Patients with multiple sclerosis may benefit from improving blood fats, otherwise known as serum lipids, according to a new study from University of Tasmania in Australia published in Multiple Sclerosis Journal. The publishing researchers were interested in the links that exist among lipids, apolipoproteins, and changes in disability related to multiple sclerosis. It has long been known that disability in patients is highly variable, but no solid conclusions have been drawn as to why.
Working off of knowledge that obesity increases the risk of multiple sclerosis and that MRI lesions and grey matter atrophy are associated with lipoproteins, the team conducted a prospective study on a cohort of 203 multiple sclerosis patients whereby disability progression was evaluated along with body mass index (BMI) and serum levels of lipid and apolipoprotein. At biannual reviews, patients were questioned about physical activity, vitamin D (a molecule with a lipid structure) supplementation, and medication use; measured for height and weight; and assessed for Multiple Sclerosis Severity Score (MSSS) using the Expanded Disability Status Scale (EDSS).
After results were compiled and analyzed, the team found total cholesterol, apolipoprotein B levels, and the ratio of apolipoprotein B to apolipoprotein A-I were associated with a higher EDSS. What’s more, the initial ratio of total cholesterol to high density lipoprotein was associated with a change in EDSS over the course of the study, but BMI was not. A higher ratio was associated with faster disability progression, leading to the conclusion that lowering lipids may benefit multiple sclerosis patients.
The study is limited in its two-year time frame, as a longer follow-up is generally preferred when evaluating changes in clinical disability. Additionally, MRI markers were not used as another indicator of disability progression. The team did not investigate a molecular pathway for lipid effects on the nervous system, making this a purely correlative study that does not indicate causation. Further work is necessary, but for now, the researchers suggest early intervention may prevent sustained disability.