Excess Abdominal Obesity Linked to Severe Disability in Multiple Sclerosis
Previous studies have shown that excess adiposity is a strong risk factor for metabolic comorbidities and is linked to poorer outcomes in people with neurologic diseases.
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Excess abdominal obesity as a component of multiple sclerosis is associated with severe disability in patients living with the condition, even when adjusting for body mass index and other obesity measures. This research was presented at the 34th Congress of the European Committee for Treatment and Research in Multiple Sclerosis, held October 10-12, 2018, in Berlin, Germany.
Previous studies have shown that excess adiposity is a strong risk factor for metabolic comorbidities and has been linked to poorer outcomes in people with neurologic diseases. The investigators of this study sought to evaluate the association between abdominal obesity and disability and symptom severity in patients with multiple sclerosis.
The study included 6231 adults with multiple sclerosis from the North American Research Committee on Multiple Sclerosis (NARCOMS) registry. Participants reported height and weight and were instructed on how to measure their waist circumference, which was used as a continuous variable. The abdominal obesity criteria for metabolic syndrome was established as follows: men with waist circumference ≥102 cm and women with waist circumference ≥89 cm. Using multinomial modelling and adjusting for age, gender, income, smoking status, pharmacotherapy, and symptom duration, the investigators evaluated the association between waist circumference and disability status and symptom severity. Disability was measured using Patient-Determined Disease Steps and symptom severity was calculated using Performance Scales and NARCOMS depression and pain scales.
Of the total sample, 4309 (69%) participants reported their waist circumference measurement along with body mass index. Of this group, 52% met criteria for the abdominal obesity component of metabolic syndrome. In multivariable analyses that adjusted for body mass index, waist circumference was independently associated with a 61% increased risk of severe disability compared with mild disability (odds ratio [OR] 1.61; 95% CI, 1.3-2.01). In stratified models, a 5 cm increase in the waist circumference of patients who reported a normal weight was associated with a 24% increased risk of severe disability compared to mild disability (OR 1.24; 95% CI, 1.15-1.35). In models adjusted for body mass index, the investigators observed no independent association between waist circumference and the severity of symptoms including depression, fatigue, or pain.
The investigators concluded that for patients with multiple sclerosis, greater waist circumference is associated with more severe disability, even after adjusting for overall obesity measures. Future studies should assess whether abdominal obesity as a component of multiple sclerosis can predict change in disability and disease severity in this population.
Disclosures: Multiple authors declare associations with the pharmaceutical industry. Please see original reference for authors' full disclosures.
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Fitzgerald K, et al. Abdominal obesity is associated with more severe disability in a large population of people with multiple sclerosis. Presented at: 34th Congress of the European Committee for Treatment and Research in Multiple Sclerosis. October 10-12, 2018; Berlin, Germany. Poster P409.