Dataset Information

Association of body mass index with longitudinal rates of retinal atrophy in multiple sclerosis.

ABSTRACT: BACKGROUND:Studies evaluating associations between body mass index (BMI) and optical coherence tomography (OCT) measures in multiple sclerosis (MS) are lacking. OBJECTIVE:To assess whether elevated BMI is associated with accelerated retinal atrophy. METHODS:In this observational study, 513 MS patients were followed with serial spectral-domain OCT for a median of 4.4?years. Participants were categorized as normal weight (BMI: 18.5-24.9?kg/m2), overweight (BMI: 25-29.9?kg/m2), and obese (BMI: ?30?kg/m2). Participants with diabetes mellitus or uncontrolled hypertension and eyes with optic neuritis (ON) ?6?months prior to baseline OCT or during follow-up were excluded. Statistical analyses were performed with mixed-effects linear regression. RESULTS:Obese patients (n?=?146) exhibited accelerated rates of ganglion cell?+?inner plexiform layer (GCIPL) atrophy relative to normal weight patients (n?=?214; -0.57%/year (95% confidence interval (CI): -0.65% to -0.48%) versus -0.42%/year (95% CI: -0.49% to -0.35%); p?=?0.012). GCIPL atrophy rate did not differ between overweight (n?=?153) and normal weight patients (-0.47%/year vs -0.42%/year; p?=?0.41). Each 1?kg/m2 higher BMI was associated with accelerated GCIPL (-0.011%/year; 95% CI: -0.019% to -0.004%; p?=?0.003) atrophy. Multivariable analyses accounting for age, sex, race, MS subtype, and ON history did not alter the above findings. CONCLUSIONS:Elevated BMI, in the absence of overt metabolic comorbidities, may be associated with accelerated GCIPL atrophy. Obesity, a modifiable risk factor, may be associated with accelerated neurodegeneration in MS.

SUBMITTER: Filippatou AG

PROVIDER: S-EPMC7293552 | biostudies-literature | 2020 Jun

REPOSITORIES: biostudies-literature

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Association of body mass index with longitudinal rates of retinal atrophy in multiple sclerosis.

Filippatou Angeliki G AG Lambe Jeffrey J Sotirchos Elias S ES Fitzgerald Kathryn C KC Aston Andrew A Murphy Olwen C OC Pellegrini Nicole N Fioravante Nicholas N Risher Hunter H Ogbuokiri Esther E Kwakyi Ohemaa O Toliver Brandon B Davis Simidele S Luciano Nicholas N Crainiceanu Ciprian C Prince Jerry L JL Mowry Ellen M EM Calabresi Peter A PA Saidha Shiv S

Multiple sclerosis (Houndmills, Basingstoke, England) 20200416 7

<h4>Background</h4>Studies evaluating associations between body mass index (BMI) and optical coherence tomography (OCT) measures in multiple sclerosis (MS) are lacking.<h4>Objective</h4>To assess whether elevated BMI is associated with accelerated retinal atrophy.<h4>Methods</h4>In this observational study, 513 MS patients were followed with serial spectral-domain OCT for a median of 4.4 years. Participants were categorized as normal weight (BMI: 18.5-24.9 kg/m<sup>2</sup>), overweight (BMI: 25- ...[more]

