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Front. Neurol. | doi: 10.3389/fneur.2018.00232

Association of pre-disease body mass index with multiple sclerosis prognosis

  • 1Karolinska Institute (KI), Sweden
  • 2Dept. of Mathematics, Royal Institute of Technology, Sweden

Both high body mass index (BMI) and smoking tobacco are known risk factors for developing multiple sclerosis (MS). However, it is unclear whether BMI, like smoking, is a risk factor for the secondary progressive (SP) course. We therefore sought to determine if high/low BMI at age 20 is associated to risk of SP development, in the context of smoking status.

Using data from MS patients with BMI and smoking information available, we examined relapsing onset patients with MS onset after 20 years of age. Cox regressions were conducted on smokers and non-smokers, with BMI as the main exposure. In total, 5598 relapsing onset MS patients were included.

The models demonstrated that BMI>30 was associated to increased risk of SPMS in smokers (hazard ratio 1.50, p=0.036). Obesity at age 20 in MS patients who smoked is associated with increased risk of SP course. Since this risk is confined to smokers, the interaction observation may give insight to disease driving mechanisms.

Keywords: BMI, progression, Disability Evaluation, secondary progressive, Multiple Sclerosis

Received: 09 Nov 2017; Accepted: 26 Mar 2018.

Edited by:

Robert Weissert, University of Regensburg, Germany

Reviewed by:

Joost Smolders, Canisius Wilhelmina Hospital, Netherlands
Gavin Giovannoni, Queen Mary University of London, United Kingdom  

Copyright: © 2018 Manouchehrinia, Hedström, Alfredsson, Olsson, Hillert and Ramanujam. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.

* Correspondence: Dr. Ryan Ramanujam, Karolinska Institute (KI), Solna, Sweden,