and McAuley's indices in patients with hypertension and type II diabetes.
        J. Hum. Hypertens. 2007; 21: 709-716
        • Savci S.
        • Inal-Ince D.
        • Arikan H.
        • Guclu-Gunduz A.
        • Cetisli-Korkmaz N.
        • Armutlu K.
        • Karabudak R.
        Six-minute walk distance as a measure of functional exercise capacity in multiple sclerosis.
        Disabil. Rehabil. 2005; 27: 1365-1371
        • Warren T.Y.
        • Barry V.
        • Hooker S.P.
        • Sui X.
        • Church T.S.
        • Blair S.N.
        Sedentary behaviors increase risk of cardiovascular disease mortality in men.
        Med. Sci. Sports Exerc. 2010; 42: 879-885
        • Washburn R.A.
        • Zhu W.
        • McAuley E.
        • Frogley M.
        • Figoni S.F.
        The physical activity scale for individuals with physical disabilities: development and evaluation.
        Arch. Phys. Med. Rehabil. 2002; 83: 193-200
        • Wens I.
        • Dalgas U.
        • Deckx N.
        • Cools N.
        • Eijnde B.
        Does multiple sclerosis affect glucose tolerance?.
        Mult. Scler. 2013; 20: 1273-1276
        • Wens I.
        • Dalgas U.
        • Stenager E.
        • Eijnde B.O.
        Risk factors related to cardiovascular diseases and the metabolic syndrome in multiple sclerosis – a systematic review.
        Mult. Scler. 2013; 19: 1556-1564
        • Wens I.
        • Dalgas U.
        • Vandenabeele F.
        • Krekels M.
        • Grevendonk L.
        • Eijnde B.O.
        Multiple sclerosis affects skeletal muscle characteristics.
        PLoS One. 2014; 9: e108158