PMID: 32297826

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Project description:The aim of this retrospective study was to review body mass index (BMI) in a large cohort of Italian pediatric type 2 spinal muscular atrophy (SMA) patients, aged between 0 and 20 years and to establish possible differences in relation to a number of variables such as ventilation, motor function, and survival motor neuron 2 gene copies. Cross-sectional data were collected from 102 patients for a total of 344 visits. Standard growth charts for height and weight were used as reference, with age adjusted BMI calculated using the Center for Disease and Prevention Children's BMI Tool. In the 344 visits, weight ranged between 3.90 and 83 kg, and the BMI between 8.4 and 31.6 with a BMI/age z-scores < - 2SD present in 28% and BMI/age z-scores > + 2SD in 9% of the measurements. The BMI/age z-scores were relatively stable < 5 years of age with an increasing number of patients < - 2SD after the age of 5, and a wider range of BMI/age z-scores after the age of 13. A difference on the BMI/age z-scores was found among the different age subgroups (< 5, 5-12, ≥ 13 years). A multivariate analysis in 58 patients with longitudinal assessments showed that baseline BMI/age z-scores and gender were significantly contributing to the changes while other variables were not.ConclusionOur results confirm that careful surveillance of weight and BMI/age z-scores is needed in type 2 SMA. Further studies, including assessments of chewing and swallowing and of lean/fat body mass, will help to better understand the possible mechanisms underlying weight issues.What is known• Feeding difficulties have been reported in a few studies and were invariably found in patients with type 1 SMA. • Type 2 SMA patients often have low BMI with a relevant number of patients requiring tube feeding.What is new• Reduction in BMI/age z-score overtime appeared to depend on baseline BMI/age z-score and gender. • Patients with a low BMI/age z-score were at higher risk of developing further reduction.

Project description:On average, African Americans with multiple sclerosis demonstrate higher inflammatory disease activity, faster disability accumulation, greater visual dysfunction, more pronounced brain tissue damage and higher lesion volume loads compared to Caucasian Americans with multiple sclerosis. Neurodegeneration is an important component of multiple sclerosis, which in part accounts for the clinical heterogeneity of the disease. Brain atrophy appears to be widespread, although it is becoming increasingly recognized that regional substructure atrophy may be of greater clinical relevance. Patient race (within the limitations of self-identified ancestry) is regarded as an important contributing factor. However, there is a paucity of studies examining differences in neurodegeneration and brain substructure volumes over time in African Americans relative to Caucasian American patients. Optical coherence tomography is a non-invasive and reliable tool for measuring structural retinal changes. Recent studies support its utility for tracking neurodegeneration and disease progression in vivo in multiple sclerosis. Relative to Caucasian Americans, African American patients have been found to have greater retinal structural injury in the inner retinal layers. Increased thickness of the inner nuclear layer and the presence of microcystoid macular pathology at baseline predict clinical and radiological inflammatory activity, although whether race plays a role in these changes has not been investigated. Similarly, assessment of outer retinal changes according to race in multiple sclerosis remains incompletely characterized. Twenty-two African Americans and 60 matched Caucasian Americans with multiple sclerosis were evaluated with brain MRI, and 116 African Americans and 116 matched Caucasian Americans with multiple sclerosis were monitored with optical coherence tomography over a mean duration of 4.5 years. Mixed-effects linear regression models were used in statistical analyses. Grey matter (-0.9%/year versus -0.5%: P =0.02), white matter (-0.7%/year versus -0.3%: P =0.04) and nuclear thalamic (-1.5%/year versus -0.7%/year: P =0.02) atrophy rates were approximately twice as fast in African Americans. African Americans also exhibited higher proportions of microcystoid macular pathology (12.1% versus 0.9%, P =0.001). Retinal nerve fibre layer (-1.1% versus -0.8%: P =0.02) and ganglion cell+ inner plexiform layer (-0.7%/year versus -0.4%/year: P =0.01) atrophy rates were faster in African versus Caucasian Americans. African Americans on average exhibited more rapid neurodegeneration than Caucasian Americans and had significantly faster brain and retinal tissue loss. These results corroborate the more rapid clinical progression reported to occur, in general, in African Americans with multiple sclerosis and support the need for future studies involving African Americans in order to identify individual differences in treatment responses in multiple sclerosis.

Dataset Information

Association of body mass index with longitudinal rates of retinal atrophy in multiple sclerosis.

Publications

Association of body mass index with longitudinal rates of retinal atrophy in multiple sclerosis.

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