TY - JOUR
T1 - Body mass index, but not Vitamin D status, is associated with brain volume change in MS
AU - Mowry, Ellen M.
AU - Azevedo, Christina J.
AU - Mcculloch, Charles E.
AU - Okuda, Darin T.
AU - Lincoln, Robin R.
AU - Waubant, Emmanuelle
AU - Hauser, Stephen L.
AU - Pelletier, Daniel
N1 - Funding Information:
The EPIC MS dataset used in this analysis is not sharable publicly. The acquisition of the brain MRIs in the EPIC MS dataset was funded by investigator-initiated studies sponsored by pharmaceutical companies.
Publisher Copyright:
© 2018 American Academy of Neurology.
PY - 2018/12/11
Y1 - 2018/12/11
N2 - Objective To determine whether body mass index (BMI) or Vitamin D status is associated with MRI measures of neurodegeneration in a cohort of individuals with relapsing-remitting multiple sclerosis (RRMS) or clinically isolated syndrome (CIS). Methods Expression, Proteomics, Imaging, Clinical (EPIC) is a longitudinal multiple sclerosis (MS) cohort study at the University of California, San Francisco. Participants had clinical evaluations, brain MRI, and blood draws annually. We evaluated patients with CIS or RRMS at baseline. In multivariate repeated-measures analyses adjusted for age, sex, ethnicity, smoking status, and use of MS treatments, annual 25-hydroxyVitamin D levels and BMI were evaluated for their association with subsequent brain volumes (normalized gray matter [nGMV], brain parenchymal [nBPV], and white matter volumes, as determined by Structural Image Evaluation using Normalization of Atrophy-X). Results Among 469 participants, each 1-kg/m2 higher BMI was independently associated with reduced nGMV in multivariate models (-1.1 mL, 95% confidence interval [CI]-1.8 to-0.5, p = 0.001). BMI was likewise independently associated with nBPV (nBPV per 1-kg/m2 greater BMI:-1.1 mL, 95% CI-2.1 to-0.05, p = 0.039). Vitamin D levels did not appear to be meaningfully associated with brain volumes. Conclusions Higher BMI appears to be associated with greater reductions in nGMV and nBPV, which is relevant because, in particular, nGMV loss portends greater longer-term disability. Because obesity is modifiable, further studies should explore these relationships in detail, and evaluating the effect of reducing BMI on imaging and clinical outcomes in MS may be warranted.
AB - Objective To determine whether body mass index (BMI) or Vitamin D status is associated with MRI measures of neurodegeneration in a cohort of individuals with relapsing-remitting multiple sclerosis (RRMS) or clinically isolated syndrome (CIS). Methods Expression, Proteomics, Imaging, Clinical (EPIC) is a longitudinal multiple sclerosis (MS) cohort study at the University of California, San Francisco. Participants had clinical evaluations, brain MRI, and blood draws annually. We evaluated patients with CIS or RRMS at baseline. In multivariate repeated-measures analyses adjusted for age, sex, ethnicity, smoking status, and use of MS treatments, annual 25-hydroxyVitamin D levels and BMI were evaluated for their association with subsequent brain volumes (normalized gray matter [nGMV], brain parenchymal [nBPV], and white matter volumes, as determined by Structural Image Evaluation using Normalization of Atrophy-X). Results Among 469 participants, each 1-kg/m2 higher BMI was independently associated with reduced nGMV in multivariate models (-1.1 mL, 95% confidence interval [CI]-1.8 to-0.5, p = 0.001). BMI was likewise independently associated with nBPV (nBPV per 1-kg/m2 greater BMI:-1.1 mL, 95% CI-2.1 to-0.05, p = 0.039). Vitamin D levels did not appear to be meaningfully associated with brain volumes. Conclusions Higher BMI appears to be associated with greater reductions in nGMV and nBPV, which is relevant because, in particular, nGMV loss portends greater longer-term disability. Because obesity is modifiable, further studies should explore these relationships in detail, and evaluating the effect of reducing BMI on imaging and clinical outcomes in MS may be warranted.
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U2 - 10.1212/WNL.0000000000006644
DO - 10.1212/WNL.0000000000006644
M3 - Article
C2 - 30429274
AN - SCOPUS:85058607456
SN - 0028-3878
VL - 91
SP - E2256-E2264
JO - Neurology
JF - Neurology
IS - 24
ER -